124 mental health clinics report 640 job vacancies

Last week, a survey by the Blue Cross Blue Shield Foundation reported that Massachusetts residents are having trouble accessing mental health care when they need it. A new survey released Tuesday by the Association for Behavioral Health Care sheds some light on why.

The survey of the trade association’s members – reflecting 37 provider organizations providing outpatient mental health care at 124 locations – found 640 vacancies among clinical staff.

“It’s not that people don’t need services. We don’t have the capacity to offer them,” said Lydia Conley, executive director of the Association for Behavioral Healthcare.

CommonWealth previously reported that staffing problems have been plaguing mental health agencies, with perennial funding issues compounded by COVID-related burnout and the need for virus-related leave. The new survey, conducted in October and November of 2021, shows just how bad the problem has become.

Almost every respondent had at least one vacancy for a mental health clinician, and the clinics reported an average of 17 vacant positions each. In 2021, the organizations reported hiring 473 clinicians with master’s degrees – but 617 clinicians left during that time. The primary reason people gave for leaving was salary and benefits.

Hiring is not easy. Around one-third of respondents said it took them at least a year to hire a psychiatrist.

Unsurprisingly, the drop in staff has resulted in worse access for patients. The providers saw 92,635 patients in 2021, an 11 percent drop from the 102,823 patients seen in 2019. That is not due to lower demand, but to a lack of availability. At the time the survey was being conducted, 13,800 patients were on waiting lists for outpatient services.

Around 60 percent of providers reported having waiting lists for initial assessments and ongoing outpatient treatment, and the average wait time ranged from 10 weeks for an adult needing an initial assessment to 15.3 weeks for a child seeking ongoing outpatient treatment. Fewer providers had waiting lists for medication services (27 percent of pediatric clinics and 35 percent of those serving adults) and the average waiting time was around nine weeks.

The Association for Behavioral Healthcare represents providers who deliver services as Department of Mental Health-licensed outpatient clinics. Around two-thirds of patients have public health insurance, primarily MassHealth, and the rest have commercial insurance. These are not the private practice therapists who do not take insurance. According to Conley, their member clinics tend to be training grounds where clinicians start working before they move to more lucrative jobs in private practice, hospitals, or other settings.

Conley said in the long term, the data reflects the need to pay providers more. Rates paid by MassHealth are set by the state, while rates paid by commercial insurers are negotiated and depend on the insurance company. She also suggested a “rebalancing” of health care spending, since investments in preventative behavioral health care will reduce the number of people seeking crisis care. Bills previously proposed by Gov. Charlie Baker and a pending Senate bill would put more money toward primary care and behavioral health care.

Conley said there is also a need to further study the workforce. It is not clear, for example, whether there are not enough providers being trained or whether there are just not enough providers in this part of the system – the safety net clinics and the insurance-based market.

The Executive Office of Health and Human Services has begun implementing a “roadmap” to increase the availability of mental health services. Baker’s fiscal 2023 budget proposal includes $115 million for new behavioral health initiatives, including improved reimbursement rates for outpatient treatment.

SHIRA SCHOENBERG

 

FROM COMMONWEALTH

State House to reopen: The Massachusetts State House, closed to the public for nearly two years, longer than any other state capitol, is reopening next week. Legislative hearings will continue to be remote, but now visitors who just want to look around or those who want to lobby their lawmaker can enter, as long as they provide proof of vaccination or a negative COVID test from the day before.

– The reopening is in many ways a symbolic gesture. State House business hasn’t suffered during COVID, and some say access to legislative decision-making has actually improved for many. But keeping the State House closed to the public had become a symbol of the Legislature’s extreme caution during COVID.

– House Speaker Ron Mariano and Senate President Karen Spilka, whose chambers oversee the building, said they don’t regret their cautious approach to reopening. “I know people, myself included, are tired of COVID and all of the vaccine requirements, the mask requirements. People want to get on with their lives. They’re tired of it. They’re over it for many folks. But COVID is not over with Massachusetts or its residents,” Spilka said.

