In­ter­pro­fes­sional ed­u­ca­tion can help close the gap in be­hav­ioral health work­force

Modern Healthcare - - COMMENT - By Dr. Marc B. Hahn

Of the health pro­fes­sion work­force short­ages pro­jected over the next 10 years, none is more dire than be­hav­ioral health. It’s es­ti­mated that by 2020, men­tal health and sub­stance use dis­or­ders will sur­pass all phys­i­cal dis­eases as a ma­jor cause of dis­abil­ity world­wide.

The Af­ford­able Care Act im­por­tantly ex­panded pro­tec­tions man­dated by the 2008 Men­tal Health Par­ity and Ad­dic­tion Eq­uity Act to elim­i­nate dis­par­i­ties in cov­er­age for men­tal health and sub­stance abuse care. With “re­peal and re­place” off the ta­ble for now, the ACA will con­tinue to ex­tend par­ity pro­tec­tions to greater num­bers of in­di­vid­u­als and en­sure cov­er­age for be­hav­ioral health ser­vices as one of its des­ig­nated es­sen­tial health ben­e­fits.

Along with th­ese pro­tec­tions has come so­ci­ety’s grow­ing ac­knowl­edg­ment of the in­ex­tri­ca­ble link be­tween the men­tal and phys­i­cal com­po­nents of ill­ness, and the need to treat pa­tients holis­ti­cally to most pos­i­tively im­pact over­all health and well-be­ing.

To­day’s be­hav­ioral health clin­i­cians are in­creas­ingly rec­og­nized as skilled team mem­bers who are crit­i­cal to the front lines of pri­mary care, pro­vid­ing much-needed di­ag­no­sis and in­ter­ven­tion, pre­vent­ing fur­ther ill­ness and dis­ease, and help­ing main­tain the long-term health of pa­tients.

In­deed, train­ing health pro­fes­sion­als to work on cross-dis­ci­plinary teams is a key ob­jec­tive of the grow­ing em­pha­sis on in­ter­pro­fes­sional ed­u­ca­tion. IPE pro­vides the knowl­edge, learn­ing ex­pe­ri­ences and skill de­vel­op­ment that are es­sen­tial for de­liv­er­ing the com­pre­hen­sive care that pa­tients need and now ex­pect.

How­ever, a stag­ger­ing short­age within the be­hav­ioral health work­force looms large. In his ar­ti­cle “Seek­ing so­lu­tions for be­hav­ioral health­care short­age,” (Jan. 9, p. 18) Mod­ern Health­care re­porter Steven Ross John­son por­tends a very real and ten­u­ous fu­ture sce­nario: 70,000 ad­di­tional providers will be needed by 2025 to meet the ex­pected growth in de­mand. What’s more, it’s es­ti­mated that over half of to­day’s be­hav­ioral health providers are age 55 or older and will soon re­tire.

Th­ese sta­tis­tics should serve as a ral­ly­ing cry for those of us in health pro­fes­sions ed­u­ca­tion. It is in­cum­bent upon ed­u­ca­tors to fur­ther iden­tify gaps in avail­able train­ing in our re­gions, cre­ate op­por­tu­ni­ties for new pro­gram­ming, and build the nec­es­sary aca­demic and cur­ric­u­lar in­fra­struc­ture to grad­u­ate greater num­bers of health pro­fes­sion­als and shrink the widen­ing chasm be­tween de­mand and sup­ply. To that end, Kansas City Univer­sity of Medicine and Bio­sciences late last year re­ceived ap­proval from the Higher Learn­ing Com­mis­sion to add a five-year prac­tice-ori­ented doc­toral pro­gram in clin­i­cal psy­chol­ogy (PsyD).

We were acutely aware of the over­whelm­ing need for be­hav­ioral health providers—par­tic­u­larly to serve on in­te­grated health ser­vices teams. At the same time, we rec­og­nized the ab­sence of a sin­gle PsyD pro­gram in ei­ther of our sur­round­ing states of Mis­souri or Kansas. Be­cause of their strong com­mit­ment to the pur­suit of clin­i­cal prac­tice, as op­posed to the pur­suit of re­search, PsyDs are by def­i­ni­tion an ex­cel­lent choice to help stem the grow­ing short­age.

Ed­u­ca­tors should also eval­u­ate train­ing gaps in light of syn­er­gies with their other aca­demic pro­grams to max­i­mize op­por­tu­ni­ties for in­ter­pro­fes­sional ed­u­ca­tion. With the holis­tic phi­los­o­phy and em­pha­sis on pri­mary care that are the hall­marks of os­teo­pathic medicine, os­teo­pathic med­i­cal schools are well-suited to ed­u­cate be­hav­ioral health providers who can ef­fec­tively serve along­side pri­ma­rycare physi­cians, addressing co-mor­bid phys­i­cal and be­hav­ioral health is­sues and pro­mot­ing the im­por­tance of mind-body well­ness.

KCU ex­pects to en­roll up to 20 PsyD stu­dents for its in­au­gu­ral class this fall. Stu­dents will be ex­posed to a broad base of dis­ci­pline-spe­cific knowl­edge and trained in pro­fes­sion-wide com­pe­ten­cies set by the Amer­i­can Psy­cho­log­i­cal As­so­ci­a­tion. Cur­rently there are 240 APA-ac­cred­ited clin­i­cal psy­chol­ogy doc­toral pro­grams in the U.S. and ter­ri­to­ries; 68 are PsyD pro­grams. In 2010, th­ese PsyD pro­grams con­ferred 1,507 de­grees, in­creas­ing 24% to 1,868 by 2015.

Even if such up­ward trends con­tinue, sup­ply dur­ing the next decade will still fall far short. We should do ev­ery­thing pos­si­ble to train and grad­u­ate more clin­i­cal psy­chol­o­gists in an in­ter­pro­fes­sional ed­u­ca­tion en­vi­ron­ment to help en­sure our coun­try’s hos­pi­tals and clin­ics have the be­hav­ioral health providers they will des­per­ately need.

Marc B. Hahn, D.O., is pres­i­dent and CEO of the Kansas City (Mo.) Univer­sity of Medicine and Bio­sciences.

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