New Report Release September 2024

Workforce shortages in New Hampshire’s behavioral healthcare sector have reached alarming levels and have stayed at these levels for nearly a decade. Despite heroic efforts from leaders from all sectors, many individuals in NH who are in clear need of behavioral health support, are not getting sufficient help. There are many ‘bright spots’ in NH’s quest to improve support for behavioral health statewide. 

All efforts have been significantly constrained by shortages of qualified staff.

In July 2024, the NH Behavioral Health Workforce Center at Dartmouth Health, the Community Behavioral Health Association, and HealthForce NH co-hosted the NH Behavioral Health Solution Session. Over 100 senior leaders representing diverse perspectives from multiple government agencies, healthcare providers, academic institutions, law enforcement and justice, philanthropy, public health, peer support, workforce development, employment security, staff licensure, and community organizations came together in Plymouth. 

The goal of the day was to be clear eyed about the state of the workforce and to get to work on solving it differently. This resulting report highlights the findings from the solution session alongside learnings from the NH Behavioral Health Workforce Center at Dartmouth Health and provides a shared path forward.

Part 1 – Prepare a BH labor market that has the gravitational pull to attract and retain highly skilled and qualified BH staff.

· Begin with our strengths and assets both as a state and as a behavioral health system of care.

· Collectively promote NH as the best place to train and work in behavioral healthcare.

· Do the hard work to correct our weaknesses. Right now, it is counter to an individual’s economic self-interest to work in a behavioral health career in NH. There is detailed, difficult change work at all levels to correct the fundamentals of revenue and wages and over complexity. This requires finding our shared interests and collaborating to solve each constraint.

Part 2 – Find, attract, prepare, and retain workforce

· Help colleges and universities attract and prepare candidates for NH BH positions

· Help BH Organizations attract and support Peer Paraprofessionals, people in recovery from mental illness and/or substance misuse, and individuals with criminal records as valued members of their teams

· Help BH clinicians return to service from private practice

· Encourage inbound migration of BH workforce / discourage outbound migration

· Utilize telehealth to gain access to more BH staff

· Utilize gig workers for some BH care

· Reduce BH demand by sharing the load with communities and technology

The NH Behavioral Health workforce is in crisis! All of the easy solutions have been tried and exhausted. The remaining work is nuanced, complex, and challenging. There are pathways out of the crisis and all of them require valuing behavioral healthcare as a society and sharing the mission to shore up NH’s systems of care. This is shared work requiring leadership from the federal and state governments, from across the entire healthcare value chain, from our partners in philanthropy and advocacy, and from those who educate and engage the public. It is in all of our shared interest to go to work on these actions together and to keep everyone engaged in collaborative problem solving and celebrating progress. The simplest indicators of success will be number of individuals hired into the NH behavioral health labor pool as a whole and the number of staff retained.