Developing the Behavioral Health Workforce in Merced County, California

Published By
Health Impact Project

Between 2018 and 2020, a team of Merced health providers, educators, researchers, and community advocates conducted an HIA to understand the impact of workforce shortages related to mild-to-moderate behavioral health (MMBH) concerns and to present ways to decrease the shortages.

Merced has still not fully recovered from the housing crisis and recession of the early 2000s, and the poverty rate is double that of California. Literature suggests that MMBH issues and poverty are tightly linked, and the HIA confirmed this linkage in Merced by examining the 2016 Merced County Community Health Assessment.

The HIA explored Merced’s behavioral health workforce shortages, which have existed for at least a decade, and found that the absence of opportunities for required training to receive a license in social work or a related MMBH field is a key barrier to expanding that workforce.

The HIA offered recommendations for behavioral health advocacy groups and health-related organizations that can supervise licensing hours, including: advocating for acceptable insurance reimbursement for behavioral health services, both for amount and type of services and reimbursement rate for services; encouraging organizations that provide behavioral health services to provide the supervised training hours required for licensure; creating local opportunities for masters-level providers to quickly complete their required hours; and ensuring that primary care providers can identify and address MMBH concerns, such as appropriate referral to services.


The HIA led to decisions and actions among organizations serving the behavioral health concerns of Merced County. Mercy Medical Center Merced (the county’s main hospital) strengthened the emphasis on behavioral health in its Family Medicine Residency Program, which trains family physicians. Community organizations that contributed to the HIA, notably the Merced chapter of the National Alliance on Mental Illness, and Adverse Childhood Events Overcomers, a community-based organization addressing the influence of childhood trauma, used the report to advance local goals for behavioral health and workforce development. 


This Health Impact Assessment Report first appeared in The Cross-Sector Toolkit for Health. The Cross-Sector Toolkit for Health was originally developed by the Health Impact Project, formerly a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts. The creation of this resource was supported by a grant from the Health Impact Project. The views expressed are those of the author(s) and do not necessarily reflect the views of The Pew Charitable Trusts, or the Robert Wood Johnson Foundation.

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