The Impact of a Statewide MSW Stipend Program on Workforce Development Goals for California's Public Behavioral Health Care System

Background and Purpose: California's public behavioral health system has struggled to recruit, train, and retain sufficient numbers of skilled, ethnically and linguistically diverse, culturally competent MSWs. California's Mental Health Services Act (MHSA) has funded a variety of Workforce Education and Training (WET) initiatives to address this. Since 2005, the MSW Stipend Program has provided specialized training and stipends to MSW students in exchange for their commitment to work in California's public behavioral health system after graduation. Key program goals include:

• Training MSWs who reflect California’s cultural, ethnic and linguistic diversity
• Training MSWs with lived experience as consumers or family members of consumers
• Training MSWs in the use of the recovery model
• Retaining MSWs in the public behavioral health system beyond their service obligation

The study objective was to assess achievement of these goals, in light of the impending sunset of MHSA WET funding and the need to develop priorities for future workforce development efforts.

Methods: This cross-sectional analysis focuses on quantitative and qualitative data collected from over 2200 program participants trained between 2005-06 and 2017-2018. Data was collected through student applications, MSW program reports, and surveys of program graduates. Trainees’ racial, ethnic, and linguistic diversity and consumer/consumer family member statuses were assessed using descriptive and multivariate analysis of program data and comparison against statewide workforce data. Program impact on participants’ use of the recovery model in service provision, commitment to employment in public behavioral health, and career trajectories were assessed through content analysis of qualitative data reported by program graduates.

Results: Quantitative analysis suggests that the program has increased the racial/ethnic and linguistic diversity of MSWs working in the public behavioral health system over time. Over 68% of recent program graduates identify as people of color and over 66% report fluency in languages other than English. Over 33% of recent graduates report lived experience as service consumers and over 48% as family members of consumers. Qualitative analysis suggests that graduates who embrace the recovery model approach their work with somewhat different expectations and goals for themselves and service consumers, which may lead to longer careers in the public system. Graduates’ career-related decision making appears to be impacted by factors including their endorsement of the recovery model, their perceptions of the value of their training, and their perceptions of the relative rewards of employment in public vs. other systems of care and in behavioral health vs. others fields of practice. 

Conclusions and Implications: Significant diversity and consumer representation among program participants reflects successful efforts to recruit, select and support the success of target students. However, graduates' perceptions of how program participation influenced their career trajectories suggest that goals for targeted intervention approaches and retention in the public system must be clearly and consistently integrated throughout training experiences, so that graduates embrace them as personal missions. To achieve program goals, workforce development efforts must also strategically address structural barriers created by uneven geographic dispersion of educational and employment opportunities and variance in compensation between different systems of care and fields of practice.