Attention surrounding Utah’s ongoing mental health crisis has drawn the attention of the recently formed Office of Professional Licensure Review (OPLR). On October 19, it was announced during a meeting of the Interim Committee on Business and Labor that the OPLR intends to conduct reviews of various regulated professions related to mental and behavioral health. The desired OPLR focus area was then unanimously approved, without modification, by the committee.
This office, created earlier this year by Senate Bill 16, is tasked with providing the Utah Legislature with objective reviews and recommendations related to occupational licensing. Each year, the agency must submit “a list of each periodic review that the agency proposes to perform in the following year.” This list is reviewed by the Interim Committee on Business and Labor, where committee members can make changes or approve the list. This list is then sent to the Legislative Management Committee, where committee members can make changes or approve the list.
The rationale for OPLR to begin its work by focusing on the mental and behavioral health professions is easy to understand. Utah doesn’t just struggle with creating positive mental health outcomes — it’s actually the worst at it, boasting the highest rates of mental illness in the United States. Overall, more than a quarter of Utah adults report having had a mental illness (nearly 7 percentage points above the national average).
When examining the cause of such disturbing statistics, what immediately stands out is the lack of mental health professionals in Utah. These professionals are critical to minimizing the devastating impact of mental illness in the community. However, according to the Health Resources and Services Administration (HRSA), there is a shortage of mental health professionals in all 29 Utah counties.
This shortage of specialists is not limited to just one aspect of the health system. Almost every professional group involved in the fight against mental illness is at risk of shortages in their professional ranks. Such a shortage clearly already exists, with a shortage of between 14,280 and 31,109 psychiatrists expected in the near future, and places closer to home such as the Huntsman Institute of Mental Health may already be experiencing staff shortages.
For individuals and families, this shortage has severe consequences. A lack of professionals can leave struggling children and those in crisis on waiting lists that stretch for months, and for many Utahns, make care completely unaffordable. The shortage of mental health professionals in Utah creates a situation where people simply don’t have access or the means to see a professional. Such treatment gaps left 62 percent of Utah adults with mild mental illness untreated and nearly half of Utah youth ages 12-17 with depression without any care in 2020.
OPLR reviews may ultimately culminate in policy recommendations that suggest changes to the licensure processes for behavioral and mental health professionals. This is to be welcomed, as one of the most practical ways the state can immediately begin investing in the prevention and treatment of mental illness is by changing the licensing laws affecting mental health professionals.
Specifically, when approaching licensing reform for these professionals, Utah should pursue policy reform that emphasizes deregulation by:
Expanding the scope of practice of these professionals. An example of this would be the extension of the ability to prescribe certain drugs used in the treatment of mental disorders to psychologists.
Shortening the period for obtaining a license. This could be achieved, for example, by removing the arbitrary requirement that each clinical mental health consultant must accumulate 4,000 hours of supervised work experience over at least two years. Currently, this rule means that aspiring individuals cannot meet this requirement and obtain their license in a shorter period of time.
Lowering education requirements. For social workers, this may take the form of lowering the required education requirements from a master’s degree to a bachelor’s degree.
Expanding the professional’s ability to perform telehealth. One way to do this would be to loosen regulations related to the ability of out-of-state mental and behavioral health professionals to provide telehealth services.
Clearly, poor occupational licensing policies are not the only determinant of Utahns’ access to mental health care. However, professional licensing generally dictates how such professionals work. Thus, licensure can be an effective mechanism for influencing the supply of mental health professionals and thus the availability of mental health services that Utahns can access.
Benjamin Shelton is a policy fellow at the Libertas Institute, a nonprofit think tank based in Lehi.