Wenzel: Long-term care, mental health staff needed

As the number of older adults increases, so does the demand for behavioral health services, case management, peer support and skilled nursing. However, the workforce needed to meet that demand is not keeping up.”

Marie Wenzel is the CEO of Delaware’s branch of the National Alliance on Mental Health.

Delaware is in the midst of a workforce crisis that is putting our most vulnerable residents at risk. Older adults who want to age in place, people struggling with behavioral health challenges and families trying to care for loved ones are all facing a harsh reality: There simply are not enough trained professionals to meet their needs.

As the number of older adults increases, so does the demand for behavioral health services, case management, peer support and skilled nursing. However, the workforce needed to meet that demand is not keeping up.

Today, more than 289,000 Delawareans live in areas where mental health care professionals are in shortage, accounting for more than a quarter of our state’s population. At the same time, national workforce projections show significant shortfalls in key behavioral health and long-term care professions. By 2037, the U.S. will face shortages of more than 87,000 mental health counselors, 113,000 addiction counselors and tens of thousands more psychologists, therapists and support staff (bhw.hrsa.gov).

Behavioral health providers alone are not enough. We also need more skilled nursing employees — including home health aides, personal care aides, nursing assistants and psychiatric aides — to support individuals aging in place or living with serious mental health or long-term care needs. National data projects that the need for long-term services and support professionals will grow by 42% between 2021-36. Demand for direct care workers, such as personal care aides and psychiatric aides, is expected to grow by 38%-135% over that period (dhss.delaware.gov).

For Delaware, these trends are especially concerning. Our over-60 population is roughly 290,180 individuals and is expected to grow dramatically in the coming decades (dhss.delaware.gov). Without a concerted effort to expand our care workforce, many residents could face long waits, limited services or forced institutional care, simply because no one is available to assist them at home.

To effectively respond, we must adopt an intersectional, collaborative strategy. Agencies and stakeholders — including behavioral health providers, Medicaid, the Delaware Division of Substance Abuse and Mental Health, the Delaware Division of Services for Aging and Adults With Physical Disabilities, and the Delaware State Housing Authority — should come together to pool resources, align programs and expand access to services statewide.

Specifically, we must:

• Immediately increase the reimbursement rates to community-based behavioral health providers.
• Invest in training, certification and retention for behavioral health professionals and skilled nursing caregivers.
• Provide incentives, including competitive pay and benefits, to attract providers to underserved areas and populations.
• Expand access to community-based long-term care, peer support and integrated care models that combine behavioral health, medical needs and housing support.

Delaware has long stood as a state that cares for its people. To keep that promise for the future and guarantee that older adults, individuals with mental health needs and residents living with disabilities have the support they deserve, we must act now. Strengthening our workforce is not just about filling jobs; it is about preserving dignity, independence and hope for thousands of Delawareans and their families.

Reader reactions, pro or con, are welcomed at civiltalk@iniusa.org.