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The behavioral healthcare workforce is changing

September 8, 2017
by Timothy J. Tolan
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The behavioral healthcare workforce in America is changing. In fact, the entire U.S. workforce is experiencing a shift from hiring traditional full time employees to a more broad-based blended workforce. This shift is largely a result of the number of baby-boomers retiring, the changes in our immigration laws and the overall shortage of qualified full time behavioral healthcare candidates.

This new blended workforce is comprised of traditional full-time and part-time employees as well as temporary workers and interim contract workers. Interim roles can range from non-exempt service roles to executive exempt leadership, including positions in the C-suite.

The Bureau of Labor Statistics (BLS) recently reported that by 2020 more than 40% of the U.S. workforce will be contingent workers. If this trend continues, 1099 workers will soon equal the traditional W-2 employees in the workplace. With the U.S. healthcare spending expected to reach a staggering 20% of our GDP by 2025, the industry will feel this shift more than any other segment in our economy. It must adapt and adapt quickly.

The Bureau of Labor Statistics’ Occupational Outlook Handbook (2016-17 Edition) forecasts employment growth for substance use and behavioral health counselors is growing faster than many other occupations. The need for behavioral healthcare workers is influenced by factors such as expanded coverage under the Affordable Care Act; returning veterans with behavioral health needs; and the criminal justice system, which is transitioning toward treatment-oriented sentences.

Projected increases in behavioral health jobs according to bureau data are stunning:

  • Substance use and behavioral health counselors are expected to increase by 22% between 2014 and 2024—generating approximately 21,200 new jobs. 
  • The number of mental health counselors rose more than 30% between 2006 and 2016 and is expected to increase again by 28.5% by 2022—generating approximately 166,300 new jobs. 
  • The number of social workers is expected to increase by 12% between 2014 and 2024—generating approximately 74,800 jobs. 
  • Marriage and family therapist roles are expected to grow by 30.6% between 2015 and 2022—generating 11,600 new jobs or more. 

The challenge is that there is not a sufficient talent funnel of up-and-coming workers to fill the void. The number of substance use treatment professionals continues to be a serious supply vs. demand issue to meet the needs of the sector.

Key concerns contributing to this shortage include:

  • Shortage of qualified workers. Substance use treatment organizations encounter insufficient number of applicants who meet minimum qualifications for open positions, and the challenge will only become more severe over time.
  • Retirement. Over half of individuals working in the addiction treatment field are over the age of 45 years. Vital Signs surveys show 60% of clinical directors are over the age of 50, and 46% of direct care staff are over the age of 45. Where will the new workforce come from?
  • Inadequate compensation. Low compensation packages are working against the need to solve the problem. Overall compensation pales in comparison for behavioral healthcare workers compared to other traditional healthcare workers.

With so many changes in flux with reimbursement and the growing need to add and retain top talent, it just makes sense to embrace the new blended workforce and develop human capital strategies now to remain competitive and to provide the level of care families and patients deserve. Many organizations have their head in the sand when it comes to adapting to the new blended workforce, and while behavioral health organizations still have time to pivot and make changes to the way they hire and retain key employees, the time is limited.

The demand for high quality behavioral health talent has never been greater. The time to act is today or you could be facing significant challenges across the workforce. And this includes hourly workers all the way to the C-suite.

Executive leadership and board members need to regularly evaluate key human talent metrics and ensure executives are measuring this critical key performance indicator so you can act long before the situation reaches a critical stage. Tracking metrics on how long it takes to fill open positions will be essential as will proactively developing plans to make the shift to the new blended workforce as soon as possible. Human capital is one of the greatest assets a behavioral health organization has today. The blended workforce is real, and it’s happening now.

Timothy J. Tolan  is CEO and managing partner of Sanford Rose Associates - The Tolan Group in St. Augustine, Fla.