It’s Time to Build Washington’s Behavioral Health Workforce

In our home state of Washington, the need for behavioral health* services is reaching critical levels, in large part due to the isolation, grief, and economic calamity caused by the COVID 19 pandemic.

Last October the Washington State Department of Health estimated that up to 45% of the state’s population could experience significant behavioral health reactions or functional impairments as a result of COVID spikes in the fall. Nationwide, mental health related emergency room visits for children under 18 are up as much as 31% since last April. These realities are compounded for communities of color, for whom the same inequities that plague every American institution apply in our behavioral health system, which is designed to cater to wealthy white people and communities. Further issues of stigma, complicated and limited access to services, and a fundamental lack of system capacity to meet the growing need are woven throughout our current behavioral health infrastructure.

This is the pandemic within the pandemic, happening across our country – and as we slowly recover from one of the most challenging years in recent memory, we see an opportunity to build a system that addresses every community’s behavioral health needs.

Over the past few months, Ballmer Group has had the privilege of learning from legislators, service providers, state agencies, and higher education institutions on how to improve our behavioral health system and are excited about the leadership and momentum we are seeing. We heard about new policies, expanded programs and a growing number of legislators who champion this issue.

During its 2021 session, our state legislature stepped up and delivered on these opportunities. Washington state leaders recognized the growing behavioral health crisis, and responded with historic levels of investment, including:

• $62 million for a 2% Medicaid reimbursement rate increase to community behavioral health providers.
• $31 million in one-time relief funding to behavioral health providers to address COVID-related financial impacts.
• $38.5 million to ensure each region in Washington has at least one adult and one children and youth mobile team to respond to calls coming into the new national 988 mental health crisis hotline.
• $25 million for outreach and intensive case management and $12.5 million for Homeless Outreach Stabilization, both related to the Blake decision which decriminalized simple possession of illegal drugs.

Ballmer Group is committed to maintaining the momentum by complementing these public investments with a set of grants that can shore up other aspects of Washington’s behavioral health system. We will begin with a focus on building Washington’s pipeline of behavioral health workers – clinicians, therapists, nurses, peers, and more. There is a huge need for qualified counselors who are representative of communities across Washington. Over 40% of rural counties in the state don’t have a single clinician, and a larger workforce would mean more practitioners who can serve as a first point of contact instead of law enforcement, more capacity to meet the growing need for these services, and opportunities for upstream, preventative treatment – rather than a cycle of crisis response.

We are announcing $38m in grant funding to build Washington’s behavioral health workforce. The grants have been awarded to the University of Washington, the Washington Council for Behavioral Health, and the Washington Health Care Authority:

• $24.7 million over 4 years to fund scholarships in seven WA colleges and universities to expand the pipeline and competencies of our behavioral health workforce.
• $5.5 million over 3 years to the UW Behavioral Health Institute to fund the development and pilot of an apprenticeship model for practitioners.
• $3.19 million over 5 years to the UW Department of Psychiatry to fund the development and pilot of Bachelor’s-level talent in behavioral health primary care.
• $2.8 million over two years for the UW Behavioral Health Institute to support state and local government partners to plan a re-design of Washington’s behavioral health crisis response system.
• $1.1 million over 4 years to the WA Council for Behavioral Health to fund an effort to establish a teaching rate for those preparing our next generation of behavioral health practitioners.
• $400 thousand over 2 years to the Health Care Authority to drive the uptake of behavioral health peers in the Medicaid and commercial systems.
• $500 thousand over 3 years to the WA State Opportunity Scholarship to match the state’s investment in a Graduate Scholarship in Advanced Health Care initially targeting nurse practitioners.

This is just the beginning. It will take time for our workforce to grow and for our system to adapt – and workforce capacity is far from the only solution needed. It is critical for us all to understand problems facing our state’s behavioral health infrastructure, and to continue investing in solutions that benefit every Washingtonian. We know there is so much more that needs to be done, and we are grateful for and excited to join leaders across the state in getting to work.

*Behavioral health refers to a broad range of conditions, from rare chronic disorders like schizophrenia to more common concerns such as seasonal depression, substance abuse, work- or school-related anxiety, and depression. Put simply, behavioral health is our everyday emotional and mental wellbeing, and it is fundamental to our ability to thrive in school, at work, and in our communities.