San Diego behavioral health workforce faces significant shortages and lower wages than other regions


Soraya Marashi


According to a behavioral health workforce report recently published by the San Diego Workforce Partnership, the region’s current demand for behavioral health services significantly outpaces its workforce.


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The report states that San Diego’s regional behavioral health system currently employs about 17,000 professionals in 11 high priority occupations, including community health workers, psychiatrists, mental health and substance use social workers, psychologists, marriage and family therapists, and more. It estimates that 25,000 professionals are needed to meet the regional demand for services, making the current workforce about 8,000 professionals short.

The report notes that approximately 7,500 behavioral health professionals are expected to leave the workforce by 2027, and that the San Diego region needs to employ and retain about 18,500 behavioral health professionals between 2022 and 2027.

The table below shows the number of behavioral health workers available compared to the estimated regional need between 2022 and 2027.


Image: San Diego Workforce Partnership


The report also includes recommendations to help build up the behavioral health workforce in the San Diego region, which are detailed below.


Invest in competitive compensation


Out of all the behavioral health workers who responded to the survey, 55% said they were dissatisfied with their compensation over all 34 job quality features they were asked about.

“Behavioral health workers in San Diego are significantly underpaid compared to their other peers in California [Metropolitan Statistical Areas (MSAs)]. In all 10 occupations, wages in San Diego County are lower than those in the median MSA (adjusted for cost of living). In 6 of the 10, wages are in the bottom 20%.”

The report also notes that compensation for workers in the San Diego public behavioral health system is significantly lower than the compensation of workers in other health care and social service settings, as well as that of local workers in non-health care fields.


Decrease administrative burden for behavioral health providers


Of all workers who responded to the survey, 39% said they were either dissatisfied or completely dissatisfied with the paperwork and administrative requirements of their jobs. The report recommends establishing a task force to develop solutions to reduce these administrative burdens for behavioral health professionals. 

“Qualitative data from focus groups with frontline staff working in public behavioral health settings described documentation as ‘impossible,’ and ‘unsustainable,’ and monitoring as ‘merciless,’ ‘brutal,’ and ‘incredibly demoralizing,’” the report reads.


Create Regional Behavioral Health Training Centers of Excellence (COEs) to develop and host training programs for behavioral health professionals


The report recommends that the County of San Diego establish partnerships with educational institutions, community based organizations that deliver behavioral health services, health systems, and the San Diego Workforce Partnership to design training programs, develop financial models, and establish key performance indicators for these COEs. 

“Behavioral health training and education programs have identified the lack of quality training sites as one of the primary obstacles to increasing the number of students and graduates in their programs,” the report reads. “A shortage of structured, paid, quality internship and supervision slots are limiting the region’s ability to produce the number and diversity of professionals the region needs.”


Establish a regional behavioral health workforce training fund


The report estimates that about $425 million in additional gradual investments in the behavioral health workforce training and education pipeline is necessary to meet workforce needs, with an initial $128 million down payment to establish key infrastructure and programs. 

The table below details this proposed $128 million behavioral health education and training investment.


Image: San Diego Workforce Partnership


Continue gathering feedback from workers


The report recommends regularly surveying behavioral health workers in the region, monitoring performance of all workforce investments and initiatives, and “… regularly report[ing] back to the local community of practice on findings and insights that can inform job quality investments for BH workers at all levels.” 

The report also recommends continuing to leverage elected and executive leadership support to address behavioral health workforce challenges and develop solutions, as well as establishing an engaged advisory committee of educational and behavioral health leaders.