After more than a year, acknowledging the mental-health impacts of the pandemic is like acknowledging a five-alarm fire — unmistakable and growing increasingly urgent each day. Not only are we all still reeling from the effects of living through a pandemic, we now know that a third of COVID-19 survivors are experiencing neurological or mental disorders, according to recent research.
As front-line workers, community behavioral health providers have witnessed firsthand the most debilitating effects. The confluence of housing insecurity, economic downturn and prolonged isolation are among the many factors that have contributed to anxiety, depression, suicidality and substance use.
While we are responsible for addressing those critical needs, it’s doubly frightening that we’re now facing an existential workforce issue. Because of chronic underfunding, community behavioral health providers throughout the state cannot hire or retain enough qualified mental-health professionals to keep pace with our communities’ needs.
As leaders of large community behavioral health agencies from Puget Sound to Eastern Washington, we see firsthand how the burden of this deficit ultimately falls onto our clients — vulnerable, low-income adults, children and teens who qualify for Medicaid benefits — and our partners in health care and public safety.
To protect our clients and the safety net, we ask that state leaders invest more in community behavioral health services so we can provide enough compensation for mental-health professionals to afford to serve our communities.
The biggest obstacle we face is the fact that chronic underfunding has led to systemic workforce challenges. We are dedicating around $0.80 of every revenue dollar to staff compensation and are still unable to provide competitive salaries. Team members often leave community behavioral health to go elsewhere — including private practice, large hospital systems, and even other state and federally run providers, such as Veterans Affairs. This isn’t necessarily a matter of preference, it’s an issue of pay.
As a result, the community behavioral health workforce across the state shrunk by 11% in the last year alone, according to a member survey by the Washington Council on Behavioral Health. Data also show that staff vacancy rates stand at 13%, with an average of five months to fill critical positions. Independent reports place vacancies as high as 26% for clinical staff positions.
High turnover rates and vacancies have a significant impact on our local communities. In fact, community behavioral health providers across the state have been forced to close programs or temporarily stop accepting new clients in order to continue serving existing clients — turning away individuals, families and children in our very communities who are in need of help.
This issue is solvable. Central to our objective is the understanding that behavioral health care is health care — and specifically, community behavioral health determines the health of entire communities. This mindset must be reflected in the structure and economics of how we are compensated.
Our team members provide care and resources to prevent suicide, treat depression, decrease the burden on first responder services and keep individuals located within their communities, where research shows they’re more likely to achieve positive outcomes. Our work alleviates burdens on other community services while avoiding the escalation of behavioral health issues that lead to more intensive and expensive care.
It’s time all front-line workers receive adequate compensation. We’re calling on Gov. Jay Inslee and the Legislature to support a 7% increase in Medicaid reimbursement rates for our services, a short-term solution that would allow us to make headway for more competitive salaries and prevent further blows to system capacity.
As the state plans to distribute COVID federal relief funding in the coming weeks, we also ask that leaders ensure equitable distribution to community behavioral health organizations — the front-line providers that will help our system respond to the longstanding mental effects of the pandemic.
Overlooking and undervaluing community behavioral health providers directly threatens our ability to care for vulnerable individuals seeking help and to support the community safety net. Instead of an insufficiently funded behavioral health system, state leaders have the opportunity to make the legacy of the pandemic one of promise and progress — a commitment to adequate compensation that will have a lasting impact on the future health of our communities.
The authors are members of Fourfront Contributor, a coalition of Washington state behavioral health providers.