Michigan residents with mental illness, developmental disabilities, or substance use disorders rely on more than 100,000 mental health clinicians and direct support professionals—staffing the state’s comprehensive public mental health system—for recovery and the ability to live a full life. Due to unprecedented turnover and vacancies in mental health positions in Michigan, many individuals find themselves unable to access the treatment and support they need.
The work of mental health clinicians and caregivers is both rewarding and challenging. Over the past decade, pay for these professionals has not kept pace with the market, making it extremely difficult to recruit and retain these essential workers. Low wages and administrative burden have proven to be the main driving factors for this turnover.
A recent survey of public mental health service providers in Michigan by our Community Mental Health Association found that the average vacancy rate for mental health employers was 19%, with the vacancy rate for some mental health employers at 63%. Among direct care worker positions—providing hands-on support—the average vacancy rate was 27%, with vacancy rates for some of these employers exceeding 85%. For these workers, the turnover rate averages 40%, with four out of every 10 workers leaving each year. This shortage has hindered the ability of Michigan’s public and private mental health systems to provide access to care, as well as the appropriate intensity and duration of that care.
Problems caused by this vacancy rate include:
- Lack of staff to meet demand, causing delays in access for people who need care
- Lack of staff continuity
- Extremely high caseloads, causing dramatic increases in workload and stress for mental health workers
There they are 60 million Americans with mental health conditions, and nearly half go without treatment. In Michigan, nearly 1.5 million residents have a mental health condition, and 355,000 adults have a serious mental illness. Even young people are affected, with 119,000 Michiganders between the ages of 12 and 17 experiencing depression.
The struggle to maintain a mental health workforce has a real impact on those who suffer. or 2022 survey by the advocacy group Consumers for Quality Care found that 58% of Michigan residents reported that it was difficult to find mental health providers that are affordable or covered by insurance. Even when insurance covers treatment, finding an available provider can be extremely difficult. However, there are solutions that can be implemented to solve the issue of staff shortages in the field of behavioral health.
- Increase starting salaries of DSP and DCW staff to $18 per hour through increased Medicaid and General Fund dollars provided to state programs.
- Behavioral health workforce plans should be developed and implemented jointly by MDHHS, MDE, and their stakeholders in communities across the state.
- Amend Michigan laws and policies on criminal background checks to include a “rehabilitation review,” similar to those authorized in 17 other states, to increase the potential pool of applicants for direct support careers.
- Providing publicly funded tuition reimbursement and scholarships to support Michiganders in their pursuit of undergraduate and graduate degrees in mental health disciplines – social work, psychology, psychiatry, nursing.
- Create the Behavioral Crisis Continuing Workforce Entry Bonus, which would provide a $3,000 entry bonus to social workers, licensed professional counselors and other behavioral health practitioners entering a behavioral health position in the public sector.
There is much that can be done to make it easier administrative burden and documentation in the state’s public mental health system. While some administrative-related demands are expected, excessive levels of non-value-added demands drive many health and human service professionals out of the field.
- The documentation requirements required of clinicians within Michigan’s public mental health system are far greater than school mental health practitioners and those in private practice. Simplify the burden to increase the time available to work with patients.
- Development of a simple clinical recordkeeping system that supports rapid engagement and immediate access to care, particularly for persons with episodic and brief mental health service needs.
- Michigan’s public mental health system is burdened by a large number of reporting requirements, many of them of little or no value.
- Modify the training requirements for clinical staff and clinical supervisors in a way that does not reduce the clinical skills of these practitioners.
While not all of these changes may be possible immediately, mental health staffing issues require that something be done so that the needs of Michigan residents facing mental health concerns can be better served. It’s not a question of whether we should do something – it’s a question of how much we can do.
Robert Sheehan is the CEO ofCommunity Mental Health Association of Michigan. He can be reached at rsheehan@cmham.org.
