Supported by a $515,005 grant from Lilly Endowment Inc., this collaborative project with partners across Indiana is designed to improve understanding about the post-secondary pipeline of mental and behavioral health care workers in the state, which is not currently meeting the demand for services.
Hannah Maxey. Photo by Eric B. Schoch, IU School of Medicine.Untreated mental illness can threaten the lives of individuals and communities, with far-reaching consequences including homelessness, poverty, unemployment and safety — all of which can have tremendous impacts on the Hoosier economy and quality of life, said Hannah Maxey, director of the Bowen Center.
Maxey will lead the project, which will include the development of a “Playbook for Enhancing Indiana’s Mental and Behavioral Health Workforce” to provide recommendations to enhance and expand the mental and behavioral health workforce in the state.
The project is focused on understanding the post-secondary pipeline of individuals who are preparing to specialize in some licensed roles in mental and behavioral health care. These roles include mental health counselors, marriage and family therapists, licensed clinical social workers, clinical addiction counselors, psychiatrists, psychologists and psychiatric mental health advance practice registered nurses.
Recognizing that early exposure to mental and behavioral health occupations is foundational to the overall pipeline, this project will work in concert with initiatives focused on the K-12 pipeline.
Although other health care providers — such as primary-care physicians and nurse practitioners — have a role in supporting the mental and behavioral health of Hoosiers, the shortage of professionals whose practice focuses only on mental and behavioral health services is a significant challenge.
“Getting a handle on Indiana’s mental and behavioral health workforce pipeline — its structure, its size, where the leaks are happening and why more aren’t entering it — is a critical step that has been missing in previous initiatives aimed at combatting the shortage of behavioral health care workers,” Maxey said. “Armed with this information, strategies can be identified and an action plan developed to strengthen the pipeline, stop the leaks and enhance the workforce.”
According to the National Alliance on Mental Illness, 1.1 million Hoosier adults have a diagnosed mental health condition, and 345,000 of them do not receive necessary mental health care. Of the 90,000 Hoosiers ages 12 to 17 who have depression, approximately 54 percent are not receiving any care, which can impact educational attainment and rates of incarceration. The shortage of mental and behavioral health providers threatens school counselors’ ability to refer Hoosier youth in need of care, Maxey said.
During the past several decades, the response to Indiana’s shortage of state-licensed mental and behavioral health providers has included incentive programs to encourage individuals to enter these professions, new care delivery models to better meet mental and behavioral health care needs and a variety of relevant policy initiatives. Despite these efforts, Maxey said, Indiana is in no better place today with regards to mental and behavioral health workforce shortages than it was two decades ago.
“In 2012, the U.S. Department of Health and Human Services designated just over half of Indiana’s counties as Mental Health Professional Shortage Areas, and 10 years later, every single one of Indiana’s 92 counties has a federally recognized shortage,” she added. “Without a skilled workforce available to those in need of care, many suffering from untreated mental illness will lack options for care. Its consequences are far-reaching, and its impact on both the economy and Hoosiers is staggering. We are excited to work with partners across the state on addressing this important issue.”
The Bowen Center’s work will be informed by subject matter advisors and stakeholders who will contribute knowledge about and solutions to mental and behavioral health workforce challenges. It will include conducting a comprehensive review of Indiana programs, initiatives and people that are educating and training future professionals, as well as the behavioral health workforce landscape in each Indiana county. The Bowen Center will also identify why people are leaving or not pursuing these professions, including whether factors such as licensing or economics have a role.
The center will also prepare a list of key strategies and useful information to enhance the pipeline, and advisors will champion their implementation across the state.
Lastly, the Bowen Center will work closely with Indiana state government agencies that contribute to the behavioral and mental health workforce, administer related initiatives or regulate the workforce through licensing and ensure alignment with both state government and non-government partners. This includes partnering with the Indiana Commission for Higher Education on assessment of, and stakeholder engagement in, Indiana’s post-secondary pipeline of behavioral health workers.
“The Indiana Commission for Higher Education congratulates Indiana University on receiving this generous grant from Lilly Endowment to address what is undoubtedly a significant shortage of mental and behavioral health professionals,” Indiana Commissioner for Higher Education Chris Lowery said. “The commission stands ready to partner with the Bowen Center in sharing our data on academic programs that prepare professionals in this area and in contributing to discussions about policies that will shore up and expand the pipeline of individuals entering these professions.”