Behavioral health insiders have identified behavioral health staffing challenges as the single most significant headwind for the industry in 2023, according to a recent Behavioral Health Business (BHB) survey. The survey, which collected responses from 150 professionals working across various behavioral health sectors, found that 53% of respondents cited staffing as the primary obstacle. Other concerns included reimbursement challenges (34%), consolidation (7%), the general economic downturn (3%), and regulatory changes (3%).
Rising Demand for Behavioral Health Services
The timing of these challenges coincides with an unprecedented surge in demand for behavioral health services. Since the onset of the COVID-19 pandemic, rates of mental health conditions such as anxiety, depression, and other mood disorders have increased dramatically. The Anxiety and Depression Association of America reports that approximately 40 million adults in the United States experience an anxiety disorder. Meanwhile, data from the CDC shows that the percentage of adults receiving any form of mental health treatment increased from 19.2% in 2019 to 21.6% in 2021. Despite this growth, more than half of adults with mental illness still do not receive treatment, according to Mental Health America, highlighting the pressure created by behavioral health staffing challenges.
Industry Leaders Address Staffing Strains
Marc D. Miller, president and CEO of Universal Health Services (UHS), emphasized the critical role of staffing in meeting this growing demand. “We know there are a lot of people who need our behavioral health services whom we want to be able to treat, but we cannot grow services without more staff,” Miller told BHB. “We believe the staffing challenges experienced across the health care sector will normalize to a significant extent in 2023.” UHS, headquartered in King of Prussia, Pennsylvania, operates 335 behavioral health inpatient facilities nationwide and has been directly affected by the sector-wide behavioral health staffing challenges.
Financial Strains and Operational Impact
Beyond being a logistical challenge, behavioral health staffing challenges also present a major financial strain for providers. The BHB survey revealed that 77% of respondents viewed staffing as the largest financial burden for 2023. Other financial concerns included telehealth implementation (8%), declining patient volume (6%), sales and marketing (3%), and liability insurance (3%). This indicates that while technology and operational costs are important, nothing weighs on the bottom line as heavily as behavioral health staffing challenges.
Recruitment and Retention Challenges
Recruitment and retention difficulties have been a persistent obstacle across the behavioral health sector, affecting inpatient facilities, outpatient programs, and specialty services such as autism and applied behavioral analysis (ABA). Kathleen Bailey Stengel, CEO of NeurAbilities Healthcare, explained how these issues impact specific treatment areas: “For health care overall, the greatest challenges will remain the ability to recruit, train, and retain qualified health care providers. In the autism space specifically, this continues to be the main barrier to growth, with both the overall need for medical and behavioral health diagnosticians and skilled therapists for ongoing treatment. While the rates of autism disorders continue to rise, clinical staff that treat this population are not trained at the same rate.”
Specialized Providers Face Unique Challenges
NeurAbilities Healthcare, a nationally accredited ABA treatment provider based in New Jersey, currently operates 17 centers across New Jersey and Pennsylvania. Like many providers, it faces significant behavioral health staffing challenges, even as demand for autism and behavioral health services grows. Limited staff availability creates bottlenecks that can delay care, restrict program expansion, and strain existing teams.
The Broader Implications
The implications of behavioral health staffing challenges extend beyond individual facilities. With demand for behavioral health services at an all-time high, limited staffing capacity can increase patient wait times, reduce access to care, and contribute to provider burnout. For organizations striving to meet the growing need, these challenges highlight the importance of strategic workforce planning, competitive compensation packages, and ongoing professional development to attract and retain skilled staff.
Moving Forward
Ultimately, the staffing crisis underscores a critical reality for behavioral health providers: meeting the mental health needs of the population requires more than beds, clinics, and programs—it requires people. Addressing behavioral health staffing challenges is essential to expanding access to care and ensuring patients receive timely, high-quality treatment. As organizations like UHS and NeurAbilities Healthcare work to overcome these hurdles, the industry will face a pivotal year in shaping the future of behavioral health care.