– Gov. Charlie Baker said the reopening is overdue. “Every other state building in the Commonwealth is open for business. I think this one should be open, too.” The governor also said he doesn’t think a vax mandate is necessary. Read more.

Mattapan trolley inquiry sought: Sen. Walter Timilty of Milton asks a Senate investigative committee to get answers on why the makeover of the Mattapan trolleys has been delayed for two years. MBTA officials say the discovery of lead paint on the trolleys and the onset of COVID are the chief causes. Read more.

OPINION

Shelter system falling short: Bill Miller and John Yazwinski, two prominent homeless shelter officials, say the state’s shelter system is falling short and needs a big infusion of money from the state. Read more.

 

FROM AROUND THE WEB

 

BEACON HILL

The State House exits of Lt. Gov Karyn Polito of Shrewsbury and long-time Worcester state Sen. Harriette Chandler will be a blow to the political clout of Central Massachusetts. (Boston University Statehouse Program)

The sports betting company DraftKings says 28 percent of Super Bowl bets made on its platform were from people with Massachusetts addresses. Gov. Charlie Baker and House Speaker Ron Mariano have been pushing the state Senate to vote on a bill legalizing sports betting. (MassLive)

Boston Herald columnist Joe Battenfeld says Gov. Charlie Baker was of no help in pressing to reopen the State House, and he rips the lame duck leader for deferring to legislative leaders and referring to the seat of state government as “their building.” 

MUNICIPAL MATTERS  

Boston Mayor Michelle Wu has raised more than $1 million, mostly from area power brokers, for her inaugural festivities, raising the perennial question of whether such donors will have undue influence over her actions in office. (Boston Globe

The husband and wife team of Bill Walczak and Meg Campbell say forget about an elected school committee and make the Boston Public Schools another city agency overseen by the mayor. (Dorchester Reporter)

Concerns are being raised in Amherst about a proposal to use $359,000 in funds raised via the Community Preservation Act to make improvements to two private homes. (Daily Hampshire Gazette)

HEALTH/HEALTH CARE

As the numbers of COVID-related hospitalizations drop, the state Department of Public Health reports that 56 percent of people in the hospital with COVID were actually hospitalized for other reasons and happened to test positive. (MassLive)

WASHINGTON/NATIONAL/INTERNATIONAL

Former president Donald Trump’s longtime accounting firm informed his company that a decade’s worth of Trump’s financial statements “should no longer be relied upon,” the latest development in a civil filing by New York’s attorney general alleging that Trump misstated the values of properties he owns. (Washington Post)  

ELECTIONS

After months of uncertainty, Massachusetts has finally set a date for this year’s state primary election – September 6 – a move that was tucked into a mid-year spending bill signed over the weekend by Gov. Charlie Baker. (Boston Globe

EDUCATION

There is lots of support for expanding the state’s early college program for high school students, but it’s unclear how much funding it will get to grow. (Boston Globe)

In the latest in a wave of university president retirements, Tufts University president Anthony Monaco announced he will retire in the summer of 2023, at which point he will have led the school for 12 years. (Boston Globe

TRANSPORTATION

Gov. Baker touts the new federal infrastructure bill while visiting the site of a new Quincy bus depot. (Patriot Ledger)

MEDIA

A federal judge said he will dismiss the libel lawsuit brought by former Alaska governor Sarah Palin against the New York Times, ruling she has not met the high bar of proving that the newspaper acted with malice in publishing an inaccurate editorial about her in 2017. (Washington Post) The judge made clear he disapproved of the way the Times editorial was handled.  “So I don’t mean to be misunderstood. I think this is an example of very unfortunate editorializing on the part of The Times,” he said. (NPR)

A Missouri prosecutor decided not to pursue charges against a reporter at the St. Louis Post-Dispatch who was targeted by Gov. Mike Parson for revealing a data flaw in a state website that left the Social Security numbers of 100,000 teachers vulnerable. The reporter, Josh Renaud, said he was relieved. “This was a political persecution of a journalist, plain and simple,” he said. (Kansas City Star)