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According to the 2019-2020 National Survey of Children’s Health, 42% of children ages 3-17 with behavioral health needs in New York did not receive needed treatment in the past year. The outbreak of the Covid-19 pandemic has further exacerbated this problem. Adequate access to treatment is stymied by the lack of, and unevenness in, distribution of trained behavioral health professionals in New York State. To address these inequities, in 2021 Adelphi University proposed an Interdisciplinary Education and Training Experience (IDEATE) Integrated Behavioral Health Fellowship, and received Behavioral Health Workforce Education and Training (BHWET) funding from the Health Resources and Services Administration (HRSA). The IDEATE fellowship trains graduate social work and psychiatric nurse practitioner students in integrated behavioral healthcare for children, adolescents and transition age youth.
Method
In this evaluation study, we implemented pre and mid-year student surveys, and collected student demographic and training site data. We used an adapted version of the Social Worker Integrated Care Competencies Scale and the Phillips Objective Structured Clinical Examination Telehealth Survey to measure six competency domains: clinical practice, practice management, consultation, documentation, team performance, and administrative. Items were added to assess competencies in prescribing medications and diversity/inclusion. Independent Samples tests were conducted to examine the differences between medians of student pre-and mid-term self-ratings.
Results
In 2021-2022, 28 students were recruited: 15 psychiatric nurse practitioner and 13 MSW students. Students were diverse in terms of age, and race/ethnicity. Approximately 86% were female and 14% male. Students' ages ranged from 22-60. Forty-three percent identified as African American or Black, 29% as white, 11% as Asian, and 7% as Asian. Eighteen percent identified as Hispanic. Comparing pre and midyear median scores, students perceived that their knowledge improved across all domains, but with greater change in the following: assessment and diagnosis (pre 2.4, midyear 3.4, r=-.57, p<.01), care coordination (pre 2.73, midyear 3.63, r=-.54, p<.01), health care basics (pre 2.5, midyear 3.63, r=.54, p<.01), and evidence based practice (pre 2.2, midyear 3.15, r=-.57, p<.01).
Conclusions and Implications
Specialized professional training programs improve students’ perceived competence in integrated behavioral health care. With an increased need for behavioral health professionals who are trained to work in integrated care, opportunities for students to participate in programs like IDEATE are necessary. Future research should include more longitudinal data, a qualitative study component to understand why students felt they improved in specific competencies, and more objective measures of competence that are less reliant on student self report.