Abstract
Changes in health care have outpaced changes in the educational programs offered to the behavioral health workforce. The result is a training gap that leaves graduate students, working professionals, and other direct care providers inadequately prepared for practice in the current health care environment. This article is based on a keynote address delivered at the Annapolis Conference on Behavioral Health Workforce Education and Training. Major changes in health care are reviewed, followed by a description of the training gap as an acute crisis that impedes the delivery of effective and efficient mental health and addiction services. The author describes a national initiative to narrow the training gap and he calls for collective action by the varied groups and organizations that have a stake in this agenda.
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REFERENCES
Adams, N. & Daniels, A.S. (2002). Sometimes a great notion ... A common agenda for change. Administration and Policy in Mental Health, 29(4/5), 319–324.
Amenson, C.S. & Liberman, R.P. (2001). Dissemination of educational classes for families of adults with schizophrenia. Psychiatric Services, 52, 589–592.
American College of Mental Health Administration. (1998). Preserving quality and value in the managed care equation: Final report of Santa Fe Summit 1997. (J. Morris, Ed.). Pittsburgh, PA: Author.
Burland, J.C. (1995). NAMI provider education course: 10 classes in mental illness education. Arlington, VA: National Alliance for the Mentally Ill.
Burland, J.C. (1998). NAMI family-to-family education program: A 12-week series of classes for families of individuals with mental illness (2nd ed.). Arlington, VA: National Alliance for the Mentally Ill.
Busch, A.B., & Shore, M.F. (2000). Seclusion and restraint: A review of recent literature. Harvard Review of Psychiatry, 8, 261–270.
Christakis, N.A. (1995). The similarity and frequency of proposals to reform U.S. medical education: Constant concerns. Journal of the American Medical Association, 274, 706–711.
Daniels, A.S., & Stukenberg, K.W. (2001). Assessing quality of care. In L.J. Kiser, P.M. Lefkovitz, & L.L. Kennedy (Eds.). The integrated behavioral health continuum: Theory and practice (pp. 257–268). Washington, DC: American Psychiatric Publishing.
Daniels, A.S., & Walter, D. (2002). Current issues in continuing education for contemporary behavioral health practice. Administration and Policy in Mental Health, 29(4/5), 359–376.
Davis, D.A., O'Brien, M.A., Freemantle, N., Wolf, F.M., Mazmanian, P., & Taylor-Vaisey, A. (1999). Impact of formal continuing medical education: Do conferences, workshops, rounds, and other traditional continuing education activities change physician behavior or health care outcomes? Journal of the American Medical Association. 282, 867–874.
Drake, R., Essock, S., Shaner, A., Carey, K., Minkoff, K., Kola, L., Lynde, D., Osher, F., Clark, R., & Rickards, L. (2001). Implementing dual diagnosis services for clients with severe mental illness. Psychiatric Services, 52, 469–476.
Drake, R.E., Goldman, H.H., Leff, H.S., Lehman, A.F., Dixon, L., Mueser, K.T., & Torrey, W.C. (2001). Implementing evidence-based practices in routine mental health service settings. Psychiatric Services, 52, 179–182.
Enarson, C., & Burg, F.D. (1992). An overview of reform initiatives in medical education: 1906 through 1992. Journal of the American Medical Association, 268, 1141–1143.
Feldman, S. (1978). Promises promises or community mental health services and training: Ships that pass in the night. Community Mental Health Journal, 14, 83–91.
Flexner, A. (1910). Medical education in the United States and Canada: A report to the Carnegie Foundation for the Advancement of Teaching. Washington, DC: Science and Health Publications.
Fox, A. (2000). MBHO/EAP enrollment reaches 220 million in 2000. Open Minds, 12, 7–8.
Glazer, W. (1998). Defining best practices: A prescription for greater autonomy. Psychiatric Services, 49, 1013, 1016.
Hay Group (1999). Health care plan design and cost trends-1988 through 1998. Arlington, VA: Author.
Himelein, M.J., & Putnam, E.A. (2001). Work activities of academic clinical psychologists: Do they practice what they teach? Professional Psychology: Research and Practice, 32, 537–542.
Hoge, M.A., Jacobs, S., Belitsky, R., & Migdole, S. (2002). Graduate education and training for contemporary behavioral health practice. Administration and Policy in Mental Health, 29(4/5), 335–357.
