Taslim van Hattum, MPH, LCSW
Chief Program Officer
When we talk about the shortage of behavioral health professionals, we often begin with how to recruit more people into the field. How do we start educating young people about career pathways early? Education and recruitment are critical. And in behavioral health, and specifically social work, we also need to ask:
What happens after people decide to enter the profession?
What keeps them there or forces them to leave?
What supports their skills, professional satisfaction and growth?
What allows them to practice in some of our most rural and at-need communities?
In Louisiana, the path from becoming a social worker to practicing clinical social work can be long, complicated and expensive. People graduate from social work programs with significant steps still ahead before they can fully practice as licensed professionals. They must navigate master’s-level examinations, applications, credentialing, CEUs, supervision, employment and, ultimately, clinical licensure. These requirements play an important role in ensuring high-quality care delivered by well-trained clinicians versed in evidence-based practices. At the same time, the process can create unanticipated barriers that interrupt a career before it has even begun.
Not achieving licensure can limit where social workers can work, who will hire them, how and where they can bill for services, what types of evidence-based treatments they can provide and their long-term economic opportunities.
Overwhelming Need for an Expanded Workforce
The behavioral health workforce crisis is both a healthcare crisis and a community crisis. Demand for behavioral health services continues to grow while the workforce available to meet that demand is shrinking. Organizations are struggling with recruitment and retention, provider burnout and unsustainable payment approaches. Individuals and families experience these workforce shortage consequences through long waiting lists, difficulty finding clinicians and increasingly complex systems of care.
Louisiana has particular challenges. The Louisiana Department of Health estimates that only 26% of the state’s mental health needs are being met. With this level of unmet need, we cannot afford to lose people along the pathway to providing critically needed services. Social workers are especially important to closing this gap. Across community-based and outpatient settings, they are one of the largest clinician groups in Louisiana and provide approximately 40% of behavioral health treatment, particularly in roles that combine therapy, care navigation and support for social needs. That makes the pathway into social work practice a critical workforce strategy for the health of Louisiana’s communities.
Supporting Social Work Pathways
We need to make it easier for people who have already chosen the social work profession to move from education into practice, licensure and sustainable careers. That means addressing the financial and logistical barriers that can make the first steps after graduation difficult, particularly for first-generation graduates, HBCU graduates, people from lower-income backgrounds and graduates who want to remain in Louisiana and return to rural communities to practice. Exam fees, applications, background checks, preparation materials and delays associated with testing and board approval can collectively create significant barriers.
The workforce pipeline also needs to begin before licensure is complete. Master’s-level clinical social workers need sustainable opportunities to complete their clinical requirements in community settings, particularly in local governing entities, community health centers, rural health clinics and other organizations serving communities with significant behavioral health needs. When practicum experiences are intentionally connected to supervision and employment, they can become pathways into long-term careers rather than temporary placements.
And the pathway does not end with licensure.
Some clinicians will move from public or community-based practice into private practice because of flexibility, financial considerations or the populations they want to serve. We cannot always prevent that movement, nor should we necessarily try to. Our workforce strategy should account for it while protecting access for people who rely on safety-net services. Supporting clinicians through credentialing and Medicaid paneling can help maintain continuity of care as their practice settings change.
The good news is that Louisiana does not need to start from scratch. We have universities educating future practitioners, clinical providers and community-based organizations delivering care, and professionals committed to serving Louisiana communities. The opportunity is to connect these pieces into a stronger workforce pathway.
If we want to expand Louisiana’s behavioral health workforce, we have to think beyond recruitment. We need a continuum that helps people move from early career awareness to education, from education to employment, from employment to licensure, and from licensure to sustainable practice, professional growth and leadership.
That is how we build a behavioral health workforce prepared to meet the needs of Louisiana’s communities, now and in the future.