Behavioral Health Workforce Research Center

The UNC-BHWRC: Mission and Overview

The University of North Carolina at Chapel Hill Behavioral Health Workforce Research Center (UNC-BHWRC) is a dynamic hub of innovative, data-driven research on the workforce responsible for providing mental health and substance use services. Our mission is to improve the behavioral health and well-being of the U.S by conducting research to strengthen the current and future behavioral health workforce through exploration of the disparities that perpetuate inequities in behavioral health treatment, access, and quality.

The UNC-BHWRC will produce research to inform policies that support the behavioral health workforce and increase access to quality behavioral health services. UNC-BHWRC, housed in the Cecil G. Sheps Center at UNC-Chapel Hill, is dedicated to producing timely and policy-relevant projects to address emerging issues and longstanding challenges to the behavioral health workforce. Research projects will explore national data sources to evaluate workforce composition, need, sufficiency, and distribution, and to better understand evolving models of behavioral health service delivery. UNC-BHWRC is supported by funding from the Health Resources and Services Administration (HRSA) and the Substance Abuse and Mental Health Services Administration (SAMHSA).

The UNC-BHWRC Consortium

UNC-BHWRC is led by a team of experienced workforce researchers with support from a national consortium of expert leaders and organizations committed to mental health, substance use, and health workforce research. Consortium member organizations include:

• The Association for Behavioral Health and Wellness (ABHW), a leading association working to advance federal policy and mental health and addiction services.
• The Collaborative Family Health Association (CFHA), a muti-guild member association whose goal is to make integrated care the standard of care across the United States and beyond.
• The Council on Social Work Education (CSWE), the national association representing social work education in the United States.
Faces & Voices of Recovery, dedicated to organizing and mobilizing Americans in recovery and their allies into recovery community organizations and networks to promote recovery through advocacy, education and demonstrating the power and proof of long-term recovery.

Year One Research Projects

The UNC-BHWRC will undertake 10 projects in year one that address national-level planning and policy-relevant research questions related to the behavioral health workforce. Our studies are designed to inform the strategic aims of both HRSA—to target funding toward programs and training that improve access to, supply of, distribution, diversity, and quality of behavioral health workforce—and SAMHSA—to strengthen the behavioral health workforce to better meet the behavioral health needs of individuals, communities, and service providers.

Project 1: Behavioral Health Screening for Transitional Age Youth
Transitional age youth (ages 16-25) stand to greatly benefit from better access to behavioral health services and screenings in integrated health settings. Using the U.S. IBM® MarketScan® Commercial Claims and Encounters data, this project will investigate the extent to which transitional age youth receive behavioral health screenings and the settings in which they are delivered.

Project 2: Defining the Perinatal Mental Health Workforce
Despite the association of perinatal mental health disorders with infant and maternal morbidity, mortality, and economic cost (Moore et al. 2021), little is known about which types of professionals commonly treat patients with perinatal mental health needs, in what settings, and for what diagnoses and treatments. Using IBM MarketScan® Commercial Claims and Encounters data, this project will investigate the perinatal mental health workforce across the U.S.

Project 3: Tele-Behavioral Health at Federally Qualified Health Centers—Differences by Provider Type
COVID-19 accelerated the use of tele-behavioral health at Federally Qualified Health Centers (FQHCs), but it is unclear if all or only some behavioral health professions (e.g., psychiatrists) are delivering virtual care. Using the Uniform Data System (UDS) for HRSA-supported FQHCs, this study will examine the use of virtual care by behavioral health clinician type to understand who is providing tele-behavioral health services at FQHCs.

Project 4: Who is the Harm Reduction Workforce?
Harm reduction, an evidence-based approach that mitigates the effects of substance use through prevention, treatment, and recovery, has recently been identified as an important facet of the U.S.’s efforts to address the opioid epidemic and substance use disorders; yet little is known about the behavioral health workforce working in harm-reduction settings. This study seeks to fill the knowledge gap on the harm reduction workforce through a mixed-methods study executed in partnership with the National Harm Reduction Coalition.

