A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

MA Children’s Mental Health Workforce Capacity: “Who is going to do the work?”

MA Children’s Mental Health Workforce Capacity: “Who is going to do the work?”

October 31, 2009

Last week, the Blue Cross Blue Shield Foundation of Massachusetts released Accessing Children’s Mental Health Services in Massachusetts: Workforce Capacity Assessment (pdf).

It’s no secret that there is a workforce shortage among mental health practitioners treating children with mental health needs. In some geographic areas, up to 82% of prescriber practices are full and unable to take new patients. Currently, there are approximately 6,800 child and adolescent mental health providers in Massachusetts. In 2020, it is estimated that we will have 8,300. However, according to those same projections, it is thought that we will need 12,100 providers.

The Foundation found that things are likely to get worse, not better: of those who responded to a survey, 54% of child mental health practitioners plan to leave the field in the next five years.

What can we do?
The payment structure for child mental health clinicians conspires to discourage new providers from joining the ranks. For some reason, child clinicians are paid at a lower rate than their counterparts who work with adults. Additionally, to provide the best care possible for a child with mental health needs, a clinician often needs to talk to many people in that child’s life: parents, pediatricians, and teachers, to name a few. However, these so-called “collateral contacts” that are vital for effectively coordinated care are not billable through private insurance.

In the survey conducted by the Blue Cross Blue Shield Foundation, establishing financial support for collateral work was listed as the top priority to improve child provider work satisfaction and was the second most frequently given factor that would increase the likelihood that providers would work with children.

The Children’s Mental Health Campaign (www.childrensmentalhealthcampaign.org) is actively working to pass legislation that would provide for reimbursement to clinicians for collateral contacts. Last month, the bill was favorably reported out of the Mental Health and Substance Abuse Committee and is expected to be acted on by the Health Care Financing Committee soon.

Many thanks to the Blue Cross Blue Shield Foundation for their hard work in putting together the report. Because of their efforts, the Campaign is better able to articulate to legislators and other policy makers the need for the passage of Collateral Contacts legislation.
Matt Noyes