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ABH Report Shows Worsening Crisis in Children's Behavioral Health Services

January 2, 2024

The Association for Behavioral Healthcare (ABH) released a report on the behavioral health workforce shortage crisis in Massachusetts and its impact on children and youth's access to vital mental health services and resources.


The newest survey by ABH of 30 behavioral services providers in Massachusetts show a growing crisis of staffing shortages that severely impact access to, the quality of, and the delivery system of behavioral health services for children and youth. ABH is a statewide organization of 81 community-based mental health and substance use disorder treatment provider organizations. ABH members deliver a wide range of behavioral health services for children and youth known collectively as the Children’s Behavioral Health Initiative (CBHI). In the survey, 208 program sites were represented across Massachusetts and 15,540 children and adolescents were served by ABH members surveyed from July 2022 to May 2023.

The Findings:

ABH found that over the last year, providers reported worsening difficulty in recruiting and retaining staff due to inadequate compensation and benefits. This has resulted in large waitlists, leaving many children and youth without access to critical care services. For example, the number of children waiting for services increased by 41% and there was a 35% total staffing vacancy rate across services. Further, financing and workforce pressures are forcing program closures and the number of children losing access continues to grow drastically.

ABH's Recommendations:

ABH's report shares solution-oriented recommendations, including:

  • Immediate actions that can be taken to increase access, which include increasing funding, investing in outpatient services and developing programming that is culturally, ethnically, and linguistically diverse.
  • Continued investment in education and training opportunities that reinforce the behavioral health pipeline and creation of a permanent workforce center, staffed by experts, to address behavioral health workforce issues through long-term planning.
  • Improve access for children with private health coverage by requiring insurance companies to indicate on member cards whether the health plan is subject to state mandated benefit laws, and to examine cost-sharing requirements to consider whether cost sharing can be eliminated or mitigated.
  • Rebalance health care spending toward behavioral health and primary care to address chronic and persistent underfunding of these vital services.

CLM's Take:

We thank our partner ABH for conducting such an important and thorough review of our state's diminishing behavioral health workforce, and its impact on vulnerable children and youth's access to critical services. CLM is working with ABH and other partners to address these issues through systems change advocacy and the passage of key legislation.

Key workforce bills on CLM's policy agenda in line with ABH's recommendations:

  • An Act establishing a behavioral health workforce center of excellence (S.829 / H.1275)
    • This bill establishes a behavioral health workforce center of excellence to assess the behavioral health workforce on longitudinal basis and recommend strategies to meet needs; gather data/research to advise policy leaders on how to address the crisis in the behavioral health workforce across the Commonwealth; and be established at one of the public institutions of higher education in Massachusetts. This bill is led by ABH.
    • Read CLM's Testimony
  • An Act establishing a loan repayment program for direct care human service workers (S.77 / H.214)
    • This bill would create an education loan repayment program for eligible human service workers who provide essential services to one-in-ten state residents, thereby also supporting human service organizations to recruit and retain a stronger, more qualified workforce.
    • Read CLM's Testimony
    • Fact Sheet
  • An act relative to livable wage for human services workers (S.84 / H.191)
    • This bill would eliminate the pay disparity that exists between the salaries of human services workers employed by community-based human service providers and state employees holding similar job titles who perform similar work.
    • Read CLM's Testimony
    • Fact Sheet

**View ABH's Report below and click here to read the executive summary of the report.**


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