An influential state panel is calling for bold reforms that would make it easier for young people to pursue psychiatry careers, addressing an acute shortage of mental health practitioners across the state.
The panel’s exhaustive report, unveiled Friday to the State Legislature, creates the first-ever road map for expanding the ranks of mental health workers in rural areas of Minnesota where the scarcity of skilled professionals has reached a crisis point, causing clinics and hospitals to curtail psychiatric services.
In September, the nonprofit Catholic Charities was forced to close a 16-bed intensive treatment center in Fergus Falls for children with severe mental illnesses after having no success at recruiting a program director and experienced mental health counselors to northwest Minnesota.
Staffing difficulties also played a role in the closing last March of Riverwood Centers, one of the state’s largest community mental health providers. The abrupt shutdown of Riverwood, which provided crisis services and mental counseling to about 3,000 people, left a broad swath of north-central Minnesota without community mental health services.
The panel’s 226-page report — the product of 18 months of work by a committee of 37 mental health practitioners, state officials and university administrators — provides the deepest look yet into the causes and severity of this workforce shortage, while offering numerous detailed proposals. These include expanding college-level mental health degree programs in rural areas of the state, adding more psychiatric residency fellowships, requiring all health insurers to reimburse providers for supervisory training and internships to mental health trainees, and more targeted efforts to expose middle- and high-school students to mental health professions.
Taken as a whole, the measures are designed to increase the visibility of psychiatry and to create a clearer career path for young people looking to pursue mental health careers.
“This is a bold plan,” said Sue Abderholden, executive director of the Minnesota chapter of the National Alliance on Mental Illness (NAMI) and a member of the committee that drafted the report. “It starts from scratch in asking, ‘How do we get young people interested in mental health careers and how do we make sure they come out the other end with training?’ ”
It remains to be seen how many of the panel’s proposals become reality, as they would require millions of dollars in additional state funds. The Minnesota Department of Human Services, which oversees mental health services in the state, has been tightening its belt because of unexpected costs related to two high-profile lawsuits involving sex offenders and people with disabilities.
Even so, one state lawmaker is already moving forward on two of the panel’s key recommendations.
Sen. Greg Clausen, DFL-Apple Valley, introduced a bill last week that would extend the state’s loan forgiveness program to mental health professionals and public health nurses. Under the program, the state forgives student loans for certain health professionals who work in rural or underserved urban areas. Clausen is also drafting legislation that would increase by four the number of psychiatric residency and fellowship slots in Minnesota over the next two years. The proposals would cost state taxpayers more than $4 million a year.
“We need to address this workforce shortage now,” said Clausen, a former school principal and long-standing advocate for expanded mental health services. “We’ve got [psychiatric] beds that sit empty because we don’t have the workforce in the facility to handle the people who would be in those empty beds.”
All but 13 of Minnesota’s 87 counties have been officially designated by the federal government as “mental health professional shortage areas,” based on the number of psychiatrists per 30,000 residents. Though Minnesota has more psychologists and social workers than the national average, the state lags in both psychiatrists and child psychiatrists. Statewide, the job vacancy rate for psychiatrists is 18 percent, compared to 2.8 percent across all occupations.
And the scarce ranks of mental health professionals is aging. Nearly half of the psychiatrists in Minnesota are 55 years of age or older, compared with 21 percent of the workforce as a whole.
The shortage of skilled mental health workers was brought into sharp relief last fall with the closing of the Catholic Charities treatment center in Fergus Falls. Since its opening in 2006, the center had treated severely traumatized children, from 12 to 18 years of age, who often suffered from severe depression and suicidal thoughts; many of the children arrived at the facility with a history of sexual abuse and neglect. It was one of just three centers across the state that treated children at risk of hurting themselves or others in a locked setting.
However, in recent years, the center struggled to recruit and retain workers in Fergus Falls. Some youth counselors left once they discovered they could make twice as much working in the booming oil fields of North Dakota, said Timothy Lieser, director of residential and day programs at Catholic Charities of the Diocese of St. Cloud. The center went more than six months without a full-time program director before closing.
“It’s a real tragedy,” Lieser said of the closure. “These are great kids with extreme mental challenges who just needed the opportunity to have treatment in a secure environment.”