Strengthening Behavioral Health Workforce: Evaluation of the Pipeline Program for Advanced MSW Training in Integrated Care

The critical shortage of behavioral health providers in the United States has intensified since the COVID-19 pandemic, disproportionately affecting underserved communities and youth in need of mental health services. In response, Fordham University Graduate School of Social Service launched the Prioritizing Integrated Care, Prevention, and Equity: Leading Interprofessional New York City-based Efforts (PIPELINE) for Youth Health program, funded by the Health Resources and Services Administration (HRSA). PIPELINE aims to prepare advanced-year MSW students to deliver culturally responsive, team-based behavioral health services to children, adolescents, and transition-age youth. The program integrates a specialized curriculum, interprofessional field placements, and seminars focused on integrated care, prevention, and health equity. It also prioritizes workforce diversification to better reflect and serve marginalized communities.

This study evaluates PIPELINE’s effectiveness in enhancing students’ core behavioral health competencies. A one-group pretest-posttest design was used with two student cohorts (2021–2022 and 2022–2023). Behavioral health competencies were assessed at the beginning and end of the program using the Behavioral Health Consultation Core Competency Tool (BHCT), which includes six domains: Clinical Practice, Practice Management, Consultation, Documentation, Team Performance, and Administrative Practice. Both students and their field supervisors completed BHCT ratings. Repeated measures ANOVA with Bonferroni correction was used to assess change over time, and cohort membership was tested as a between-subjects factor.

Results indicated statistically significant improvements in five of the six competency areas based on student self-ratings: Clinical Practice (F(1,50)=9.05, p=.004, η²=.15), Practice Management (F(1,49)=23.11, p<.001, η²=.32), Consultation (F(1,47)=8.77, p=.005, η²=.16), Documentation (F(1,48)=6.80, p=.012, η²=.12), and Administrative Practice (F(1,46)=11.81, p=.001, η²=.20). Team Performance showed improvement but did not reach statistical significance (F(1,49)=3.51, p=.067, η²=.07). Supervisor ratings revealed similar significant improvements: Clinical Practice (F(1,43)=17.25, p<.001, η²=.29), Practice Management (F(1,43)=15.27, p<.001, η²=.26), Consultation (F(1,41)=9.89, p=.003, η²=.19), Documentation (F(1,42)=6.60, p=.014, η²=.14), and Administrative Practice (F(1,43)=6.28, p=.016, η²=.13). Team Practice Skills improved (F(1,43)=5.86, p=.020, η²=.12), but did not meet the Bonferroni-adjusted threshold. No significant differences were observed between cohorts, indicating consistent program effects across groups.

These findings suggest that PIPELINE effectively enhances key competencies for MSW students entering integrated behavioral health care settings and contributes to the development of a more diverse and prepared workforce.Despite these promising outcomes, the study has several limitations. The absence of a comparison or control group limits the ability to draw causal conclusions about the program’s effects. Additionally, the use of self-report measures introduces the potential for social desirability and response bias, despite being supplemented by supervisor evaluations. The modest sample size also limits generalizability. Future research should incorporate mixed-methods designs, larger and more diverse samples, and experimental or quasi-experimental approaches to strengthen the evidence base. Nonetheless, PIPELINE offers a replicable, equity-focused training model for expanding the behavioral health workforce serving youth and families.