Chapter 11: Future Opportunities

Chapter Overview

This chapter describes future work in progress to help with meeting the broad mental and behavioral health needs of the general population.

Use the links below to jump to a particular section:

Current Scope of BHSS Workforce Development Project
Supervisor Training & Development
Child & Youth Curriculum
BHSS Specializations
Registered Apprenticeships

Current Scope of BHSS Clinical Training Program

The BHSS Clinical Training Program, through generous support of Ballmer Group, was funded to develop competencies, learning objectives, materials, and curriculum to prepare a BHSS for work with general adult populations (See Chapter 1. Program Description for an overview on project funding and development). Additional philanthropic and/or public funding may be needed to expand learning opportunities over time. All sectors of behavioral health are important, and it is natural for certain sectors experiencing behavioral health workforce shortages to desire an emphasis on their sector regarding BHSS preparation. We ask community partners to remember a BHSS is a bachelor-level prepared practitioner and calls for specialized service with highly compromised and vulnerable populations will take time to develop.

Future BHSS Opportunities

Supervisor Training and Development

Challenge

During the 2022 BHSS focus group meetings, community partners emphasized the importance of supervisor training and development for a new behavioral health workforce role in Washington state. Several focus group members indicated concern over a perceived statewide supervisor workforce shortage. Currently, Washington State DOH does not maintain a database that would help quantify the ratio of approved supervisors to current associates. One would suspect, given the broad behavioral health workforce shortage, that a concurrent supervisor shortage likely exists. HB 1724 requires DOH to create a database of approved supervisors that will help match supervisor and master’s level associates. This information may be helpful in the future to identify available supervisors for students enrolled in BHSS programs.

Response

The BHSS Project Team is in the process of identifying alternate philanthropic sources for supervisor training and education to help boost available supervisors for both master’s- and baccalaureate-level providers.

Child and Youth Curriculum

Challenge

Ballmer Group funded the BHSS Clinical Training Program to create a curriculum for adult behavioral healthcare. Several child and youth advocacy groups have expressed concern to the BHSS Project Team that the new credential may not help alleviate the workforce shortage in child behavioral health.

Response for Child Behavioral Health

As of Version 1 of this Implementation Guide, our project team is consulting with subject matter experts in child and adolescent behavioral health. Based on our discussions, we currently recommend that persons interested in delivering child and family interventions pursue one or both of the following pathways: (a) a four-year bachelor’s program designed specifically for the child and family population, such as the University of Oregon’s Bachelor’s in Child Behavioral Health or (b) a master’s degree dedicated to applied skills in child and family work, such as the University of Washington Applied Child & Adolescent Psychology Program. The aforementioned UW master’s program can be completed in 15 months, which is significantly less time than most graduate programs in behavioral health, which typically range from 24-36 months in duration. We believe the examples of options above are best for academic preparation due to the complexity of care (knowledge of child intervention and family systems), and legal, ethical, and professional issues in delivering child and family behavioral health care. For persons with graduate education, there are graduate licensure options in Washington state. For people with a bachelor’s degree (like the degree offered by the University of Oregon), there may be an opportunity to explore, with DOH, BHSS credentialing with a child, youth, and family specialization.

Response for Adolescent Behavioral Health

While child and adolescent behavioral health are not easily separated, Washington state does allow people aged 13 and older to make some independent decisions regarding their medical and behavioral health needs. The BHSS Project Team is exploring, with subject matter experts, options for creating an adolescent and young adult curriculum that may be offered as an elective by participating institutions or as continuing education. The patient population age range for this curriculum would be 13-25 years. Given the broad concern with adolescent behavioral health at the national level, it makes sense to consider options to expand the BHSS’ scope to help alleviate problems when possible. There are specific concerns in integrated care regarding separating child and adolescent behavioral health. In most pediatric environments, a behavioral health consultant would need to be able to deliver care across the 5-17 age range. We believe that people trained across the developmental spectrum in programs such as those mentioned above are the best candidates for clinical positions, in addition to other graduate programs with a focus on children and youth.

BHSS Specializations

Challenge

Some clinical directors in specialty mental health services have expressed concern that the BHSS intervention competencies do not include a focus on persons with severe and persistent mental illness. As an example, some specialty mental health employers would prefer that a BHSS be skilled in delivering brief treatment for psychosis.

Response

At present, the BHSS Project Team is focused on successful integration of the BHSS competencies into existing four-year degree programs. In doing so, we want to be prudent regarding the number of competencies we are asking educational partners to teach and assess. It is the project team’s belief that the initial launch of the BHSS workforce role should prepare a workforce with generalist skills to work across the adult spectrum of care.

As part of a systematic evaluation of workforce impact, we will collect data that helps us understand the needs of the workplace in relationship to the preparation of the BHSS. Based on data analysis, our project team will make recommendations to educational partners on knowledge, skill, and attitude development related to special populations. In the meantime, continuing education opportunities may be the appropriate vehicle for teaching skills to work with special populations. Additionally, some educational partners may offer training for special populations within their existing programs.

Registered Apprenticeships

Challenge

During focus group feedback sessions in 2022, some participants raised concerns over the lack of options in educational pathways for a BHSS.

Response

SSB 5189 allows for a registered apprenticeship to be combined with a bachelor’s degree as a possible pathway for a BHSS. This is an innovative approach that will involve collaboration between DOH, the Department of Labor and Industry, the SEIU Training Fund, a sponsoring academic institution, sites that will host BHSS apprenticeships, and the BHSS Project Team. As of V1 of this Implementation Guide, this is under development. Higher education institutions interested in developing a registered apprenticeship option for students may contact Leigh Christopherson with the SEIU Training Fund at lchristopherson@healthcareerfund.org or contact the BHSS Clinical Training Program at bhsswa@uw.edu.

Summary

• Based on funding by Ballmer Group, the current scope of the BHSS Clinical Training Program is to prepare a BHSS for working with general adult populations.
• The BHSS Project Team has identified future areas to expand the scope of the BHSS Clinical Training Program; these opportunities will depend on available funding and will take time to develop.
• There are likely other considerations or challenges related to expanding the scope of the BHSS Clinical Training Program that have not yet been addressed. The BHSS Project Team will listen to these issues over the next academic year and address concerns in V2 of this Implementation Guide.