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Oswalt: We don't have enough mental health professionals

Oswalt: We don't have enough mental health professionals

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In the 72 years since May was first proclaimed Mental Health Awareness Month, there has never been a time when so many in Virginia and the country are suffering from anxiety, depression and other basic mental health conditions.

The COVID-19 pandemic has made us all aware of the tremendous toll too much stress, emotional upheaval, and uncertainty can create.

From frontline health professionals to essential workers to those who have lost their jobs, stress and anxiety abound!

The current reckoning with racial inequalities has added another layer of emotion and stresses.

For once, we don’t need Mental Health Awareness Month to call attention to the mental health needs all around us.

What many are not aware of, however, is the insufficient number and distribution of behavioral health professionals to counsel and treat individuals who need their help.

There were not enough behavioral health professionals in Virginia before the pandemic. There are certainly not enough at this point, when the need has soared. (40% of Virginians report symptoms of depression and anxiety compared to 10% pre-pandemic.)

Most Virginia localities (2/3), including the entire Roanoke region and all points south and west, are federally designated as mental health professional shortage areas. This means there are not enough behavioral health professionals per capita to provide needed mental health services to those who reside there.

This problem is exacerbated by demographics: 40% of all behavioral health professionals in Virginia are 55 years of age or older.

Although the percentages vary by type, e.g. psychiatrist, psychiatric nurse practitioner, clinical psychologist, Licensed Clinical Social Worker (LCSW), Licensed Professional Counselor, the current pipelines for these mental health professionals are not producing sufficient numbers to replace those who will retire over the next 10-12 years.

In addition to this overall shortage, the proportion of behavioral health professionals who are people of color is woefully disproportionate to the percentage of the population.

For example, while 19.9% of Virginians are Black and 9.9% are Hispanic, only 13% of LCSWs are Black and just 2% are Hispanic. The numbers are equally poor for clinical psychologists, of whom only 6% are Black and 4% are Hispanic.

These are more than just data points. It is important for those suffering from mental health conditions to be able to obtain counsel and treatment from behavioral health professionals who can relate to them culturally and understand the experiences that help create their stress, anxiety and depression.

At the Virginia Health Care Foundation, we have been chipping away at these workforce shortages by giving grants to community health centers, free clinics and other similar organizations in underserved areas to recruit and hire behavioral health professionals.

We have also established a scholarship program to underwrite the costs of a post-masters certificate for nurse practitioners who want to become psychiatric nurse practitioners (only 217 in all of Virginia).

Fortunately, help is on the way. In the new state budget just signed by Governor Northam, the General Assembly included $1.6 million to establish a state Behavioral Health Loan Repayment Program.

This will be available to all types of licensed behavioral health professionals and will repay a portion of their student loans in return for them practicing in one of Virginia’s mental health professional shortage areas for two or more years.

The intent is that this will attract new mental health providers to these areas and provide an incentive for those living in mental health professional shortage areas to pursue training and licensure in one of the behavioral health professions and practice locally.

Addressing the shortage of behavioral health professionals in Virginia will require a multi-pronged approach and the attention and collaboration of many partners. This will not happen overnight.

The General Assembly’s action is a good first step, however. We celebrate the legislature’s awareness of this important issue and are grateful for its actions to help address it.

Deborah Oswalt is founding executive director of the Virginia Health Care Foundation, a public-private partnership initiated by the General Assembly and its Joint Commission on Health Care in 1992. VHCF’s mission is to increase access to primary health care for uninsured and medically underserved Virginians. Contact her at:

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