Huey, L. (2002). Problems in behavioral health care: How can we catalyze change? Administration and Policy in Mental Health, 29(4/5), 403–419.
Institute of Medicine, Committee on Quality Health Care in America. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press.
Karam-Hage, M., Nerenberg, L., & Brower, K.J. (2001). Modifying residents' professional attitudes about substance abuse treatment and training. The American Journal on Addictions, 10, 40–47.
Katon, W., Rutter, C., Ludman., E.J., Von Korff, M., Lin, E., Simon, G., Bush, T., Walker, E., & Unutzer, J. (2001). A randomized trial of relapse prevention of depression in primary care. Archives of General Psychiatry, 58, 241–247.
Kohn, L.T., Corrigan, J.M., & Donaldson, M.S. (Eds.). (2000). To err is human: Building a safer health system. Washington, DC: National Academy Press.
Manderscheid, R.W., Atay, J.E., Hernandez-Cartagena, M. del R., Edmond, P.Y., Male, A., Parker, A.C.E., & Zhang, H. (2001). Highlights of organized mental health services in 1998 and major national and state trends. In R.W. Manderscheid & M.J. Henderson (Eds.), Mental health, United States, 2000 (DHHS Publication No. SMA 01-3537). Washington, DC: U.S. Government Printing Office.
McHugh, P.R. (2001, June). Clinical psychiatry in academia: Future challenges and opportunities. Paper presented at a meeting of the Academic Behavioral Health Consortium, Baltimore, MD.
Morris, J., & Stuart, G.W. (2002). Training and education needs of consumers, families, and public sector staff in the context of culturally competent behavioral health practice. Administration and Policy in Mental Health, 29(4/5), 377–402.
National Council for Community Behavioral Healthcare. (2002). National Council Online. Available: http://nccbh.org/nconline.htm.
Nickels, M.W., & McIntyre, J.S. (1996). A model for psychiatric services in primary care settings. Psychiatric Services, 47, 522–526.
O'Connell, M.J., Gill, D., Artar, A., Jones, A., & Vargas, T. (2002). Student voices: Perspectives on behavioral health education. Administration and Policy in Mental Health, 29(4/5), 421–434.
Peterson, B.D., West, J., Tanielian, T.L., Pincus, H.A., Kohut, J., Pion, G.M., Wicherski, M.M., Vandivort-Warrant, R.E., Palmiter, M.L., Merwin, E.I., Lyon, D., Fox, J.C., Clawson, T.W., Smith, S.C., Stockton, R., Nitza, G., Ambrose, J.P., Blankertz, L., Thomas, A., Sullivan, L.D., Dwyer, K.P., Fleischer, M.S., Goldsmith, H.F., Henderson, M.J., Atay, J.E., & Manderscheid, R.W. (2001). Mental health practitioners and trainees. In R.W. Manderscheid & M.J. Henderson (Eds.), Mental health, United States, 2000 (DHHS Publication No. SMA 01-3537). Washington, DC: U.S. Government Printing Office.
Robinson, J.C. (2001). The end of managed care. Journal of the American Medical Association, 285, 2622–2628.
Rosenheck, R., Morrissey, J., Lam J., Calloway, M., Stolar, M., Johnsen, M., Randolph, F., Blasinsky, M., & Goldman H. (2001). Service delivery and community: Social capital, service systems integration, and outcomes among homeless persons with severe mental illness. Health Services Research, 36, 691–710.
Ross, E.C. (2001). The promise and reality of managed behavioral health care. In R.W. Manderscheid & M.J. Henderson (Eds.), Mental health, United States, 2000 (DHHS Publication No. SMA 01-3537). Washington, DC: U.S. Government Printing Office.
Stuart, G.W., Burland, J., Ganju, V., Levounis, P., & Kiosk, S. (2002). Educational best practices. Administration and Policy in Mental Health, 29(4/5), 325–333.
info.html.
U.S. Department of Health and Human Services. (2001). Mental health: Culture, race, and ethnicity-A supplement to mental health: A report of the surgeon general. Rockville, MD: Author.
Weiss, E.M. (1998, January 11). A nationwide pattern of death. Hartford Courant, p. A1.
Zarin, D.A., Seigle, L., Pincus, H.A., & MacIntyre, J.S. (1997). Evidence-based practice guidelines. Psychopharmacology Bulletin, 33, 641–646.