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Felice J. Freyer

The professionals who provide care at community mental health clinics around the state are leaving their positions faster than they can be replaced, worsening access just as the stresses of the pandemic have intensified the need among their mainly lower-income patients, according to a survey released Tuesday.

The survey, conducted by the Association for Behavioral Healthcare, found that for every 13 clinicians who leave these outpatient facilities, only 10 can be found to replace them. As a result fewer patients are getting care than before the pandemic, while many more are seeking it. The 37 clinics that responded to the survey had nearly 14,000 people on waiting lists.

The number one reason workers gave for leaving clinic jobs: the low pay. Many are going into private practice or taking hospital jobs that pay significantly more.

The survey focused on one critical component of the mental health care system, the state-licensed community mental health centers, most of whose patients are enrolled in the state’s Medicaid program, MassHealth.

But the clinics’ troubles reveal yet another stress point in the broader health care workforce as it confronts the pandemic’s extraordinary challenges.

“This is something that was known before the pandemic. [Patients] were having a problem with accessing services,” said Rebekah Gewirtz, executive director of the National Association of Social Workers, Massachusetts chapter. “Then the pandemic hits and we have an exacerbated crisis that isn’t going to go away.”

Diane Gould, chief executive of Advocates, a Framingham-based agency that encompasses five mental health clinics, described a “convergence of an already strained workforce, and layer COVID on top of that and a mental health crisis related to isolation and illness and loss.”

The Association for Behavioral Healthcare, the trade group for outpatient mental health clinics, surveyed 60 of its members in November and December last year and received responses from 37 organizations with a total of 124 outpatient sites. Together, those agencies had served nearly 100,000 people in the previous year.

Among the clinics that responded, nearly all had vacancies – an average of 17 per clinic – for a total of 640 unfilled jobs.

Advocates has 40 vacancies among a staff of 110, resulting in a waiting list of 132 children and 22 adults, Gould said.

In the past month, Advocates hired 16 clinicians but 26 left. “The money they can make elsewhere is a significant draw,” Gould said. Some have major student loan debts to pay off and say they like the work but can’t afford to stay, she said.

The Boston Globe