Background: Gaps and needs surveys assist state behavioral health officials in identifying service strengths and flaws to implement evidence-based practices (EBPs) effectively. However, EBPs require comprehensive data on community needs, resource availability, and workforce capacity, particularly in Louisiana’s rural areas. To address these challenges, the LSU Center for Evidence to Practice, in collaboration with the Louisiana Department of Health, conducted a survey assessing workforce gaps and needs of Medicaid-serving providers and populations.

Methods: First, 2023 Medicaid claims data were analyzed to examine diagnoses, services, and geographic distribution. Next, a statewide Behavioral Health Gaps & Needs Survey based on a convenience sample of 431 behavioral health providers and agency representatives investigated workforce strengths, service challenges, and barriers to EBP implementation. Lastly, three focus groups comprising agency leadership and frontline staff interpreted survey findings and explored EBP implementation challenges.

Results: Findings revealed significant challenges in providing EBPs to the community, including workforce shortages, lack of funding, and administrative burdens related to Medicaid reimbursement. Despite these challenges, providers reported low burnout and high personal accomplishment levels. Focus groups further explained potential EBP implementation challenges including need for greater accuracy in referrals and service-matching, workforce retention, and EBP certification. Focus group participants also identified top barriers to EBP implementation, which included clinical supervision, funding stability, lack of staff diversity, and availability of training programs. Notably, increased utilization of telehealth emerged as a solution to many challenges with Medicaid billing hindering EBP delivery.

Conclusions: Louisiana’s behavioral health challenges require systemic improvements in workforce development, compensation, and EBP adoption to ensure accessible, high-quality care. With Louisiana nationally ranked 37^th in mental health resources and 38^th in service availability, efforts to remove structural barriers, streamline Medicaid processes, and invest in sustainable workforce solutions are vital to improve population health. High provider passion for delivering mental health services highlights the need to continue to support provider efforts to serve the community by expanding training initiatives and leveraging telehealth services to build a more resilient behavioral health system to meet evolving community and workforce needs.