Amid mental health crisis, new agreement allows social workers to work across state lines • Rhode Island Current

Stefani Gerich, a licensed sex therapist and social worker in private practice in Detroit, sees several dozen clients a month, most of them from underserved minority groups. She discusses sensitive issues like gender-reassignment care with her clients, but building trust takes time.

Hard-earned relationships are often upended when clients move out of Michigan, because most states prohibit social workers from providing telehealth services across state lines, making it hard to find another therapist who’s a good fit. Especially in many parts of the country There is a shortage of mental health providers.

“It takes so long to find someone you feel comfortable with,” Goreich says, “and then your spouse gets transferred and you lose all of that? Statistically, people are more likely to stop therapy altogether because they don’t want to go through that again.”

among them Many Americans Amid a growing mental health crisis, a growing number of states are trying to address the issue by giving social workers more authority to operate across state lines.

Under the Social Work Licensure Compact, social workers may obtain multistate licensure, which allows them to care for patients in participating states even if they do not live in those states. Social workers must comply with the laws of the state in which the patient resides.

Missouri became the first state to approve the compact bill in July 2023. Since then, 14 States have already signed on, and at least 17 other states, including Rhode Island, are reportedly considering similar bills. The Council of State Governments Exchange of ideas across state lines.

The agreement was signed by the Council, the U.S. Department of Defense, the Association of Social Work Boards, which develops social work certification exams; The National Association of Social Workers and the Association for Clinical Social Work, membership organizations for social workers, are partners in this effort.

The Defense Department is involved because military families move frequently, many of whom include social workers. Getting new licenses every year or two would be a hassle. The social work compact is one of 10 interstate licensing compacts that the Defense Department agreed to fund several years ago. From education to beauty, According to Matt Schafer, deputy program director for the Council of State Governments.

Schafer told Stateline it will probably take a year to a year and a half before a license under the social services agreement is issued.

This isn’t the first compact to allow mental health professionals to practice across state lines: Thirty-six states have passed bills allowing psychologists to practice elsewhere by joining an interstate compact known as PSYPACT.

“It works,” Robin MacLeod, a senior director at the American Psychological Association, said of PSYPACT, “and it allows people with specialized practices to provide care and people who need specialized care to get care.”

For example, a therapist might specialize in treating people with autism and also speak Arabic, McLeod said. The interstate compact would allow the practitioner to serve more people with those specific therapeutic and language needs through telehealth.

But McLeod noted that therapists practicing under the agreements still must comply with laws that vary from state to state. She gave the example of Texas, where health care providers must be aware of laws banning abortion and gender-affirming care.

“That can be really difficult,” she said. “If you’re coming from another state to practice here, there are Texas health and safety laws that you have to follow.”

But Kenyatte Hassell, the Democratic state representative who led the successful compact bill in Alabama, believes the benefits outweigh the potential complications. 2023 Report Mental Health AmericaA nonprofit organization focused on mental illness issues ranked Alabama 48th in effectiveness at addressing mental health and substance use issues, citing the high prevalence of mental illness and limited access to care.

“We know that as a state we need to put more funding into our health departments to address mental health, from schools to the workplace,” Hassell told Stateline. “We’ve cut funding to some of the mental health hospitals in the state, and that’s become an issue.”

In Colorado, a bill is on the governor’s desk that would allow the state to join the compact, but Democratic state Assemblywoman Emily Sirota, a social worker herself, said the issue is bipartisan. Minnesota, New Hampshire and Tennessee also have compact bills awaiting their governors’ signatures, according to the Council of State Governments.

“Recognizing the need for a workforce is not a partisan issue,” Sirota told Stateline. He said the licensing agreements are a way to make the relationship between patients and social workers “more streamlined and effective.”

For Goreich, who sees patients in at least four states, anything that makes it easier for therapists to get licensed is a good thing. In addition to Michigan, Goreich has gone through the licensing process in Arizona and Ohio so he can continue to treat patients who move to those states. He also works in Florida, where he is registered as a telehealth provider and doesn’t need to be fully licensed, he said.

“I went through all the hoops and got my license,” she says, “but it ended up costing me money. But I’m OK with that because I get to help people. But if we had some sort of agreement, I would be able to see them without having to do that.”