NASW Secures Federal Government Study on the Social Work Workforce

NASW, together with Rep. Barbara Lee (D-CA), a social worker and chair of the Congressional Social Work Caucus, have secured a comprehensive government study to be conducted on the social work workforce.

The study was ordered through the Departments of Labor, Health and Human Services, and Education and Related Agencies Appropriations Bill, which was approved by the House Appropriations Committee on July 15. The report is to explore recruitment, retention, research, and reinvestment, and provide recommendations and strategies to ensure a sufficient and strong social work workforce.

Millions of Americans are not receiving the mental health, behavioral health, and social care services they need, and the COVID-19 pandemic has only increased the need for these services. Ensuring a strong and sufficient social work workforce is more important than ever to meet this moment. This urgently needed study is a key step in achieving that goal.

“Social workers provide services in the community across many different settings,” says Sarah Butts, MSW, NASW’s director of public policy. “It’s critical that we have workforce data about the profession, including the scope and contributions of social workers and that there is investment so that we can recruit and retain a highly skilled and diverse workforce.”

The study provision included in the just-passed Appropriations bill was previously included in the Dorothy I. Height and Whitney M. Young Jr. Social Work Reinvestment Act that Rep. Lee and other lawmakers introduced in prior Congresses.

Below is the text of the NASW-supported language that was included in the House Appropriations Committee report:

Social Work Reinvestment Commission — The Committee is aware that millions of Americans are not receiving the mental, behavioral, and social care services they need. The COVID-19 pandemic has increased the need for services. The nation’s 700,000 social workers are the largest provider of these services, so it is imperative that we ensure a robust social work workforce. As such, the Committee directs the Health Resources and Services Administration (HRSA) in collaboration with Substance Abuse and Mental Health Services Administration, the Administration for Children and Families, the Office of Minority Health, and the Centers for Medicare & Medicaid Services to conduct a study and to report to Congress and the Secretary on policy issues related to social work recruitment, retention, research, and reinvestment. Not later than 18 months after enactment of this Act, HRSA shall submit its findings and recommendations regarding recommendations and strategies to ensure a sufficient and strong social work workforce.

— Source: NASW

Study Finds Telehealth Helped Address Health Disparities During Pandemic

The Hispanic/Latinx community was the most engaged in telehealth for mental health visits in 2020—adopting the technology more than any other ethnic or racial group, according to a new analysis of Medicaid members in 14 states as part of an Anthem, Inc State of the Nation’s Mental Health special report during National Minority Mental Health Awareness Month.

Telehealth served as a silver lining during the pandemic and a strong alternative to seeing clinicians and counselors in person. Telehealth visits—either via video or phone—for people with existing mental health conditions significantly increased during the height of the pandemic. Visits that started in the single digits before COVID-19 accounted for 49% of all Medicaid mental health visits during a six-month period in 2020. Telehealth regulations that were lifted during COVID-19 have assisted in removing barriers people may have experienced in accessing telehealth.

Overall gaps in getting mental health care between races and ethnic groups remained essentially the same before and during COVID. A higher percentage of Hispanics/Latinxs were already receiving in-person or telehealth mental health visits before COVID-19. By greatly boosting the numbers of people using telehealth, COVID-19 may have jumpstarted broader adoption of telehealth for mental health conditions—especially with Hispanics/Latinxs. In fact, during COVID-19, almost 40% of Hispanic/Latinx members had a telehealth visit, while white members had 34%, Asian members had 33%, and Black members had 28%.

While telehealth did boost visits during COVID-19, it didn’t make up for the dramatic drop in in-person visits for all races and ethnic groups. And there were significant differences among them. In fact, Black people had the lowest percentage of combined telehealth and in-person visits (56%) before COVID-19 and remained the lowest with 49% after COVID-19.

On average, Black people had 7% fewer mental health visits compared with white people with similar demographic, clinical, and socio-economic backgrounds. The rates are particularly noteworthy, as surveys have indicated that people of color were experiencing more stress and mental health conditions than other populations in 2020 and people of color were disproportionately impacted by COVID-19.

“There are likely many reasons behind the differences in mental health care visits—including issues that prevent people from seeking care, such as medical injustices and a history of receiving culturally insensitive care,” says Anthem Chief Health Officer Shantanu Agrawal, MD. “Health equity is a key driver for mental and physical well-being. To achieve equity in our health care, we need to understand where and why barriers to health exist, and then couple these insights with the scale and scope of Anthem to drive changes to a new system of health that puts equity at the center.”

Historically, major depression and anxiety are underdiagnosed at rates of 32% to 40% less in Black and Hispanic/Latinx communities, according to the BCBS Health Index. The American Psychological Association says that lower diagnosis rates are likely driven by lack of provider understanding of cultural differences, stigma around diagnosis or treatment, and barriers getting care.

For Medicaid members with an existing mental health diagnosis, the most common telehealth diagnoses were anxiety, depression, and bipolar disorder, according to the special State of the Nation’s Mental Health report. High blood pressure was among the top five diagnoses for Black, Asian, and Hispanic/Latinx people, while high cholesterol was a top five medical diagnosis for Hispanic/Latinx and Asian people. Opioid use disorder was one of the top five diagnoses for white people, while severe back pain was a top diagnosis for Black people. These data reinforce that mental health and physical health are connected and improving one can help the other.

“While telehealth wasn’t a panacea in eliminating health equity gaps, it helped boost connectivity for all and made internet visits possible when COVID temporarily closed physical doors, allowing health care to continue to be delivered with some semblance of normalcy,” Agrawal says. “This study is a key reminder that technology alone won’t be sufficient to bridge this gap and the bridge may not be the same for all people. However, it may be the connector needed by certain communities or geographic areas. Clearly, outcomes during the pandemic would have been much worse without telehealth.”

Interestingly, members used telehealth and in-person mental health services similarly whether they lived in an urban or rural area.

Anthem will continue to evolve the following efforts to ensure that it can bridge the gaps for all people that take into consideration their specific needs. Some of these efforts include the following:

social drivers of health benefits that can assist in improving health equity for physical and mental health;
peer programs, such as those offered by Anthem and Beacon, may also help create trust by pairing members with someone who has the same lived experience;
education and informative efforts that involve connections to trusted sources, like churches and even barbershops, have been shown to have greater impact on community acceptance of health services; and
CME programs, such as mydiversepatients.com, that train clinicians about bias and cultures different from their own, and go a long way in creating stronger, more trusting, and culturally responsive relationships between clinicians and patients.

Anthem supports making permanent many of the telehealth policy changes that have occurred during COVID beyond the public health emergency. These include legislative and regulatory policies that do the following:

allow consumers to see doctors or clinicians from their homes;
allow providers with appropriate medical licensure to deliver services across state lines; and
eliminate pre–COVID-19 policies that placed prohibitions on prescribing medications via telehealth.

— Source: Anthem, Inc