Growing the Behavioral Health Workforce and Addressing Equity: Two Ohio Policy Priorities

For many of us working to improve health care, the challenges we face can sometimes seem overwhelming, especially in two of the most difficult areas — behavioral health and overall health equity.

That’s why it’s important to share news of the promising work being done in Ohio, where Gov. Mike DeWine has made health equity and a stronger behavioral health care system among his top priorities, backed with action and funding. We learned about some of the most promising work this spring at an OAHP Executive Forum.

Ohio Department of Mental Health and Addiction Services Director Lori Criss outlined the vision Gov. DeWine shared in his State of the State address: an Ohio with expanded residential and community-based mental-health treatment, where intervention happens early and there are fewer emergency department visits for mental health crises and fewer mentally ill people living on the streets.

We know that making this vision a reality requires not only capacity at inpatient psychiatric hospitals, but expanded community resources including short-term “stepdown” facilities, permanent supportive housing and independent housing for those in recovery. And to sustain all of those things, Director Criss reminded us, we’ll need a much more robust workforce for behavioral health — not just psychiatrists, but also counselors, peer supporters, navigators and more.

Director Criss shared research showing that, while the number of behavioral-health professionals in Ohio grew by 174% from 2013 to 2019, the demand for services grew twice as fast — by 353%.

Those are daunting numbers, but we can draw encouragement from the state’s response: a robust recruitment effort, funded by $230 million, that will involve multiple state agencies, universities, community colleges and workforce boards. That commitment represents 39% of Ohio’s funding for home and community based services through the American Rescue Plan Act, and that gives me hope that our state can look forward to substantial progress on this urgent public need.

On the broader challenge of health equity, there’s more good news. Jamie Carmichael, chief health opportunity advisor at the Ohio Department of Health, briefed OAHP executives on a major effort funded with another federal grant of $32 million. The funding is focused on addressing disparities in health care around the COVID-19 pandemic, but that work serves to improve equity across the board.

Jamie told us that the goal is nothing less than eliminating health disparities at the population level. Not reducing, not tinkering, but getting to a place where the health of Ohioans no longer can be predicted by their demographics or socioeconomic status. The project’s four objectives are: ensuring an equitable response to COVID-19; establishing equity as a pillar of public health; addressing social determinants of health with specific initiatives; and improving the clinical care experience for the most vulnerable.

That last one should be of special interest to health care providers. Research has shown that many people in underserved communities are poorly treated at medical offices and clinics — talked down to, not listened to or not believed.

Addressing inequities is at the core of our member health plans’ work and it is exciting to know that Jamie and her team are available play a more active role in coordinating that work.

There’s a lot of work ahead — to educate vulnerable health-care consumers on their rights and options; to improve data collection so we better understand needs and opportunities; to recruit and retain the workforce we need, especially in clinical settings with high Medicaid use, and so much more.

It’s clear that health equity is a priority for the state and for our health plans. We look forward to working together to transform that priority into results.