During the best of circumstances, it can be anxiety-producing for any parent to try to help a child going through a mental health crisis. During the pandemic, Daniel Svoboda of Fairview Park said he faced long waits for doctor call backs and appointments while seeking treatment for his son. The crises, where they needed help right away, were the most frustrating, he told The Land.
“When we ran out of medication, needed emergency treatment, or we just didn’t know what to do, we could only leave a message for our doctor,” Svoboda said.
The family coped as best they could, while Svoboda, who volunteers with the National Alliance on Mental Illness Greater Cleveland, leaned on his own lived experiences. “I’ve dealt with my own mental illness since I was a teenager, so I’ve gained a certain bit of knowledge about providers and treatment options,” he said. He built a connection of empathy with his son while they navigated the care system as a family.
Although the Svobodas didn’t know it at the time, many parents are in the same boat. Across Cuyahoga County, demand for mental health services for youth diagnosed with anxiety, depression and behavioral problems has been rising, forcing many patients to wait longer for critical services. According to a report by The Ohio Council of Behavioral Health & Family Services Providers released in December 2021, over 70% of behavioral health care providers reported a higher need for adult and youth mental health services. At the same time, 98% of the responding providers reported difficulty recruiting staff. Vacant clinical/medical positions last from two months to a year.
The report cites that “behavioral health care is often stressful with long, irregular hours… and high-risk situations.” According to the survey responses, “Staff often feel unrecognized as the critical health care workers they are. Insufficient insurance coverage and reimbursement has not been available for all licensed professionals… contributing to wage stagnation.”
To address this shortage, Cuyahoga County, the city of Cleveland, and Ohio Means Jobs held a press conference in August announcing the creation of a Sprint Task Force of mental health community leaders. The leaders will participate in facilitated sessions over the next few months (through mid-February) to recommend ways to grow the mental health workforce and better serve young people.
The goal of the task force is to deliver specific recommendations for a localized set of strategies, focusing on equitable pay for behavioral health providers, loan forgiveness, professional capacity building, interstate licensure simplification, diversity and equity, and integrated behavioral healthcare. The task force will share their recommendations in a report.
“The number of young people diagnosed with behavioral health problems continues to grow, yet the mental health workforce specializing in treating young people has shrunk … providers are stretched thin in an already demanding field,” said Cuyahoga County Executive Chris Ronayne.
A coordinated approach
Cleveland Mayor Justin Bibb described the roundtable conversations that have taken place so far since January 2023. Leaders have talked about how to address gaps and barriers in behavioral health care for youth and held a fireside chat with residents of Cleveland. Bibb officials invited U.S. Surgeon General Vivek Murthy to a meeting in April 2023, where mental health care providers and young people spoke up about the need for more accessible care for youth.
“This sprint task force’s report will allow us to act with urgency to support our young people, which in turn impacts our schools and educators, and the overall health of our city,” Bibb told leaders at the Ohio Means Jobs meeting. Michelle Rose, executive director of Ohio Means Jobs Cleveland-Cuyahoga County, will coordinate the sprint task force.
The shortage of providers has a direct impact on families seeking help. Svoboda described his family’s arduous search for care. “First you have to locate doctors who are taking new patients, then you sort out the ones who take your insurance, then they have to be a good fit for your child. Once you choose, your first appointment is still 2-3 months away, or longer,” Svoboda said.
Service providers have struggled to keep workers, with over 88% of providers reporting difficulty with staff retention and about 77% reporting higher staff turnover, according to The Ohio Council report.
“People are exiting not just mental health, but education because they are on the front lines of meeting the needs of young people,” said Habeebah Grimes, executive director of the Positive Education Program (PEP), a Cleveland-based organization that provides behavioral health support to children and their families. Youth and providers both witnessed racialized violence and economic stressors during the pandemic, exacerbating mental health concerns, she said.
Scott Osiecki, CEO of the Alcohol, Drug Addiction and Mental Health Services (ADAMHS) Board of Cuyahoga County, said pay is also an issue. “New staff are coming out of school with $100,000 worth of college debt and need a living wage,” he said. He highlighted the board’s efforts to address workforce gaps, such as its successful advocacy for a 10% increase in the rates behavioral health providers receive for Medicaid services. The board also created videos that explore careers in behavioral health for high school students.
Next steps
NAMI Greater Cleveland executive director Katie Jenkins responded positively to the news about the sprint task force agenda, which is slated to come out with a report with specific, actionable goals for moving forward after its planning meetings wrap up in February.
“NAMI Greater Cleveland is thankful for the progressive vision of the county, city, and Ohio Means Jobs,” she said. “We see firsthand the struggle our community members encounter in accessing affordable and highly qualified mental health services, but also the hardship recruitment and hiring has caused for our partner organizations over the last several years.”
“This task force is a huge step in closing the gaps between our community’s needs and our ability to meet them,” she added. “NAMI will always remain a strong resource for family and friends who are affected by mental health conditions.”
Parent Daniel Svoboda believes that any coordinated efforts to improve access to behavioral health care for youth will position Cleveland as a forward-thinking city, committed to the wellness of children and youth, and the families who love them.
“You have to build some sort of better support network just so parents don’t feel like they’re on an island,” he said. “That feeling of stress by kids – they start to blame themselves. They start to get upset that they’re making their parents upset. The approach can’t be the existing model – it has to be an improved model that’s different.”
Contact Michelle Rose, executive director of Ohio Means Jobs Cleveland-Cuyahoga County, and sprint task force coordinator, at michelle.rose@jfs.ohio.gov. Learn more about NAMI Greater Cleveland on their website.
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