Use of a Statewide Stipend Program to Increase Diversity, Cultural Competence and Consumer Participation in the Public Behavioral Health Workforce

Background and Purpose: California's public mental/behavioral health care system has long struggled to recruit, train, and retain sufficient numbers of skilled, ethnically and linguistically diverse, culturally competent social workers. Since 2005, the California Social Work Education Center (CalSWEC) has collaborated with 21 California MSW programs to address this issue through a stipend program funded by California's Mental Health Services Act (MHSA). Modeled on Title IV-E, this program provides stipends and training to MSW students based on collaboratively identified goals and competencies, in exchange for students' commitment to work in California's public mental/behavioral health system after graduation. Program goals focus on:
•    Increasing the proportion of MSWs in the public mental/behavioral health care workforce who have lived experience as consumers and/or family members in that system
•    Increasing the degree to which those MSWs reflect the cultural, ethnic and linguistic diversity of the consumers they serve
•    Increasing the proportion of those MSWs who are trained to employ the recovery model in service provision

Methods: This cross sectional analysis examines data collected from over 2000 MSW stipend program recipients who participated in the stipend program between 2005 and 2016. Data was collected through required student application and tracking information submissions, and through follow up surveys of program graduates. Programmatic impact on workforce development goals around racial, ethnic, and linguistic diversity and consumer and family member involvement in public mental/behavioral health services are assessed through descriptive and multivariate analysis of program data, as well as comparison against statewide workforce data. Qualitative analysis examines graduates' perceptions of how program participation, especially training in the recovery model, influenced their career choices and trajectories.

Results: Findings suggest that the stipend program has helped to increase the racial/ethnic and linguistic diversity of MSWs working in California's public mental/behavioral health system. In recent cohorts at least 60% of stipend recipients identify as people of color, the majority being Latinx, Asian/Pacific Islander or African-American. In addition, at least 50% of these recipients report being able to deliver services in at least one language other than English, most commonly Spanish and languages of Asia and the Pacific Islands. Findings also suggest the program is successful in recruiting and training students with lived experience as consumers and/or family members in the public mental/behavioral health system. In recent cohorts at least 23% of recipients report lived experience as consumers and at least 35% report family members having such experience. Finally, this analysis suggests important ways in which MSW students trained in the use of the recovery model approach their work and their careers guided by different expectations and goals.

Conclusions and Implications: The notable diversity and representation of consumers and their family members among program recipients reflects targeted collaborations between CalSWEC, social work employers and schools of social work to recruit, select and support the success diverse students and consumers and family members in the stipend program. Policy implications focus on the need for legislative and advocacy efforts to secure ongoing funding for and development of this program.