sumers, families, advocates, and public and private providers about the ‘workforce crisis’ in mental health care. Today, not only is there a shortage of providers, but those providers who are available are not trained in evidenced-based and other innovative practices. This lack of education, training, or supervision leads to a workforce that is ill-equipped to use the latest breakthroughs in modern medicine” (p. 70). The commission further states that the mental health field needs “a comprehensive strategic plan to improve workforce recruitment, retention, diversity, and skills training” and calls on DHHS to “initiate and coordinate a public-private partnership to undertake such a strategy” (p. 75).

2004. The Annapolis Coalition on Behavioral Health Workforce Education convenes a national meeting that generates 10 consensus recommendations to guide the development of M/SU health care workforce competencies (Hoge et al., 2005a).

2005. SAMHSA contracts with the Annapolis Coalition on the Behavioral Health Workforce to develop a national strategic plan on workforce development by December 2005.


Some changes have taken place as result of the initiatives described above. In general, however, M/SU health care professionals are trained the way they have been for many years, and problems such as maldistribution and the lack of representation of minorities in the workforce have improved only slightly, if at all. Despite significant efforts, attempts to train non-psychiatric physicians to do a better job of caring for people with M/SU problems and illnesses have not been particularly effective. Broader efforts to bring about similar changes in the M/SU treatment workforce overall have had similar results.

The committee finds, as others have before, that without a properly trained, culturally relevant, and appropriately distributed M/SU health care workforce, significant improvements in the quality of care are not likely. The committee further finds that the problems that attenuate the effectiveness of the M/SU health workforce in America are so complex that they require an ongoing, priority commitment of attention and resources, as opposed to the short-term, ad hoc initiatives that have often characterized responses to the problem in the past. As noted above, the committee recommends that the approach used to educate and train other key providers (physicians and nurses) in the health care workforce, as described below, be employed to marshal the sustained attention, collaboration, and resources needed to produce a stronger M/SU health care workforce.

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