Maine’s mental health workforce has grown significantly over the past five years, but providers say the growth has had little impact on the long waiting lists for those waiting for treatment.
The increase is largely due to an increase in the number of licensed social workers, which will increase from 4,413 in 2019 to 7,613 in 2024, according to data provided to Maine Observer by the Maine Department of Health and Human Services and analyzed by the Investigative Reporting Studio.
Overall, the total number of mental health providers in the state — which includes counselors, substance use counselors, social workers, psychiatrists and psychologists — will increase from 7,494 in 2019 to 12,060 by November 2024 (the 2024 data does not include psychiatrists because data is only available through 2023).
Despite the cost increases, agencies say they are struggling to hire providers and patients are still waiting months for care.
Jayne Van Bramer, CEO of Sweetser, a nonprofit behavioral health provider, said the organization has had extreme difficulty hiring clinicians.
“The workforce shortage is really at the core of our access to care issue,” Bramer said, adding that many clinical positions that require the highest requirements and degrees remain unfilled.
Jerry Stevens, a psychotherapist who has practiced in Maine for 45 years and former president of the Maine Mental Health Counselors Association, said she has “not necessarily seen an increase in the number of providers at the clinical level.”
Data provided by the state show the number of licensed clinical counselors in the state will nearly double from 1,229 in 2019 to 2,438 in 2024, and the number of licensed clinical social workers will increase 80% from 2,639 in 2019 to 4,773 in December 2024.
The only mental health field that did not see an increase in providers was psychiatrists, whose number would drop from 110 in 2019 to 60 in 2022, according to the BLS.
The BLS data differs significantly from data from the Maine Medical Licensing Board, which shows 343 licensed psychiatrists in Maine as of January 2025. Timothy Terranova, the board’s executive director, told the Monitor that the state does not track the number of active licenses by year.
A representative from the Bureau of Occupational Employment and Wage Statistics (OEWS) said in an email that there could be several reasons for the data discrepancy. The BLS survey is based on all part-time or full-time workers who earn a specified wage or salary, which would exclude “providers working in other occupations, self-employed providers, domestic workers, or unpaid domestic workers.”
The discrepancy could also be because “an active license does not mean the licensee practices medicine in Maine,” Terranova said.
A survey released last fall by several advocacy groups, including the Maine chapter of the National Association of Social Workers, found that “while the BLS reports behavioral health clinicians as one of the 20 fastest-growing occupations in the nation, national projections for the supply and demand of (behavioral health) providers in Maine do not align with the reality for providers and patients.”
“Waiting lists for treatment are getting longer, inpatient beds are becoming scarce, and patients are lingering in emergency rooms for weeks awaiting intensive care that doesn’t exist,” the authors wrote.
Meeting the greatest needs in rural areas
While the number of providers has increased overall, the need for mental health care has also increased.
“The need (for services) has been increasing, and I think COVID has made some progress in reducing health stigma. So that has increased the need as well,” said chapter president Julie Schirmer.
The survey found that for those seeking behavioral health care, “access challenges are across the board,” with the biggest gaps in treatment and prescription services, especially in rural areas.
According to the study, Maine has nearly 13,000 patients seeking personal service providers, mental health counseling or prescription services, with an average wait time of eight months. The longest wait times were for mental health counseling, with more than 8,000 patients waiting six to 24 months.
The survey also found that organizations are closing services because reimbursement levels don’t meet the cost of care and because it’s difficult to hire and retain clinicians.
Sweetser’s Bramer said recruiting staff in rural areas is extremely challenging.
“Providers don’t want to move to rural areas unless you grew up in that area. There’s not enough to do there,” Bramer said. “They’re not moving there.”
Supplier shortages strain capacity
Bremer added that job requirements are also affecting the workforce. “We’re seeing compassion fatigue. We’re seeing burnout. We’re seeing some people, even if you can hire them, they’re not going to stay.”
The problem isn’t limited to rural areas, however. The survey also noted that agencies are having an increasing difficulty hiring for positions in Portland, as housing costs there have risen sharply in recent years.
Expenses are also taking a toll on students, said Carolyn Shanti, associate dean of the School of Social Work at the University of Southern Maine. Shanti said the program has seen a noticeable drop in applicants over the past few years, as students are finding it increasingly difficult to afford to live in Portland and often carpool long distances.
Prior to the pandemic, the bachelor’s degree in social work program enrolled an average of 120 students per year, according to Shanti, which dropped to about 70 students during the pandemic and is now slowly climbing back up.
“We have a vast majority of commuters,” Shanti said of the program.
Shanti said students are also having trouble getting internships at agencies. Internships are a requirement to become a licensed agency in the state, but most are unpaid, and students are increasingly uninterested in or unable to afford them. Additionally, agencies can’t accept interns if they lack the time and resources to supervise them.
“We have a hard time finding enough internships for all of our students because the industry is so stressed out,” Shanti said.
Van Bramer said this mismatch between supply and demand, especially the workforce shortage, has a ripple effect on patients. “It’s leading to reduced services, closures, and long wait times, with people having to receive services in more expensive settings — like hospitals, emergency rooms, and even the criminal justice system.”
Stevens said waiting so long for care can also exacerbate a person’s mental health issues.
“If I’m not mentally well right now and I think I need services, I don’t have the ability to start calling around. I’m desperate,” Stevens said.
“I keep calling and people don’t return my calls or tell me they can’t see me… and that just exacerbates my mental health issues.”
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