Mental health workforce and needs assessment: A history and rationale

This presentation provides a history of mental health planning and rationale for up-to-date mental health workforce and needs assessment. The shrinking of state psychiatric facilities led to a shift in the burden of financing mental health services from state to federal sources. This shift undermined local planning authority and led to a growing level of unmet need for services in the community. A national perspective on the level of unmet need for mental health services across the U.S. is important to gain a better understanding of the scope and depth of this problem and strategies to overcome it. The goal of the studies presented here is to better assess national workforce counts, small area prevalence of individuals with SMI, and patterns of mental health service utilization. Currently, only regional workforce assessments are available. National counts of the variety of mental health providers are necessary to gain an understanding of location patterns and strategies for alleviating unmet need. New county-level estimates of the prevalence of SMI based on the recently released National Comorbidity Survey Replication (NCSR) and Census data reflect population growth across the U.S. Utilization patterns are derived from two current nationally representative surveys, the NCSR and the Medical Expenditure Panel Survey. Combining utilization data for individuals with and without SMI from these two surveys reflects the different levels of need among individuals with SMI and those without. These developments provide a new depth of information that not only identifies unmet need but also suggests strategies to address it.