Benjamin Shelton: Look at licensing reform to ease Utah’s mental health crisis

The attention surrounding Utah’s ongoing mental health crisis has been turning heads at the recently formed Office of Professional Licensure Review (OPLR). On October 19, it was announced, during the Business and Labor Interim Committee meeting, that OPLR intends to conduct reviews of various regulated mental and behavioral health occupations. OPLR’s desired area of focus was then subsequently unanimously approved, without modification, by the committee.

This office, established earlier this year, through Senate Bill 16, is tasked with providing the Utah Legislature objective reviews and recommendations related to occupational licensing. Annually, the office must submit “a list of each periodic review that the office proposes to conduct during the upcoming year.” This list is reviewed by the Business and Labor Interim Committee, where committee members may make modifications or approve the list. Then, this list is submitted to the Legislative Management Committee, where committee members may make modifications or approve the list.

The rationale for OPLR beginning their work by focusing on mental and behavioral health occupations is easy to understand. Utah does not just struggle with creating positive mental health outcomes — it’s actually the worst at doing so, boasting the highest levels of mental illness within the United States. Overall, more than a quarter of Utah’s adults report experiencing a mental illness (nearly 7 percentage points above the national average).

When examining the cause of such troubling statistics, what immediately stands out is Utah’s lack of mental health professionals. These professionals are critical to minimizing the devastating impact of mental illness within the community. Yet, according to the Health Resources and Services Administration (HRSA), in all of Utah’s 29 counties, there is a shortage of mental health professionals.

This shortage of professionals is not limited to just one aspect of the health care system. Nearly every professional group dealing with combating mental illness is at risk of shortages within their professional ranks. Such shortages are clearly already in motion, with a deficiency of between 14,280 and 31,109 psychiatrists expected in the near future, and closer-to-home places like the Huntsman Mental Health Institute may already be experiencing a staffing shortage.

For individuals and families, these shortages have severe repercussions. A lack of professionals can leave struggling children and those in crisis on waitlists spanning months, and for many Utahns, put care completely out of reach. Utah’s shortage of mental health professionals is creating a situation where individuals simply do not have the access or means to see a professional. Such gaps in treatment have left 62 percent of Utah adults with mild mental illness without treatment and nearly half of Utah’s youth aged 12–17 with depression without any care in 2020.

OPLR’s reviews may ultimately culminate in policy recommendations that suggest changes to the occupational licensing processes for behavioral and mental health professionals. This should be welcomed, as one of the most practical ways the state can immediately begin to invest in the prevention and treatment of mental illness is by altering the occupational licensure laws impacting mental health professionals.

Specifically, when approaching reform for the licensing of these professionals, Utah should pursue policy reform that emphasizes deregulation via:

  • Expanding these professionals’ scope of practice. An example of this would be expanding the ability to prescribe certain medicines used in the treatment of mental disorders to psychologists.

  • Shortening the period of time it takes to receive a license. This could be pursued, for example, by eliminating the arbitrary requirement that every clinical mental health counselor has to accrue 4,000 hours of supervised work experience in at least two years. This rule currently means that ambitious individuals cannot complete this requirement and receive their license in a shorter period of time.

  • Reducing education requirements. For social workers, this could take the form of lowering required education requirements from a master’s degree to a bachelor’s degree.

  • Expanding a professional’s ability to perform telehealth. One avenue of doing so would be to loosen regulations surrounding the ability of out-of-state mental and behavioral health professionals to provide telehealth services.

Obviously, poor occupational licensing policies are not the sole determinant of Utahns’ access to mental health care. However, occupational licensure does broadly dictate how such professionals operate. Thus, licensing may be an efficacious mechanism for influencing the supply of mental health professionals and, thereby, the availability of mental health services Utahns can access.

Benjamin Shelton | Libertas Institute

Benjamin Shelton is a policy associate at Libertas Institute, a nonprofit think tank based in Lehi.