Jenny Smulson, Senior Legislative & Federal Affairs Officer, APA Education Government Relations Office, March 2008

Education Government Relations Office (GRO) has been at the forefront of federal efforts to strengthen the mental and behavioral health workforce and increase training opportunities for students of psychology.

Education GRO submitted a number of important recommendations to Congress related to the reauthorization of the Substance Abuse and Mental Health Services Administration (SAMHSA) intended to improve access to qualified mental and behavioral health professionals for individuals living in communities throughout the United States.

Education GRO focused on three critical initiatives: authorization of the Minority Fellowship Program; a new federal training program; and support for students in eligible metal health professions in accredited graduate programs.

The Minority Fellowship Program, first funded in over three decades ago, provides stipends for pre and post doctoral fellowships for minority psychologists and others dedicated to working with minority populations. The program does not have an authorization and must rely on Congress for an annual programatic earmark. Education GRO working in partnership with Public Interest GRO, has reached out to other mental and behavioral health associations to form a coalition to champion the Minority Fellowship program.

The mental and behavioral health workforce needs a boost in order to ensure that people living in all communities, rural or urban, throughout the United States have access to good care. SAMHSA strategic plan affirmed the need for this investment in our mental health workforce. The Strategic Plan, which followed on the heels of recommendations from the Annapolis Coalition, acknowledges the need for dramatic improvement in initial clinical training and continuing education using evidence based practices; the need to initiate widespread leadership training; the need to address critical training topics (e.g., integration of mental/behavioral services with primary care) and shortages (e.g., services for children and older adults). Education GRO developed and promoted two initiatives: a loan repayment and an institutional grant program. The loan repayment program would provide loan forgiveness to licensed or certified mental health professionals working in facilities that served underserved populations with priority given to those working with high priority populations and who demonstrate financial need, competence in evidence based practice, or cultural competence in practice. The institutional aid program would create a competitive grant program for eligible entities (a graduate education and training program, internship, residency or fellowship in one of the eligible health professions) for planning, developing, and operating a mental health professional training program that includes student stipends. In addition, Education GRO staff sought to expand the Research Data Collection & Analysis authority to include gathering information on providers (i.e., what health professions are needed and where).

Finally, Education GRO sought support for changes to SAMHSA's Campus Suicide Prevention program which would allow these competitive federal grant funds to be used to "Strengthen and expand mental and behavioral health training opportunities in internship and residency programs", such as psychology doctoral and post-doctoral training, among others. This change to the current law would enable counseling centers to increase their capacity to serve more students - a concern which remains one of the most critical issue facing counseling centers today.

While Education GRO fought, with little success in securing changes in these areas, it was Education GRO staff that made workforce an issue that the Senate was forced to address. Even though Education GRO was able to garner a great deal of support for these initiatives, there was some opposition with the fragile balance of power in the Senate that was enough to deny our recommendations. However, statutory language was included that requested that training for interns and fellows be considered for all relevant SAMHSA programs. Nevertheless, there is still hope. The SAMSHA reauthorization is currently stalled in the Senate. There has been no movement on the SAMHSA reauthorization in the House. These delays in action will give Education GRO new opportunities to continue to educate and advocate for these critical workforce development issues.

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