| Agency Description This request provides general fund support of $1,595,876 in FY 2025 and $995,876 in FY 2026 to support the following initiatives related to the children’s mental health workforce:
• Expansion through the creation of a new mental health workforce certification for a wellness coach, with specific efforts to support schools;
• Increasing capacity by streamlining licensure;
• Improving quality and competency through training the current general mental health workforce to better serve youth and families using high quality evidence based interventions.
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| Consequences of not funding/Justification The 2022 Mental Health America Report ranked Virginia 48th in the country for youth mental health access to care, which is largely impacted by the state’s limited workforce that specialize in youth mental health and substance use disorders. According to Virginia’s Healthcare Workforce Data Center, the current mental health workforce largely does not serve youth. There are nearly 2 million youth in Virginia, where 1 in 5 youth have a mental health disorder and the current licensed mental health landscape is as follows:
- There are only 211 child and adolescent psychiatrists.
- Of the 9,113 Licensed Clinical Social Workers, only 6% treat children and another 6% treat adolescents.
- Of the 8,168 Licensed Professional Counselors, only 7% specialize in child mental health.
- The ratio of student to school psychologists is 1:1393 compared to a national average of 1:1127 and a national recommended ratio of 1:500.
There is a significant need for targeted efforts to build the capacity and expand the behavioral health workforce that serve youth, to enable them to meet their developmental milestones, academic, and career goals, as well as mitigate the lifelong impacts of untreated mental health conditions that current burden the adult mental health system. This budget requests aims to do the following:
1. Develop of a certification and training program for a mental health wellness coach
The current structure of the mental health workforce places a significant burdened on licensed mental health professionals to carry out all related mental health supports and interventions, either through direct services, or supervision of unlicensed mental health staff. This structure does not allow LMHPs to work to the full extent of their training and expertise to serve youth with serious emotional disturbance or serious mental illness. To expand the youth serving workforce, this initiative aims to collaborate with community colleges and higher education to create a training and certification for a mental health wellness coach, to provide prevention and wellness services within the school setting, supportive interventions, strengths based student initiatives, liaise with families on mental health and promotion of student mental health wellness, and social shifts related to the mental health of students to improve educational engagement. This is a model that California has successfully implemented to address the high need for school mental health workers, as the current pipeline is insufficient to meet the needs.
2. Streamlining licensure
A significant portion of Virginia’s mental health workforce is the Qualified Mental Health Professional (QMHP). There is currently a distinction between QMHP-A (adult) and QMHP -C (child), which is the only behavioral health profession under DHP that requires this designation. This limits the flexibility of an existing workforce to serve both youth, adults, and families through additional regulatory burden, without any impact on quality of care. Targeted efforts are needed to reduce the regulatory burden and providing support for this workforce to serve youth through common requirements. Analysis is needed to maximize the unlicensed mental health workforce in Virginia, including understanding barriers to licensure and developing post-graduate training or certification opportunities for those pursuing a career change.
3. Increasing Competency and Quality
Through the enhancement of youth behavioral health services in Medicaid and the implantation of the Families First Prevention Services Act, there is a need to train and equip providers to deliver these statewide services in order to meet the intended outcomes of Right Help Right Now. Targeted training efforts to include service definitions, provider qualifications, and behavioral health interventions associated with meeting the fidelity of the service model are essential to increase delivery of high-quality, cost-effective behavioral health services which are often complex. In order to successfully implement new Medicaid services, a provider training program will be required to include training resources to help bridge the gap between behavioral health research and practice of behavioral health services for the following new services: (1) Enhanced Intensive In-Home Services; (2) Specialty Outpatient (Trauma-Focused Cognitive Behavioral Therapy and Parent Child Interaction Therapy) (3) Coordinated Specialty Care; (4) Multi-Tiered School-based Behavioral Health Services; and (5) High Fidelity Wraparound. Consistent statewide training practices and providing post-training support will assist providers in overcoming barriers and empower problem-solving needed to sustain the new services long-term and thus providing positive treatment outcomes for Virginians.
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| Explanations and Methodologies This request includes support for:
Item Description FY25 Cost FY 26 Cost
Develop of a certification and training program for a mental health wellness coach.
Contract with an academic institution of higher learning or community college to design, develop, and implement a certification program for a mental health wellness coach. This includes curriculum development with the consultation of mental health and workforce experts in the field. 1,000,000 (FY25 one time)
Implementation of the mental health wellness coach certification program Provides funding to recruit students to enter the program. Provides scholarships to students entering the program. $300,000 (FY26 one time
Data and evaluation Conducts ongoing evaluation of the curriculum and tracking workforce data and impact. $200,000 (ongoing)
Streamline licensure Conducts and analysis of the current unlicensed mental health workforce in Virginia to streamline licensure requirements including diversification of the scope of the workforce so that they may better serve youth, and determine the type of training required to establish the core competencies of this workforce. Includes a mechanism to provide remediation and corrective action for unlicensed mental health professionals to maintain practice standards. $250,000 (one time)
Central Office Mental Health Workforce Training Director Salary and Fringe for a Mental Health Workforce Training Director to coordinate, design, and strategically plan training activities responsive to the behavioral health needs of the Commonwealth. $145, 876 (ongoing) $145, 876 (ongoing)
Workforce training on evidence based practices Provides ongoing training for the current mental health workforce on high quality, evidence based practices for youth mental health and substance use disorder conditions. $200,000 (ongoing)
$350,000 (ongoing)
Subtotals 1,595,876 995,876
TOTAL 2,591,752
Position Salary Fringe Non Personnel Total
Central Office Mental Health Workforce Training Director $100,000 $40,876 $5,000 $145,876
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