Northern Michigan health department spearheads effort to expand behavioral health workforce

This entry in the Nonprofit Journal Project is part of a series of articles about how Michigan health care professionals are responding to the state's health care workforce shortage. It is made possible with funding from the Michigan Health Endowment Fund.

As this series reported in January, all of Michigan is facing challenges in staffing the health care workforce. The Michigan Health Council's Michigan Healthcare Workforce Index found that nearly all Michigan health care occupations are experiencing and projecting workforce shortages through 2032. The report also notes that behavioral health occupations face immense shortages, especially in the state’s rural areas.

Serving 10 counties, the Health Department of Northwest Michigan (HDNM) is leading an innovative program called Seeding Success to Behavioral Health, which seeks to address the behavioral health needs of HDNM's rural population. This cross-sector collaboration involves a wide range of stakeholders who are pitching ideas and taking action on recruiting and retaining behavioral health care professionals across the region — and beyond.

While the project addresses workforce needs of all the various behavioral health practices, agencies, schools, and community-based organizations in HDNM's service area, HDNM itself is no stranger to the shortage. Its own behavioral health team includes a total of 32 positions, six of which are currently unfilled.

We recently chatted with HDNM Deputy Director Holly Campbell and Dr. Pennie Foster-Fishman, project leader for the Northwest Michigan Community Health Innovation Region Behavioral Health Initiative, about how they are collaborating to solve the workforce shortage in their region.

Q: What kinds of behavioral health services does HDNM provide?

Campbell: Here at the Health Department of Northwest Michigan, our mental health providers are school based. We're in 12 different districts. We have full clinical models where we have a nurse practitioner, mental health professional, and a public health tech within a school. And we have several schools that have just a mental health professional available for the kids to come and see — their caseloads are bursting at the seams. We're spread so thin that, a lot of times, it's hard to provide all of the children that have needs with the services they deserve. We have a hard time recruiting enough people in our region to fill the need that we have.

Foster-Fishman: Many mental health conditions first appear in youth and young adults, with about 50% of all conditions beginning by age 14. And youth are six times more likely to complete mental health treatment within a school setting than a community setting.

Q: Which type of behavioral health positions does HDNM have the most challenge filling?

Campbell: In most school-based health care, providers have their [Master of Social Work degree]. They are in hot demand right now. In the region the health department serves as well as in all of rural Michigan, everybody competes for the same social workers. I would guess that social worker positions are the hardest to fill because they're the most versatile degree.

Q: Why is it important that these positions be filled?

Campbell: Having clinicians in schools, whether that's a social worker or a nurse, provides such needed services. A lot of our families in rural Northern Michigan face several barriers, whether that's transportation or insurance — we don't discriminate based on the type of insurance or if a family is underinsured or uninsured. Since we're able to provide these services in schools, the parents don't have to leave work to come and get their kid and take them to therapy. The students are not missing as much class time, and they're able to build such a special relationship with that therapist in that school. If you think back to elementary school or middle school about the people that had such an impact on you — that's what we're seeing as these kids go through. They're able to work through some of their things. That might be difficulty with friends or some problems at home. They may only need to be seen a couple times, and they're good. Or, year after year, they're seeing the therapist so they're able to develop a close relationship and have that mentor, which we know is tied to helping children be resilient.

Q: How is the Seeding Success to Behavioral Health through Cross-Sector Action program addressing the behavioral health workforce shortage in Northern Michigan?

Foster-Fishman: We currently have 13 cross-sector action teams. Three are primarily focused on the issue of retention and recruitment — one is solely focused on recruiting interns, because we know that we have to grow our pipeline and interns are one of the most effective ways to do that. Interns are very likely to do their first job where they do an internship. Our internship website currently has 21 organizations in Northwest Michigan. It’s searchable by population, degree type, and the type of opportunity. That’s been very effective to get the word out to field placement officers at major programs and universities across the state. Many of the websites in our region are not designed to recruit people like Fortune 500 companies say we should be to make them attractive to the younger generation. So, we're going to do a lunch-and-learn on how to do that.

We also have an action team that's focused on recruiting professional providers. They did a series of conversations with HR leaders, key leaders, and supervisors in organizations that provide behavioral health services to identify what are some of the biggest recruitment challenges. They identified four challenges that we have the capacity to have an impact on, and we're in the process of offering a series of lunch-and-learns to build local capacity to address those issues.

Also, we collected data from 182 behavioral health providers to find what's their current status of burnout, what's their intention to leave their current job, and what are their work-life experiences. We have built a series of interventions, tools, and lunch-and-learns around the findings. What we're trying to do in the simplest way is build organizational capacity to support healthy work-life conditions.
Estelle Slootmaker is a working writer focusing on journalism, book editing, communications, poetry, and children's books. You can contact her at or

Photos courtesy of Pennie Foster-Fishman and Holly Campbell.
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