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Health professionals who work with people with intellectual and developmental disabilities, mental health conditions and substance use disorders are in high demand. 

To make sure there are enough health care workers in these fields to meet the demand for services in New Jersey, state officials are dedicating up to $60 million to recruit, train and retain more workers, the head of the Department of Human Services told lawmakers earlier this week.  

Legislators, policy makers, health care providers and other stakeholders are confronting an epidemic of loneliness and isolation, all while people, notably younger people, struggle through an ongoing mental health crisis. In 2021, 10% of surveyed high school students across the nation attempted suicide one or more times during the past year, according to a report released in February by the Centers for Disease Control and Prevention.  

“One of the top priorities that we had in this budget was investing in workforce because developing a strong pipeline is the only way we get to that place where we can do even more to serve people,” Sarah Adelman, the commissioner of the Department of Human Services, said during the Assembly budget hearing earlier this week. “So that $100 million investment I talked about, a huge portion of that goes directly to our mental health and substance use providers.” 

The state plans to invest $100 million for home- and community based-services in the upcoming budget, of which the $60 million for hiring and training professionals to work with people with intellectual and developmental disabilities is included. The $100 million will also go towards certification and training programs, including one for “recovery support practitioners,” or people with lived experience who have dealt with substance abuse and mental health concerns, to work in the community-based behavioral health field. Lawmakers are reviewing that budget proposal and need to have an agreement with Gov. Phil Murphy before July 1. 

Additionally, this funding aims to support a “dual diagnosis” pilot program for mental health professionals to become certified in treating people with both intellectual and developmental disabilities and mental health conditions.   

‘Long overdue’

“It’s an important and long overdue step,” Assemblywoman Aura K. Dunn (R-Morris), who sits on the Assembly Budget committee, said of state funding for mental health professionals who can treat people with both intellectual and developmental disabilities and mental health concerns. “The current system and what’s available has not been working,” she said.  

People with intellectual and developmental disabilities are at high-risk of co-occurring mental health conditions, including major depressive disorder, bipolar disorder, anxiety disorders and impulse control disorders, according to Psychiatric Services, a journal of the American Psychiatric Association.  

Still, across the board, the mental health profession is severely understaffed in a majority of programs, according to Mary Abrams, a senior health policy analyst at the New Jersey Association of Mental Health and Addiction Agencies.  

“It just really comes down to wages,” Abrams said. “How many that move to other fields or move to kind of different venues that would maybe return to community-based service with higher wages remains to be seen.” 

The upcoming budget aims to add nearly $172 million in state and federal funding to increase wages for childcare workers, certified nurse aides, behavioral health and substance use professionals and “direct support professionals” who support people with disabilities. 

“By the time the budget’s finalized in another month and a half and then by the time contracts are updated and the money starts flowing, and it’s going to be all at the same time of these redeterminations [for Medicaid], I’m at a loss of how we fare as need continues to rise [and] demand for services continues to rise,” Abrams said.  

There was a 23.1% vacancy rate for licensed clinical social workers, a 28.4% vacancy rate for certified alcohol and drug counselors and a 17.4% vacancy rate for registered nurses across 27 agencies in the state, according to the latest data from the New Jersey Association of Mental Health and Addiction Agencies in December 2022.  

In 2021, 10% of surveyed high school students across the nation attempted suicide one or more times during the past year, according to a report released in February by the Centers for Disease Control and Prevention.  

Psychiatry needs an influx of new young people coming into the field, said Dr. Frank Ghinassi, the president and chief executive officer for Rutgers Health University Behavioral Health Care. 

“Historically, [it] may not have drawn as much in the way of recruits in medical school because, quite frankly, the way the payment structure’s set up, professions in medicine that do procedures — surgery, dermatology, even dentistry — tend to be more financially advantageous to both the institution and to the individual who’s practicing that,” said Ghinassi, who also serves as the senior vice president for the behavioral health and addiction service line at RWJ Barnabas Health.   

The upcoming budget will distribute more money for the Mental Health Professional Capacity Expansion programs, including $4 million to add 10 new medical residency positions and $920,000 for four new child and adolescent psychiatry fellowship positions.  

And introducing careers in the behavioral health care field to students in high school and college can be another step to add more professionals in the state, according to Ghinassi. 

“It would be great to instill an interest in behavioral health and/or developmental disabilities as a career early on,” said Ghinassi. “When they get to college, many people are often undecided and it would be useful, if there were across the universities and colleges, ways of imparting to them how important and needed and how good of a career path [it is] in terms of being in high need and high demand and almost guaranteed work,” he said.