March 25, 2025

During 2024, 43 of 44 responding state mental health agencies reported a behavioral health workforce shortage when asked in a survey about the adequacy of three major components of state behavioral health systems: state psychiatric hospitals, community mental health services, and behavioral health crisis programs. Across the responding states, 37 reported shortages for all three components, and six reported having a shortage of one or two components. Of the responding states, 41 of the 44 reported a shortage of workers for state psychiatric hospitals.

The states were asked to characterize the severity of the shortages, with options ranging from “unknown,” “minor,” “moderate,” to “catastrophic.” At the catastrophic level, the shortage results in reduced available services or beds or very long waits for services.

The 37 states reporting a shortage of all three components include: Alabama, Alaska, Arkansas, Connecticut, Delaware, Florida, Georgia, Idaho, Illinois, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Mississippi, Missouri, Montana, Nebraska, New Hampshire, New York, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington, West Virginia, and Wisconsin.

Six states reported various types of shortages:

• Two states reported shortages only in their community provider organization system (Arizona and Virginia)
• Three states reported shortages in both community providers and state psychiatric hospitals (Hawaii, Indiana, and Louisiana)
• One state reported shortages in only crisis system provider organizations (Minnesota)

Across the 41 states reporting a workforce shortage for their state psychiatric hospitals, the level of severity ranged as follows:

• In 14 states, the shortage was catastrophic: Arkansas, Delaware, Hawaii, Idaho, Iowa, Maryland, Mississippi, Missouri, Nebraska, New Jersey, Oklahoma, South Dakota, West Virginia, and Wisconsin.
• In 20 states, the shortage was moderate: Alabama, Alaska, Connecticut, Kentucky, Louisiana, Maine, Massachusetts, Minnesota, New Hampshire, New Mexico, New York, North Carolina, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, and Washington.
• In two states, the shortage was minor: Indiana and Georgia
• In five states, the severity of the shortage was reported as “unknown:” Florida, Illinois, Kansas, Montana, and North Dakota

In 41 of the 44 state responses, the states reported workforce shortages of community mental health provider organizations, and 40 states reported workforce shortages for behavioral health crisis systems. The most frequent professionals for which states reported workforce shortages were social workers at the Masters of Social Work level (41 states), adult psychiatrists (40 states), registered nurses (39 states), and nurse practitioners (37 states).

These findings were presented in “State Behavioral Health Workforce Shortages & Initiatives, 2023-2024,” by NRI, which works with state agencies, the Federal Government, and other entities to define, collect, and analyze data on public behavioral health systems. NRI requested information from the 50 states (the District of Columbia was not included in the analysis). The goal was to determine current trends in health care workforce shortages.

The full text of “State Behavioral Health Workforce Shortages & Initiatives, 2023-2024” was published in October 2024 by NRI. A free copy is available online at https://www.nri-inc.org/media/tghpz5uu/smha-workforce-shortages-2023.pdf (accessed March 20, 2025).