Nebraskans got a little good news this week when it comes to narrowing gaps in access to behavioral health care.
According to a new report, the state saw a 15 percent increase in its behavioral health workforce between 2010 and 2016. The report, released recently, was compiled by the Behavioral Health Education Center of Nebraska, established by the Nebraska Legislature in 2009 to increase residents’ access to behavioral health care by bolstering the workforce.
Dr. Howard Liu, director of the center, said the number is significant because observers are seeing declines across the country among different groups of behavioral health care providers.
In Nebraska, the behavioral health workforce is aging, with more than half of providers now over age 50. Eighty-eight of the state’s 93 counties meet the federal criteria for a Mental Health Professions Shortage Areas designation and 32 lack a behavioral health provider of any kind.
“Every percent gain is potentially more access for families,” said Liu, also an associate professor in the University of Nebraska Medical Center’s psychiatry department and a child and adolescent psychiatrist.
A collaborative effort among all University of Nebraska campuses and Creighton University as well as community agencies, law enforcement, hospitals and others, the center works to cultivate the behavioral health workforce through a variety of programs targeted all along the pipeline, with a particular focus on rural and other underserved areas.
It hosts a series of presentations, conferences and events to introduce students in high school, college and professional school to careers in behavioral health. It also places behavioral health trainees in clinical rotations and internships across the state. Headquartered on the UNMC campus in Omaha, it also has a hub in Kearney.
The center also works to support practicing providers. Several months ago a team traveled to western Nebraska to try to set up a network that can offer providers there support and training. A key partner in the area, Liu said, is local psychologist Catherine Jones-Hazledine, who provides training opportunities for practitioners and works with high school students interested in behavioral health careers.
Working with the Nebraska Department of Health and Human Services, the center is launching this month and next a collaborative “tele-mentoring” program called Project ECHO — ECHO stands for Extension for Community Healthcare Outcomes — that allows health care providers to share expertise and collaborate across distances.
Funded by the federal Substance Abuse and Mental Health Services Administration, the program will provide information and training on managing addictions and chronic pain, two issues that have arisen with the nation’s opioid crisis.
Another recent bright spot is the number of medical school graduates choosing psychiatry. Since 2013 the number of UNMC medical school graduates earning spots in psychiatry residency programs has more than doubled, totaling a record high of 16 in 2017, or 13 percent of the class. At Creighton University Medical School, 7.4 percent of graduates secured psychiatric residencies last year. Both were above the national average of 5.3 percent.
Liu also noted significant growth in the number of psychiatric advanced practice registered nurses and physician assistants, both of which can prescribe medications.
Liu said he hasn’t found any similar stand-alone programs in other states. Often workforce development is a function of state health agencies.
While Nebraska is seen as a largely rural state, a lot of the programs the center is developing also can work in its urban underserved areas. Those include north Omaha and South Omaha, where the center is working with local partners to figure out how to increase the number of Spanish-speaking providers. “That’s a big need and a big shortage,” Liu said.
But even with the progress the center has made, he said, challenges remain. A person seeking behavioral health help for himself or a loved one still would face delays.
“I’m pleased, but we’re not satisfied,” he said. “There are still significant gaps.”