Over the last six years, ensuring that children and families have access to behavioral health services has been a central public health priority for Georgia policymakers. While Georgia has made progress in that time, it remains that about 43 percent, or approximately two out of five children, were unable to access the mental health services they needed.

One of the most apparent barriers to accessing this care is the limited number of behavioral health providers practicing in the state. Forty-five counties in Georgia have neither a licensed psychologist nor a licensed social worker. Moreover, among practicing behavioral health professionals, levels of quality and cultural competency vary greatly, particularly among those practitioners accepting insurance – public and private. Voices for Georgia’s Children’s (Voices) 2017 Analysis of Georgia’s Child and Adolescent Behavioral Health Workforce found that a critical pain point for emerging behavioral health professionals, and possibly a major contributor to workforce shortages and turnover, is a lack of access to clinical supervision that effectively supplements their academic learnings, allows them to attain and maintain licensure, and assists them in translating theory into practice. Additionally, despite the known impact of providers’ cultural competency on the outcomes of their behavioral health clients, cultural competency training is not a standard requirement for acquiring or maintaining licensure in Georgia.

In order to identify potential solutions, Voices conducted key informant interviews with a diverse sample of behavioral health provider agencies to explore clinical supervision models and ways providers can support and retain emerging professionals through supervision and other related policies.

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None of the county is a shortage area

Part of the county is a shortage area

All of the county is a shortage area

Key Findings in Our Report

Through a series of interviews, Voices identified the following supporting factors for, and challenges to, providing quality clinical supervision and increasing provider cultural competency and employee retention:

  • Telesupervision, or clinical supervision through remote communication methods, is a helpful mechanism for increasing productivity and access to diverse supervisors, supporting cultural competency learning, and eliminating the burden on senior staff to provide clinical supervision.
  • Incentives such as loan repayment programs attract and retain employees; however, many agencies find it difficult to use established federal loan repayment programs.
  • Disincentives for leaving a position, such as repayment of the cost of supervision, also help to retain employees.
  • Incentives and supports for supervisors such as providing a small stipend, or reducing the productivity requirement helps compensate for the time taken from providing billable services.
  • Cultural competency training and requirements vary greatly across agencies, suggesting lack of a common, baseline proficiency across providers.

Together with the Georgia Department of Behavioral Health and Developmental Disabilities and Georgia State University’s Center for Excellence for Children’s Behavioral Health, Voices garnered the following from interviews with representatives from the University of South Carolina about the John H. Magill School Mental Health Certificate Program for budding school-based mental health providers:

  • University-pipeline programs that partner with a state’s behavioral health agency can increase the state’s access to students and recent graduates through coordinated internships and grow provider expertise in critical areas of need (e.g., child and adolescent services and SBMH).
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Next Steps Identified in Our Report

Voices suggests the following next steps for Georgia to increase access to quality supervision and retain more qualified, culturally competent, licensed behavioral health professionals.

  • Increase the use of loan repayment programs by behavioral health agencies and professionals.
  • Leverage telesupervision to increase workforce productivity and access to diverse supervisors.
  • Adopt a universal standard of cultural competency training and requirements.
  • Build on relationships with higher education institutions to improve the workforce pipeline from universities to employers.

Implementing these next steps could help increase access to high-quality clinical supervision opportunities, improve consistency in training, and encourage newly licensed providers to remain in this field in the state—all of which strengthen Georgia’s child and adolescent behavioral health workforce. Such an impact has the potential to increase access to needed services and ultimately improve child and adolescent behavioral health outcomes in the state.

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