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Workforce Education & Training Impact Study
MHSA's 10 year funding comes to a close

Article Doris Estremera, Mental Health Services Act Manager

The Mental Health Services Act (MHSA) has provided dedicated funding to transform behavioral health systems and improve the quality of life for individuals living with behavioral health conditions. Workforce Education and Training (WET) strategies received a one-time $3,437,600 funding allocation in Fiscal Years 2006 to 2008, with a ten-year timeframe to expend the allocated funds. With MHSA WET funding ending in 2018, BHRS is preparing to sustain the most effective and impactful elements of these investments.

In the spring of 2017, the BHRS Office of Diversity and Equity (ODE) hired an independent consultant to assess the impact of WET and identify priorities that would shape the future landscape. Input was gathered through surveys and listening sessions with staff, community-based agencies and contractors, and participants in WET programs, including the Lived Experience Academy and Cultural Competency Stipend Intern program. Additionally, materials reviewed included training logs, pre/post-tests for trainings, evaluations collected during trainings, reports developed, WET Plans and annual updates.

WET Impact

Prior to MHSA WET funding, there were fewer staff trainings offered annually and topics skewed toward direct clinical training, due to an emphasis on medical interventions. In more recent years, training topics included cultural humility, co-occurring care, trauma-informed care, crisis management, safety and self-care. From 2014 to 2017, 95 trainings were provided to over 3,000 staff, contract and community providers. MHSA WET-funded trainings for and by clients and family members, aimed to increase understanding of mental health and substance use issues, reduce stigma, promote available treatments and supports, and support leadership development of clients and family members. 

Feedback was largely positive, and the majority acknowledged how WET trainings shape BHRS culture and improve services.

“[Trainings] helped me see my clients in a new light and really, really show respect for them and support them,” said one training participant.

Stakeholders discussed how WET trainings improved cultural humility, created a culture of learning and valuing lived experience, built capacity for co-occurring and trauma-informed care, increased awareness of the importance of self-care and allowed for a focus on client-centered services. 

“Ongoing education is so important for a clinician,” said another participant. “It really raises our standard of care.”

Lived Experience Academy participants shared how the trainings and supports provided to them have decreased shame and isolation, building a grassroots movement to use their voice to empower others to seek recovery.

“Empowering. Non-shameful. A supportive journey,” said one participant. “I felt that I was not just a consumer, but part of the team. My mentally ill children have a different experience of me now. We all have our individual stories. This helped me with my children, moving them from street drugs to taking their meds, and they are now open to seeing a psychiatrist.”

WET Sustainability

Throughout the 10 years WET priorities evolved, programs were discontinued and priority efforts were refined. While most of these priorities require a more integrated and systemic approach for meaningful transformation, there are undoubtedly positive impacts, cultural shifts and appreciation by stakeholders across the system. The most impactful elements will be sustained, with a total of $500,000 per year, through the following three strategy recommendations:

Recommendation 1: A Systemic Approach to Workforce Education and Training

Moving forward, a systemic approach to foundational knowledge and BHRS transformation goals should be the standard. The approach should include cultural humility, trauma-informed care, standard of care, co-occurring and other integrated care, lived experience integration and self-care. Trainings should initiate dialogue, personal level impacts and the beginning of cultural shifts. Policies, leadership qualities and intentional linkages to quality improvement goals will advance sustainability and genuine system transformation.

Recommendation 2: Creating Pathways for Individuals with Lived Experience in Behavioral Health Careers and Meaningful Participation

The WET internships, specifically the Cultural Competence Stipend Internship Program (CCSIP), are valuable resources for preparing future clinicians. They promote an understanding of the behavioral health field and increase the diversity of staff to better reflect our client population. More must be done to recruit, hire and retain diverse staff.

To view the full WET Impact & Sustainability report, visit the MHSA webpage.

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