It’s no secret that children’s hospitals across the country are facing a staffing crisis in behavioral health care. The U.S. Department of Health and Human Services has estimated that by 2025, the nation will have 10,000 fewer mental health professionals than it needs. This shortage disproportionately affects children, as fewer than 4% of clinical psychologists are trained to care for children and adolescents.
Successfully addressing this need requires the best skills and traits health care providers collectively have to offer. But for Julie Swiderski and her colleagues, patience is not among those attributes.
“We’re the type of team that’s not going to wait for a solution to come to us,” says Swiderski, MBA, executive director of mental and behavioral health at Children’s Wisconsin in Milwaukee. “We’re going to create it ourselves.”
Behavioral health workforce strategies
What Children’s Wisconsin has created is a multi-faceted approach to meeting the growing need for behavioral health care for children and adolescents, including:
- Telehealth. As was the case with most care providers, the pandemic hastened the hospital’s reliance on virtual visits. But the hospital continues to invest in the technology—Swiderski says it’s especially helpful in recruiting because virtual providers can work from anywhere.
- Integration. Children’s Wisconsin has prioritized establishing a behavioral health care presence across its primary and specialty care locations, as well as in more than 65 area schools.
- Outpatient care. Dedicated walk-in clinics provide additional opportunities for children who need to access behavioral health services.
- Care coordination. The hospital has hired behavioral health care navigators to help ensure that patients receive the care they need—and to handle any other questions or concerns they may have around the process.
It’s all part of an aggressive strategy to fulfill the hospital’s mission by addressing untreated behavioral illnesses—Swiderski says Wisconsin children are four times more likely to be hospitalized with behavioral health conditions. To support this approach, Children’s Wisconsin is heavily focused on expanding the pipeline of providers.
“We have made very specific investments to help grow the workforce to support us as we embark on these plans,” Swiderski says. “We know we need the providers to get us there.”
Training up a behavioral health workforce
Those investments include a therapist fellowship program. Launched in 2019, the program enables providers who’ve completed their educational training to satisfy the clinical hours needed to achieve licensure while earning full-time pay with Children’s Wisconsin.
“For our therapist fellows to get these hours, they typically would have to work multiple jobs to sustain themselves—that’s not very easy to do,” says Jenny Walczak, Psy.D., clinical director for mental and behavioral health at Children’s Wisconsin. “We’ve made the commitment to training our fellows so we can help build that pipeline.”
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Since its inception, the hospital has served more than 3,000 children—nearly 23,000 sessions total—through the fellowship program.
Children’s Wisconsin also houses training for psychologists across multiple levels with practicum, residency and fellowship programs. It also continues to facilitate one of the nation’s first child and adolescent psychiatry fellowship programs. Established in 1965, it has trained more than 200 pediatric psychiatrists.
The long view: new behavioral health workforce takes time
Swiderski and Walczak credit strong support from the entire organization in funding and executing these efforts. And while their team knew they couldn’t afford to simply wait for solutions to materialize, they do acknowledge that it takes time to backfill the practitioner pipeline.
“This is a marathon and absolutely not a sprint,” Walczak says. “It has taken multiple years for us to grow all these different programs—it definitely did not happen overnight.”