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Strengthening the workforce

November 1, 2006
by ANN McMANIS, MA, MICHAEL A. HOGE, PhD, and JOHN A. MORRIS, MSW
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The Annapolis Coalition details its efforts at national workforce development

The Annapolis Coalition on the Behavioral Health Workforce has been engaged in an ongoing effort to improve training, education, recruitment, and retention in the mental health and substance use disorders fields. What follows is a review of the first five phases of this work, culminating in a draft national workforce action plan that was completed this past summer.

Phase I—Building National Consensus

Sixty-five individuals came together in Annapolis, Maryland, on September 10 and 11, 2001, to focus on growing concerns that the behavioral health workforce was in a crisis. Those gathered included providers, educators, persons in recovery, and family advocates with expertise in both mental healthcare and substance use disorders treatment. These participants adopted a broad definition of workforce that encompasses persons in recovery, family members, professionals, direct-care staff without professional training, and other health and human services providers, such as teachers, emergency room personnel, and primary care providers.

Although the meeting was cut short because of the terrorist attacks, consensus had been reached about a number of key problems related to workforce training and education, as well as potential strategies to address these issues. This initial meeting was the impetus for what has become a continuing and ever-widening effort to develop a national consensus on the nature of the workforce crisis and to stimulate key strategies for reform, not only in education and training, but in recruitment and retention practices as well.

The initial meeting was funded by the federal Agency for Healthcare Research and Quality, along with SAMHSA's Center for Mental Health Services (CMHS). The meeting was organized by representatives from two organizations: the Academic Behavioral Health Consortium and the American College of Mental Health Administration. With these organizations' support and encouragement, the Coalition was formed as a separate, not-for-profit entity. The Coalition is focused on strengthening the behavioral health workforce through policy development with federal and state agencies, and through the provision of technical assistance to all types of behavioral health organizations.

Phase II—Dissemination of Recommendations

The second phase focused on dissemination of the recommendations from the first Annapolis Conference and continued efforts to raise awareness nationally about the workforce crisis. The findings and recommendations from the conference and subsequent strategic planning were summarized in two special issues of the journal Administration and Policy in Mental Health. This work was distributed in hard copy to key leaders in the field, presentations at professional and advocacy meetings, and a Web site (http://www.annapoliscoalition.org). The Coalition offered consultation to the President's New Freedom Commission on Mental Health and drafted recommendations on workforce issues for the commission's final report.

Phase III—Focus on Competencies

The greatest area of consensus among workforce experts was the need to place increased emphasis on competency development and assessment. To move this agenda forward, the Coalition convened a national summit on competencies in Annapolis in May 2004. Experts from business and 13 sectors of behavioral health reported on the status of competency development in their workforce sectors. A summary of these reports and recommendations to guide future work on competencies was published as a third special issue of Administration and Policy in Mental Health in May 2005. (Note: Issues of Administration and Policy in Mental Health can be accessed via http://www.annapoliscoalition.org.)

Phase IV—Consultation to the Institute of Medicine

To promote attention to workforce issues, the Coalition organized a panel of mental health and substance use disorder workforce experts, persons in recovery, and family advocates that developed recommendations for consideration by the Institute of Medicine (IOM) committee developing the landmark report released in November 2005. Two senior members of the Coalition in collaboration with Eric Goplerud, PhD, an expert in substance use disorders workforce issues, were commissioned by CMHS and the IOM to draft a detailed background paper for the IOM committee. The final IOM report did indeed place a major emphasis on workforce issues.

Phase V—National Strategic Plan

The Coalition's work entered its most ambitious phase during 2005 and 2006. With support from SAMHSA, the Coalition managed the development of a national action plan on behavioral health workforce development. The New Freedom Commission's report called for the development of such a plan, and SAMHSA's Center for Substance Abuse Treatment (CSAT) and Center for Substance Abuse Prevention (CSAP) had organized various efforts to examine and address workforce issues. SAMHSA decided to commission a national workforce plan that encompassed prevention and treatment across the mental health and addiction fields, and identified a core set of practical strategies for strengthening the workforce.

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