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COLUMBUS, Ohio — Unprecedented demand and a sparse workforce are adding stress to Ohio’s already strained behavioral health system.
From 2013 to 2019, demand for behavioral health services increased 353% statewide, according to data from the Ohio Department of Mental Health and Substance Abuse Services. Demand increased again in 2021, with providers reporting a 70% increase in need for adult and youth mental health services and a 60% increase in need for addiction services.
“The demand is definitely on the rise,” said Eric Morse, CEO of The Centers in Cleveland, a nonprofit that offers a range of services including case management, counseling, psychiatric services and treatment for drug addiction. “It was high before COVID, I think. COVID just made the situation even worse.
There are several reasons for the shortage, mental health professionals have said.
Workers and clients have become accustomed to telehealth appointments, and it’s difficult to get workers to want to return to private homes where much of the mental health assistance takes place, Morse said.
Low wages also discourage new people from entering the profession, and existing workers become burnt out as workloads increase and are more likely to change careers or retire.
Justin Larson, who oversees support programs for Thrive, a peer recovery service for people with mental health or addictions, said the pandemic has hampered his ability to find new workers.
“Sometimes it’s been difficult to find peer recovery supporters who actually want to work in a hospital,” especially during Covid peaks, he said. “It was a bit difficult to get people to want to work in an environment where people were coming in that might test positive for Covid-19.”
Higher demand and fewer staff mean longer wait times for services, which could be dangerous for patients.
“I can’t even imagine. It could be a potential death,” said Kelitha Bivens-Hammond, a peer supervisor at Thrive. “Honestly, if we were to turn someone down, they might go back and use and overdose. That’s my first thought. It is a life or death situation. »
Bivens-Hammond knows firsthand how dangerous addiction and mental health issues can be. Before becoming a peer recovery counselor, she struggled with addiction. She started drinking alcohol when she was 9 years old. At 21, she started trying out treatment centers. After 27 attempts at sobriety over her 20s, she got help from Blossom.
“I know I would be dead. I know that for a fact,” she said. “That’s where I was going. I had already been institutionalized. I had already been to prison. All I had to do was die.
Bivens-Hammonds helps up to 10 people a day at the Thrive location at St. Vincent Charity Medical Center in Cleveland. Thrive also has locations at MetroHealth, University Hospitals, Cleveland Clinic and elsewhere in the state.
A shortage of behavioral health services could add pressure on other systems, The Center’s Morse said. People may need to go to a hospital or an emergency room to receive services. If an incident occurs, the police may be called, leading to criminal charges or other damage to someone’s mental health.
“We know statistically that the suicide rate and the overdose rate continue to get worse,” he said. “I would say that if we had a better ability to help people, those numbers – I hope – would go down. That’s ultimately what I hope. If we had good access to healthcare, there would be fewer deaths.
Hiring and retention are the biggest barriers to meeting demand, according to mental health care providers.
“The number of providers wanting to enter the community behavioral health space is always a challenge,” Morse said. “The labor market is obviously very favorable to employees at the moment. Even though we’ve increased our wages quite substantially over the past two years, we’re still competing for jobs that are certainly a lot less stressful than doing the job here. Particularly among case managers, where we generally hire people with a bachelor’s degree in psychology, sociology or social work. People with these degrees can obtain better paying and less stressful jobs.
Morse employs 28 case managers. He has a budget of 40, and he says he can use 60 to 80 because the demand is so high. Each social worker serves approximately 100 people. The median salary is $40,000 per year.
“That’s another reason why we have turnover,” he said. “The work is really, really hard. The workload should be around 40-50, as these are people who need a lot of attention. Due to the lack of staff, the workload being 100, it really changes the work. It changes your ability to meet the needs of all you serve.
Luke Church, team leader for Thrive at MetroHealth Hospital, says the system definitely needs more people. “I don’t think it was for lack of trying,” he said. The difficulty lies in finding the right people with the right background, the right references, the temperament and the passion.
“It’s kind of a niche in the job market,” Church said. “With a shortage of jobs on top of all these variables, I think it’s hard to find people. There simply aren’t enough organizations able to apply.
Five peer counselors report to the Church. “Two more people would make it more comfortable,” he said.
Paul Bolino, CEO of the nonprofit Ashtabula County Community Counseling Center, is seeking to fill 11 positions at his agency, representing a 10% labor shortage.
“We are understaffed in several programs,” he said. “A lot has happened during the pandemic. As the stress increased, people made different choices and made changes. We weren’t immune to the big shake-up.
Attrition is also a factor, he said.
“We also have a number of private practitioners in the region who are retiring,” he said. “They’re leaving the job market, and that’s tough because when you’re dealing with commercial insurance that requires a higher license – an independent license – and years of experience, we don’t fill those positions fast enough. So when these providers leave the networks, leave the region, or leave the workforce, young clinicians don’t have time to catch up.
“We need to build a skilled workforce,” he said.
To this end, his organization has launched an internship program. It also highlights a new social work program planned at regional campuses across Kent State, including Ashtabula.
“We said, ‘Let’s bring in people who are new to the field, which is students, whether they’re traditional or non-traditional students. Let’s bring them in as interns, develop them in our system, and then hopefully through our engagement with them during this time, we will get them to stay and be part of our organization for the longer term,” he said. -he declares.
Morse tries a similar tactic.
“We are looking at how we can be more present in schools. To really hype like a good career,” he said. “You can start as a case manager, then get your master’s degree, then move on to therapist. Then move on to management. It can be a good career for someone, not just a job. We want to promote that.
Even if the pipeline issues are resolved, salary will likely remain an issue.
“Obviously there’s a point where if we could get high enough salaries, I think it would be more attractive work and maybe we’d have fewer vacancies,” Morse said.
“We need to continue to make these jobs attractive and pay enough with solid benefits so that you can have a career in this position,” Bolino said. “There are so many things at work. But if we don’t, we’ll serve fewer people, and I don’t think we can afford to do that with the heaviness of things right now.
Ohio lawmakers also see the need. In May, Governor Mike DeWine announced that the state would commit $85 million to strengthen the behavioral health system. The money will be used to create scholarships and paid internships to attract new employees to the field.
“More options for entering behavioral health careers will mean more new clinicians to help patients in need,” said Teresa Lampi, CEO of the Ohio Council of Behavioral Health & Family Services Providers, during the announcement.
This is good news in the state.
“It’s going to take more than a village,” Bolino said. “It’s going to take a state and beyond to fix this.”
This story is part of Northeast Ohio Solutions Journalism Collaborationof the Making Ends Join project. NEO SoJo is made up of more than 18 Northeast Ohio news outlets, including Eye on Ohiowhich covers the entire state.