Exploring Organizational Barriers and Facilitators to a New Bachelor's-Level Behavioral Health Role

Mental health provider shortages and associated mental health service treatment gaps have led to recent initiatives to broaden the types of providers delivering mental health services in the USA. A key example is the Behavioral Health Support Specialist (BHSS), a supervised bachelor's-level mental health provider, introduced in Washington State in 2023. Yet there is limited understanding of how behavioral health organizations who may employ these new providers perceive the acceptability and feasibility of these new roles, though such perceptions have critical implications for successful rollout and uptake. The research team conducted semi-structured individual interviews with n = 18 staff at organizations delivering behavioral health services throughout Washington to understand staff perspectives on these roles as the first cohort approached graduation and prepared to enter the workforce. The research team identified four main themes related to anticipated acceptability and feasibility: (1) the introduction of a bachelor's-level mental health provider role alongside existing behavioral health credentials was viewed as acceptable; (2) a lack of clear information on billing codes and financing could present an organizational barrier to uptake; (3) limited supervisor availability could present a barrier to feasibility at some organizations; and (4): high levels of burnout that exist among mental health providers could also present feasibility challenges for bachelor's-level providers. Although findings suggest promise for ongoing bachelor's-level mental health provider initiatives in Washington and other states, they also highlight several areas in which proactive implementation support may be needed to support successful introduction and sustainment of these roles.