Betsy Cauble: Pa. needs more behavioral health professionals

Pennsylvania is facing a severe shortage of mental and behavioral health professionals. Over 50 of its 67 counties are designated as mental Health Professional Shortage Areas. Throughout the state, 1.8 million Pennsylvanian adults have a mental health condition, yet 1.7 million live in communities that don’t have enough mental health professionals to meet their needs.

To push for improved access to mental health services in Pennsylvania, state Rep. Aerion Andrew Abney, D-Allegheny, introduced House Bill 554, which would authorize Pennsylvania to join the Social Work Licensure Compact (SWLC). The compact would allow social workers to serve clients across states that join the compact without having to go through multiple relicensure processes. If passed, this move could significantly increase the availability of critical mental health services across the state, particularly in rural and underserved areas.

Rural Pennsylvanians face serious health disparities, with 41% fewer mental health resources than urban areas. Stigmas surrounding mental health treatment are another persistent barrier to care, especially in small, close-knit communities where people may already personally know their local providers, deterring them from seeking care due to shame or embarrassment. The SWLC can change this by giving rural Pennsylvanians increased access to telehealth services and allowing patients to access care from the privacy of their own homes.

But this mental health emergency isn’t specific to rural Pennsylvania — it’s running rampant throughout the commonwealth. While the covid-19 pandemic and ongoing opioid epidemic exacerbated the mental health crisis, increased demand for care and burnout continue to intensify the mounting shortage of mental health professionals, physicians, social workers and nurses statewide.

The SWLC would help combat this shortage by facilitating social workers’ ability to practice across state lines without the burden of going through multiple relicensure processes, which consume time and resources that could instead go toward serving their clients. Similarly, the SWLC would allow social workers living in different states to treat patients in Pennsylvania, bringing much-needed relief to the nearly 600,000 Pennsylvanians who forgo mental health treatment due to barriers to care such as high costs, lack of insurance and behavioral workforce shortages.

The compact would also improve continuity of care when clients or practitioners relocate across state lines. Current licensure processes and state regulations prevent social workers from serving patients outside of the state where they’re licensed. If they or their patient move, all the time and investment that went toward building their client-practitioner trust is gone. The SWLC would eliminate this problem by allowing social workers to continue serving their clients no matter where they live.

Although Pennsylvania’s proposed SWLC would bring urgent resources for its residents and underserved communities, there is still much more to be done. A survey by The Pennsylvania Council of Children, Youth & Family Services found that out of 51 child welfare and behavioral health service agencies, one in four said that they have more than 30 unfilled positions. Although they make up only a small portion of the population, Pennsylvania’s children lack access to a sufficient workforce of professionals to address their behavioral health needs.

Addressing these issues requires better support for both prospective and current social workers. Student debt and low pay continue to place a heavy burden on social workers, discouraging prospective social workers from entering the field and worsening the shortage. This also contributes to burnout, as social workers must often take on more work. Solutions like paid internships and increased scholarships can help ease these pressures and support the social workers who care for Pennsylvania’s most vulnerable communities.

Social workers are essential resources for communities across Pennsylvania, especially rural ones. If Pennsylvania passes the SWLC and implements more creative strategies to combat burnout and close the behavioral workforce gap, it will make significant strides toward ensuring all of its communities get the care they so desperately need.

Betsy Cauble is a board member at Preferra Insurance Company RRG, a behavioral health liability insurance company overseen by social workers, and the retired department head and associate professor of social work emeritus at Kansas State University.