OCBH director outlines the effects of capacity and workforce shortages on behavioral health providers

Oregon’s behavioral health system is struggling with capacity, workforce, and access concerns, according to Heather Jefferis, executive director of the Oregon Council for Behavioral Health (OCBH). While overdose deaths are continuously rising in Oregon, she says, behavioral health providers continue to lose qualified employees, which creates capacity difficulties. 

 

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A June 2021 report from OCBH says:

“The impacts of COVID and a longstanding under-operationalized system leave out membership in a workforce exodus. Left unaddressed, this catastrophe will impact access and population health outcomes for years to come.”

According to Jefferis, Oregon continuously lies within the bottom ten of states for the number of residents in need of substance use disorder (SUD) care. She says this is due to a lack of access to behavioral health services in the state, which is the result of limited services and workforce to treat those with SUD. She says:

“Because we have reduced capacity, it means there’s less places for people to go. So people are lingering — [like you see in hospitals] — at home and not seeking help as soon as they used to before COVID. Their health is actually greatly diminished compared to where people would ask for help before COVID.”

Capacity at mental health and SUD congregate facilities has decreased significantly. The image below shows the number of their full capacity and licensed number of beds, and their actual capacity with the number of functional beds — not occupied beds — as of Aug. 30.

 

Image: Oregon Council for Behavioral Health

 

According to the report, behavioral health facilities are suffering between a 37-75% reduction of their workforce capacity compared to their pre-COVID numbers.

Jefferis says lost capacity is exacerbated by the workforce shortage and inability to maintain and hire employees. She says the main reason workers are exiting the field is increased wage competition amongst providers and the stress and burnout from the hardships of the work itself. 

The report says 50% of employees who leave are heading to jobs in the same career but with a higher-paying competitor. Higher-paying competitors include hospitals, private telehealth companies, and travel positions.

This increased competition for higher wages has led to many behavioral health providers raising their employee’s wages. The image below shows the survey results for the question, “Have you had to increase wages to obtain applications and/or retain staff? Can you project supporting the new wage structures with a balanced budget in the next cycle?” These responses were from members of OCBH.

 

Image: Oregon Council for Behavioral Health

 

Jefferis says providers have also instituted bonuses, provided mental and behavioral health services to staff, given appropriate personal protective equipment (PPE), flexible scheduling, onsite snacks, and more to keep their employees content and supported.  

These measures are also in place to relieve stress that staff face daily. Jefferis says their stress comes from capacity concerns as they are being forced to deal with more patients than they can handle. 

With the demand greater than the supply, they are often overworked, she says. Providers are trying their best to maintain a healthy and supportive work environment. 

“We are just trying to create and foster a caring and positive employee environment. That is something we do have some skills at, and people are really working hard to reduce stress as much as we can.”