Project 5: Are Behavioral Health Providers Located in Areas of Deprivation?
The distribution of behavioral health providers in high need, yet under-resourced areas is an important indicator of the behavioral health workforce’s ability to address the increasing behavioral health challenges of vulnerable communities. To examine the proportion of the behavioral health workforce co-located in high-need areas, this study will analyze the geographic location of three behavioral health professions across a standardized index of area disadvantage.

Project 6: Preparing and Retaining the Behavioral Health Workforce in Safety Net Clinics: How Educational Experiences Relate to Work Satisfaction and Retention (Lead Don Pathman, MD)
Increasing access to behavioral health providers in safety net clinics is vital to ensuring behavioral health care equity; however, the field lacks knowledge of the factors that better prepare behavioral health providers to practice in these settings. This project will focus on how experiences with medically underserved populations during the education of behavioral health professionals affects their satisfaction and retention when subsequently working in safety net settings.

Project 7: Assessing the Child Mental Health Physician Workforce in a Time of Crisis (Lead Alex Gertner, MD PhD)
Despite the mental health crisis youth face in the United States, little is known about how children differentially access mental health care from primary care providers and psychiatrists. Using the National Ambulatory Medical Care Survey (NAMCS), this project examines demographic and diagnostic differences in treatments for child mental health among provider types (family medicine vs. pediatricians vs. psychiatrists) and insurance status (Medicaid vs. private vs. uninsured) to enhance our understandings of how child and provider characteristics impact service delivery.

Project 8: Exploring the Pipeline to Graduate Social Work Education
Increasing the diversity of the behavioral health workforce is critical to providing culturally competent and responsive behavioral health care to minority communities. This study will use the National Survey of College Graduates (NSCG) to understand the pipeline of diverse Bachelor of Social Work (BSW) graduates to Master of Social Work (MSW) programs in order to assess how student demographics, educational programs, and loan debt burden impact pathways into the profession.

Project 9: Assessing the Adequacy of Training for Certified Peer Support Specialists (CPSS) Providing Mental Health and Substance Use Services
Peer support specialists provide important services to people managing mental health or substance use challenges; however Certified Peer Support Specialist (CPSS) training programs and requirements significantly vary state by state. This study will assess the extent to which peer providers perceive their CPSS training programs prepared them for peer support work while also identifying areas of continued training needs to further bolster this workforce in providing vital behavioral health services.

Project 10: Recovery Support Specialists Experiences of Burnout and Plans for the Future
Extensive research has focused on provider burnout during the pandemic, yet comparatively little attention has been paid to the experiences of burnout for the peer recovery support workforce. This study will develop and deploy a national survey to peer recovery support specialists regarding their experiences of burnout and intentions to remain active members of the behavioral health workforce.

UNC-BHWRC Leadership

Brianna M. Lombardi, PhD, MSW, serves as the UNC-BHWRC Director. Dr. Lombardi is an Assistant Professor in the Department of Family Medicine at the UNC-CH School of Medicine and holds a secondary appointment as a Research Assistant Professor at UNC-CH School of Social Work. Currently, Dr. Lombardi serves as the Deputy Director of the HRSA-funded Carolina Health Workforce Research Center.

Lisa de Saxe Zerden, PhD MSW is the Deputy Director of the UNC-BHWRC. Dr. Zerden is a tenured Associate Professor at the UNC-CH School of Social Work. She currently serves as the Social Work Director of Interprofessional Education and Practice.

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Funding Statement

This project is supported by the Substance Abuse and Mental Health Services Administration (SAMHSA) and the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U81HP46529‐01‐01 Cooperative Agreement for a Regional Center for Health Workforce Studies for $1,121,875. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by SAMHSA, HRSA, HHS or the U.S. Government.