Demand for mental health and substance use treatment has reached historic levels. But a massive workforce shortage hinders the ability of communities to provide care.
The Wall Street Journal recently reported that the Health Resources and Services Administration (HRSA) estimated the shortage of mental health professionals was nearly 8,000 in 2022, up from 2,593 in 2013. That has left more than 158 million people without access to care, up from 94.8 million a decade ago, according to HRSA.
We need to dive deeper into those figures. Only 4% of psychologists are Black — 86% are White — according to an American Psychological Association report. The lack of Black providers has an impact on whether Black Americans seek care.
While rates of mental illnesses in Black/African Americans (B/AAs) are similar to those of the general population, only 26.4% of Black and Hispanic males ages 18 to 44 who experienced daily feelings of anxiety or depression were likely to have used mental health services, compared with 45.4% of non-Hispanic White males who also reported feelings of anxiety and depression.
That is a massive discrepancy, and it provides evidence that too many people aren’t receiving the care they need. We must reverse these trends. Here is a simple strategy that addresses both the workforce shortage and the inequities in mental health treatment: Boost culturally competent care by hiring more Black Americans to fill clinical positions. When people seek care, they want psychiatrists, psychologists, peer specialists, case workers and others in the field who look like them.
Studies have shown mental health treatment can be more effective when it aligns with the culture of the client and when therapists demonstrate multicultural competence. But clients can’t always find clinicians who look like them, and it can prevent some people from seeking the care they need. For many, it’s a matter of trust. The Journal of Black Psychology found that the relationship between Black American patients and their Black American provider displayed a “distinct sense of solidarity … as evidenced by having a better understanding of the context of Black clients’ lives.”
A recently published paper, Recruitment and Retention of African American Men in the Mental Health and Substance Use Workforce, addresses how to boost employment and why it’s important.
As we observe Black History Month, we have an opportunity to raise awareness about solutions to help people in need of care and the strategies that can help resolve the workforce shortage our field struggles to overcome.
As one mental health professional recently wrote in Slate, “Our mental health workforce should reflect the population it serves, and right now, Black individuals are extremely underrepresented. If we truly want to improve the mental health of Black adults as well as children, we need to get busy.”
Boosting employment in the field among Black males can help Black Americans who prefer to receive culturally competent care. It can also help overcome our workforce shortage.
Organizations that provide mental health and substance use treatment need to improve recruitment and retention efforts. We simply are not graduating enough people to replace folks who are retiring or leaving the field. Improving reimbursement rates for community providers will help dramatically by allowing the organizations that provide treatment to increase salaries. In addition, academic institutions should consider investing in programs to attract Black men (who are particularly underrepresented) into the profession by developing pipelines to encourage their entry into the field.
Rather than view the current workforce shortage as an obstacle, we need to view it as an opportunity to introduce people to the field and provide them with a path to meaningful, gainful employment in a growing field.
Help is wanted. Not just among people who need treatment, but also among the organizations that provide that treatment.
Check out our report on recruitment and retention and the paper we wrote with Health Management Associates on diversity in the workforce that provides valuable information, Diversity, Equity and Inclusion: Emerging Opportunities for the Behavioral Health Workforce.
Then let us know if you have any ideas to improve recruitment and retention of Black Americans to the field of mental health and substance use treatment.
(he/him/his) President and CEO
National Council for Mental Wellbeing