The COVID-19 pandemic not only disrupted our daily lives, it showed us in stunning clarity the fragility of some of our most valuable and crucial social systems. One of those systems is community behavioral health care, and amid a growing wave of mental health needs, it’s more important than ever that we invest in its value as a care provider.

As we responded to the health and safety needs of our communities throughout the pandemic, nonprofit community behavioral health agencies provided frontline care to some of our most vulnerable citizens. Our ability to provide these services, ranging from mental health care to substance use treatment, also eases the burden on hospitals, law enforcement, and other members of the community safety net.

Unfortunately, the value of these services is not reflected in the resources that are allocated to support our organizations. As we face a pandemic-related mental health crisis, longstanding workforce shortages that have worsened in recent years have left us ill-prepared to handle the increased needs of clients and communities.

As leaders of two of the largest community behavioral health providers in our state, we know that we and other providers can’t overcome this burden alone.

Our message is urgent because we provide direct support to vulnerable community members, many of whom qualify for Medicaid. We are access points for housing, medical services, and trauma-informed care. Together with health care providers and first responders, we form a robust support system that de-escalates crises and removes barriers to care.

Making up the foundation of these services are our incredible employees, whose numbers exceed 700 in the Spokane area alone. Our staff is also reflective of our standing as valuable employers in the region, generating a significant impact on our local economies.

Frighteningly, we have reached a tipping point. Chronically inadequate Medicaid reimbursement rates have resulted in workforce shortages that we alone can’t repair. Despite allocating around 80 cents of every revenue dollar to salary and benefits for our staff, we are unable to provide competitive wages compared to private practices, large hospital systems, and even other state-funded health care providers.

This is a statewide issue. Across Washington, community behavioral health staff vacancy rates persist at 13%, and it takes an average of five months to fill certain open positions, according to a member survey by the Washington Council for Behavioral Health. At some agencies, vacancy rates among clinical staff positions exceed 25%.

At Frontier Behavioral Health, staff vacancies have resulted in swelling caseloads, placing significant additional stress on the dedicated employees who remain. At Comprehensive Healthcare in Central Washington, three school-based therapist positions have gone unfilled for nearly a year.

We and others call on stakeholders to make sustainable long-term funding of community behavioral health care a priority so that we can address the deep divide between our social and economic contributions and the resources we have available to provide adequate compensation to build a robust workforce.

Jeff Thomas is CEO at Frontier Behavioral Health, and Jodi Daly is CEO at Comprehensive Healthcare. Their respective agencies are members of Fourfront Contributor, an advocacy and leadership collective of four of the largest community behavioral health agencies in Washington state.

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