Addressing the Primary Care Behavioral Health Workforce Gap in Texas
Throughout the vast expanses of Texas, people in both rural and urban communities benefit from behavioral health care professionals, who address the needs of children and adults in challenges ranging from diabetes management to substance abuse. The state, however, faces a challenge—more than 75 percent of counties in Texas qualify as behavioral health shortage areas. Across rural areas, the need is particularly acute, and it grows even more for patients who are Spanish-speaking.
Becky Scott, Ph.D., senior lecturer in Baylor’s Diana R. Garland School of Social Work, and Elissa Madden, Ph.D., associate professor of social work, are working to change that. Scott serves as program director of the Baylor Integrated Behavioral Health Certificate Program, with Madden as associate director. Together, they are coordinating a program, supported by significant funding from the Health Resources and Services Administration (HRSA), to develop a qualified workforce to address critical needs throughout the state.
“Behavioral health is a comprehensive concept that looks beyond acute mental health symptoms and focuses on behaviors and cognitive processes that support someone in achieving health goals,” Scott says. “This grant and this workforce training effort is meant to train behavioral health professionals that can be integrated into primary care health teams. Most Texas counties are looking for professional support addressing behavioral or mental health needs, and we are training MSW students to become part of a state-wide solution after they graduate.”
Bridging the Gap, Elevating the Discipline
A two-fold challenge faces those who hope to bridge the behavioral health care workforce gap. The sheer scope of the state of Texas is one—hundreds of rural counties need behavioral care just as significantly as do their larger counterparts, but recruiting licensed professionals can be difficult. A second challenges comes in training individuals to become qualified professionals.
“We know the primary care behavioral health model works when done correctly, and we know we need to build not just a larger workforce, but a workforce that knows how to practice with model fidelity,” Scott says. “To do that, we’ve got to lengthen the workforce on-ramp by providing focused training opportunities and programs that build a stronger foundation professionals entering this demanding context for behavioral health.”
The Integrated Behavioral Health Certificate Program is fueled to accomplish these goals through $1.9 million in funding to granted to the Baylor University Diana R. Garland School of Social Work. Baylor’s efforts are enhanced through a longstanding partnership with Waco Family Medicine, which has collaborated with Scott on evidenced-based practice research in primary care behavioral health. For the past eight years, the two organizations have teamed up to provide a high-quality on-the-job training program for clinical social workers.
Additional state-based partnerships include University of Houston and University of Texas Rio Grande Valley in their respective HRSA behavioral health workforce training programs.
A Meaningful Launch
Since Scott and Madden began work on the project last year, 28 students have received stipends and tuition to participate in the certificate training program. These scholarships allowed MSW students to earn a certificate in primary care behavioral health while graduating with reduced debt burden. Classes provided students with an array of training methods and best practices in behavioral health care, with a focus on addressing the needs of medically underserved communities.
Measures from the program evaluation conducted by Danielle Parrish, Ph.D., professor of social work, showed that students in the first year cohort demonstrated significant gain in skills and knowledge for work in integrated behavioral health teams. Many of these students received employment in team-based medical care within two months of graduating. A second cohort is now underway. Journal articles providing an overview of these outcomes are forthcoming.
“In many of our community-based systems and organizations, the best and most easily accessible care is reserved for those with the most resources,” Scott says. “This program, like the entirety of social work, upends this by training professionals who want to serve people who have the least access or sometimes inferior quality services, and train them in the very best assessment and intervention methods.
“Our students, for no extra cost, receive world class training and can then go out into Texas and work for community health centers, school districts, or church-based clinics from Houston to El Paso, Dallas to McAllen, and everywhere in-between.”