Community services

Community service boards are strained, but persist under pressure

State-funded mental health care providers in the region are caught in a perfect storm: they are understaffed, their workforce is aging, and their community partners also have limits on the number of patients they can serve. can process. Reports by Randi B. Hagi of the WMRA.

Kimberly McClanahan, executive director of the Valley Community Services Board, summarized the biggest challenge she and other mental health care providers face in 2022.

KIMBERLY MCCLANAHAN: We don’t have the bodies to do all the work that we need to do.

Community Services Boards, or CSBs, are state-funded regional bodies that provide services such as therapy, psychiatry, addiction treatment and support for intellectual and developmental disabilities – often to clients who don’t cannot afford to consult a private supplier. As such, they are on the front lines of mental and behavioral health issues in their communities. And while it seems like every business and organization is understaffed these days, CSBs have some very specific challenges filling their rosters.

MCCLANAHAN: People aren’t getting into the behavioral health fields as much as they used to be, and now that there are more options for telehealth, some people are leaving community service boards or your health centers. community mental health to go into private practice…because they can stay home and work from there.

The licensed workforce as a whole is also aging. A report published by the Virginia Health Care Foundation earlier this month found that, [quote] “Virginia is rapidly approaching a provider cliff with 61% of psychiatrists age 55 or older and 39% of psychology NPs age 60 or older.” About one-third of all licensed clinical psychologists and social workers and licensed professional counselors in the state are also nearing retirement age.

To add a rock to this tough spot, new state-level regulations now require higher levels of accreditation for certain CSB employees.

ADAM YODER: And that’s for the benefit of the services offered –


It’s Adam Yoder and Rebekah Brubaker, with Harrisonburg-Rockingham CSB.

YODER: At the same time, they’re being enacted so quickly that it’s just not possible to keep up with that when you ask someone with a license to now oversee staff or authorize services. Licenses take two to three years to get, plus lots of residency hours…and then the other part of COVID is people have delayed going to school or going back to school because they don’t want to learn online.

Kim Shaw, executive director of Rockbridge Area CSB, said understaffing meant many of their customers had to wait to access services.


KIM SHAW: We have people waiting backstage. Whereas at one point before the pandemic we had no waitlist, or a very minimal waitlist, we now have a six-month waitlist for some of our services. And we have fewer resources here in the Rockbridge area than even Harrisonburg-Rockingham or Valley, so we don’t even have other providers to refer them to in some cases.

Even in places where these other providers exist – such as therapists in private practices – they are also usually at full capacity. Rebekah Brubaker said this translates to more people showing up at their doorsteps in a crisis.

BRUBAKER: What we’re hearing is that these people aren’t able to find someone because these therapists are full.

For those who reach crisis level requiring hospitalization or some other form of inpatient care, CSBs are further handicapped because, as Kimberly McClanahan points out, institutions such as assisted living facilities and Western State Hospital restricts admissions.

MCCLANAHAN: That, I think, will continue to be a challenge, as far as I know, at least for the foreseeable future. Because, again, we work with the most vulnerable in our population… We’ve had situations where people have been in the Augusta Health ER for days.

HAGI: Wow.

MCCLANAHAN: For days before they can enter anywhere. And again, this is not unique to Valley.

A silver lining Valley CSB has found during the pandemic is that more clients are tracking their medications now that they can meet their prescribers remotely.

MCCLANAHAN: And that’s probably often because these people maybe don’t have transportation, just can’t come here… so it’s kind of been these medication management appointments that have really been a lot better followed up with the use of telehealth and telephone.

Mental and behavioral healthcare providers see us in and through some of our darkest places – often at risk of suffering burnout or secondary trauma themselves. Although they don’t have enough, every administrator I spoke to praised their employees.

SHAW: My staff is just amazing. They go above and beyond everyday, and they don’t even question it. They do so much with so little.

A proposed bill currently being negotiated at the General Assembly would add more than $160 million to incentives for hiring and retaining CBS employees.