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April 01, 2017 01:00 AM

Guest Commentary: Interprofessional education can help close the gap in behavioral health workforce

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

    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 primary-care 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.

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