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Legislation could boost access to mental health care

Antoinette Steinbarth has been fighting for this for more than a decade. It has included trips to Albany and plenty of talks with major players to gain their support.

Then, in the most recent session in Albany, it finally happened.

A bill passed that expands the scope of practice for licensed mental health counselors, licensed marriage and family therapists and licensed psychoanalysts, creating a for those professionals to, finally, diagnose patients on their own without the pathway supervision of a psychiatrist or clinical social worker in certain settings. Gov. Kathy Hochul signed it into law June 24.

“For me, it’s a relief,” said Steinbarth, a licensed mental health counselor and program director for crisis centers at Spectrum Health & Human Services. “I’m happy, because the reality of it is we are trained.”

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Spectrum Health, BestSelf Behavioral Health and many other mental health treatment providers are cheering the legislation, which should expand the pool of professionals who can diagnose a new patient. New York was one of the last states where licensed mental health counselors, who need master’s degree level or higher credentials, did not have the authority to diagnose.

Here’s why they say this law is a big deal:

For Steinbarth and Brittany Derry, a clinical director at Spectrum Health, what the legislation truly does is validate the position of licensed mental health counselor.

The legislation aligns the requirements for diagnostic privilege for licensed mental health counselors with those of licensed clinical social workers.

And as long as counselors meet the education and experience requirements set forth in the legislation, they are authorized to diagnose without the need for supervision. Those requirements for diagnostic privilege include a 60-semester hour master’s degree or higher, including 12 semester hours of clinical courses, and finishing at least 2,000 hours of supervised, direct client contact hours.

“It allows us to be on that level playing field with your licensed clinical social workers, where they were often seen above us, despite the ample training that we’ve had to go through in order to become a licensed mental health counselor,” Derry said.

Spectrum Health South Buffalo

A Spectrum Health & Human Services location in South Buffalo.

Courtesy of Spectrum Health

The legislation aims to address a couple key issues, namely the heightened need for mental health services at a time when the industry is experiencing critical workforce challenges.

By increasing the number of licensed mental health professionals authorized to diagnose, the legislative reasons, that should help meet the high demand for services by allowing providers to treat more patients.

“We are grateful that the legislature and the governor have recognized the valuable role that licensed mental health counselors and other experienced mental health professionals playing in treating individuals experiencing behavioral health issues like mental illness and addiction,” BestSelf President and CEO Elizabeth Woike-Ganga said in a statement. “These changes to the scope of practice for these professionals will enhance access to vital care in our community.”

While the legislation validates the licensed mental health counselor title and could help with the influx of patients, officials say more is needed to help bring people into the field.

A major hurdle remains adequately pay for the clinicians in the field, said Brandy Vandermark-Murray, a licensed mental health counselor and senior vice president of operations at Horizon Health Services.

“Reimbursement rates and funding are not sufficient to sustain staff, and many staff leave community mental health due to the challenges of the job and lack of adequate compensation, despite providers working hard to advocate for increased funding to retain skilled staff,” she said.

Several versions of the bill had been introduced in prior sessions over the last decade, but it took until 2022 to get one passed and signed.

At least one reason, according to Shannon Hodges, is because associations representing clinical social workers had long opposed licensed mental health counselors gaining diagnostic privilege because they feared it would cost their members jobs.

“That’s a mistaken belief, because there’s more work than even counselors, social workers and the rest of them combined can meet,” said Hodges, professor of clinical mental health counseling at Niagara University.

Hodges, who gets calls every month from providers looking to recruit graduates, thinks the legislation can shorten waitlists for services, while also improving the quality of care.

“The other thing to remember is New York was one of the very last states to do this,” he said. “New York has frequently been one of the last states to change. So it will definitely improve access, which will improve the quality of mental health care.”

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