By HFT Staff

At a time of record demand, behavioral health staffing vacancies and high staff turnover rates have resulted in fewer individuals served, longer waitlists and further strained resources, according to a survey by the Association for Behavioral Healthcare (ABH). Recruitment and retention concerns and hundreds of vacancies are contributing to months-long waitlists and an 11 percent decrease in the number of individuals served compared to 2019. 

“Clinicians are leaving community-based outpatient clinics faster than they are being hired, and this is causing an unprecedented number of vacancies in key positions and creating long waitlists for people seeking care,” says Lydia Conley, the association’s president and CEO. “We must act now – through enhanced reimbursement, rate parity and other measures – to better support our clinicians and address the mental health crises being experienced in classrooms, living rooms and workplaces across Massachusetts.” 

Survey responses point to significant recruitment and retention problems. In 2021, for every 10 master’s level clinicians hired, approximately 13 master’s level clinicians left their positions, contributing to the nearly 640 staffing vacancies across respondents – an average of 17 per clinic. Other survey findings include: 

• Two-thirds of respondents' report needing nine months or more to fill a psychiatrist position.  
• Ninety-two percent reported at least one vacancy for a mental health clinician.  
• Nearly 14,000 individuals are on waitlists to receive outpatient services.  
• Sixty-two percent of respondents reported waitlists for initial assessment for children and adolescents.  
• Children and adolescents spend an average of 15 weeks on a waitlist before starting ongoing therapy. 

Many vacancies can be attributed to the pay gap, which widened to nearly 38 percent in 2020, between salaries in the behavioral healthcare system and acute care hospitals for equivalent positions. On average, a licensed clinician earns $20,000 more annually in a hospital setting than in the community-based behavioral health treatment system. 

ABH offers several recommendations to address the crisis, including a collaboration among policymakers and private insurers to ensure rate parity between hospitals and community-based providers. Other recommendations include: 

• Calling on commercial and public payers to invest in short- and long-term access through immediate outpatient clinic rate increases 
• Implementing a behavioral health workforce data collection and planning strategy 
• Adopting MassHealth’s allowable providers by health plans to include license-eligible clinicians 
• Expanding student loan repayment programs for recruitment and retention 
• Private and public health plans taking immediate steps to reduce redundant or outdated administrative and documentation requirements.