Behavioral health workforce shortages remain a critical barrier to care in rural areas across the United States. According to the Health Resources and Services Administration’s State of the Behavioral Health Workforce report, substantial shortages are projected for many occupations over the next 15 years, including psychologists, psychiatrists, addiction counselors, mental health counselors, school counselors, and marriage and family therapists. As of December 2, 2025, 40% of the U.S. population lives in a mental health Professional Shortage Area (HPSA), indicating insufficient provider availability.
The National Governors Association examined how states are leveraging the Rural Health Transformation Program (RHTP) to address these challenges. RHTP offers states federal funding to support workforce development and expand behavioral health services in rural areas. However, tight deadlines and competing priorities have led states to prioritize initiatives with established provider networks ready to use funds immediately.
States are implementing integrated care models to expand capacity without necessarily growing the workforce. Illinois is embedding behavioral health services into primary care settings through the Collaborative Care Model, building clinical connections between rural primary care providers and behavioral health specialists. Oklahoma is transforming community mental health centers into Certified Community Behavioral Health Clinics (CCBHCs) designed to provide comprehensive mental health and substance use disorder services while integrating behavioral health with physical healthcare.
Telehealth represents another key strategy for extending provider reach across rural divides. Louisiana has identified telehealth as a multimodal strategy to reach patients, though the state acknowledges the need to increase telehealth infrastructure to address potential rural broadband access challenges, with telehealth companies identified as key stakeholders.
Workforce incentives—including recruitment bonuses, relocation assistance, and capacity payments—are being used to stabilize rural provider workforces. Washington is allocating RHTP funding toward establishing workforce incentive programs specifically for rural opioid treatment providers, recognizing these as essential in-person services.
States are braiding multiple funding streams to ensure sustainable workforce growth beyond the five-year RHTP period. By aligning RHTP funding with complementary grant opportunities and training programs supported by agencies like HRSA, states aim to build capacity that persists after the time-limited federal funding ends.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.nga.org/publications/governors-policy-actions-on-behavioral-health-access/