As the need for mental health care in Washington far exceeds the state’s ability to provide it, a group of university leaders have a new strategy: to train students earning a bachelor’s degree in evidence-based speech therapy.

This move could quickly increase the number of providers available and ease the burden on those with more advanced training. It would also mark a big shift in Washington’s mindset about who can provide care for conditions like anxiety and depression.

Today, most mental health professionals in Washington must earn a master’s or doctorate – and undergo thousands of hours of supervision – before they are allowed to work with patients.

The idea of ​​undergraduate training, inspired by a similar program in the UK, may soon become a reality.

The University of Washington’s Department of Psychiatry and Behavioral Sciences received a $ 3.7 million grant from philanthropic group Ballmer in May to take the idea from a proof of concept to something scalable .

Within five years, authorities hope that at least 50 students will be certified and practice under the new title of “Behavioral Health Support Specialist”. (The Seattle Times Mental Health Project is funded by Ballmer Group. Our reports operate independently, and this program was brought to our attention in discussions with UW staff, without donor involvement.)

For years, the state has struggled to recruit, train and retain a diverse workforce in behavioral health. Additional degrees are expensive and can result in years of debt. The low salaries of some mental health professionals can put people off – and for those new to the field, they might not be able to afford to stay.

Getting students through a training pipeline faster and at lower cost could transform the ability of individuals to access care.

“We want to be really bold in our vision for this,” said Dr Anna Ratzliff, director of the UW Psychiatry Residency Training Program, who is developing the baccalaureate training program with her colleagues. “It is necessary and we are trying to build it as quickly as possible.”

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The finer details still need to be ironed out. Creating a new class of licensed healthcare workers may require changes in state law – something UW Medicine officials are trying to figure out over the next year or so. They will need to work with insurance companies to determine how these licensed professionals can bill for services. They are just beginning to collaborate with the social work and psychology departments at UW and other colleges and universities in the state. And they are aimed at vendors who could provide students with clinical training.

The concept is not an instant solution to the deep problems in the state’s behavioral health system, said Susan Skillman, senior associate director of the Center for Health Workforce Studies at UW. Many mental health professions at the master’s level are poorly paid. Washington mental health counselors and social workers earn an average of less than $ 52,000, while Metro bus drivers earn an average salary of $ 56,000, according to a 2017 analysis by Skillman and colleagues.

Adding a lower-skilled, lower-paid occupation would not solve salary-related retention issues unless “comparable attention is given to retaining the existing (more skilled) workforce at the same time. Skillman said.

The training program can help diversify the largely white mental health workforce; the time spent on obtaining a diploma and the cost of vocational training limit those with fewer resources to pursue training programs.

But the field should focus on bringing people with a wider range of life experiences and cultural backgrounds to all levels of the mental health field, Skillman said. Increasing scholarships for expensive master’s and doctoral programs, for example, could help.

“This is part of a really big spider’s web of trying to find ways to solve our problems by getting people who need behavioral health services to access those services,” he said. said Skillman. “More power for each of these potential solutions. But it will take each of these potential solutions.

Sessions with a baccalaureate-level provider would be an “entry point” for people in need of care, Ratzliff said, and a way to get more people into treatment early, before their symptoms wore off. worsen and need more intensive interventions.

But the diploma would probably have limits. Licensed providers would not be allowed to diagnose behavioral health problems, but could refer people with greater needs to social workers, psychologists or other more trained professionals.

And they couldn’t prescribe drugs. They would only provide talk therapy and would likely require some level of ongoing supervision from more highly trained professionals, Ratzliff said.

A version of the program is already underway at Eastern Washington University. There, the School of Psychology developed a 20-credit certificate program that allows students to learn and practice low-intensity interventions under supervision. Students learn to practice cognitive behavioral therapy and teach clients coping skills, among other things.

So far, five students have enrolled, but officials say they expect the program to grow, especially if the state formalizes a bachelor’s-level degree.

The university has gone ahead with the program because many medical offices currently rely on medical assistants and other staff to do this work now, said Kayleen Islam-Zwart, who chairs the School of Psychology. of the EWU. “The work is being done at a certain level by people who have never been trained to do it,” Islam-Zwart said; for example, a medical assistant may suggest coping strategies to an anxious patient.

“We want students to be ready to go as soon as the opportunity presents itself. And in the meantime, they can work in the jobs that are out there that just might not have the title that is exactly what we’re training them for. “

Ratzliff and his colleagues at UW Medicine collaborate with EWU. The UW team began piloting the concept about four years ago by developing a curriculum and teaching a class of undergraduate students; preliminary data from a small study suggests that these students may offer basic treatment for mild and moderate depression. The team is now creating resources that could facilitate the adoption by other colleges and universities of similar training programs.

For now, they focus their curriculum on caring for adults with common disorders such as anxiety, depression, and substance use disorders. But they can eventually expand the training to include therapy for children.

“We need these kinds of ideas to really make a difference for access to effective treatment in Washington,” said Ratzliff.

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