With the 2025 Legislative Session approaching, MACo is profiling major issues, including behavioral health, that stand to gather attention.
The Maryland Department of Legislative Services is forecasting additional legislative measures to address behavioral health workforce issues across the state. Maryland faces a severe behavioral health workforce shortage, with almost all counties designated as mental health professional shortage areas. Labor challenges significantly impact the delivery of behavioral health care in Maryland, with shortages observed across the health care industry, including among psychiatrists, counselors, social workers, nurses, and addiction specialists.
According to the 2025 Issue Papers:
A behavioral health workforce shortage continues to be a pervasive issue limiting access to care in the State. Almost all of Maryland is designated as a mental health professional shortage area. In 2024, the Maryland Health Care Commission issued a needs assessment with findings and recommendations related to disparities in the State’s behavioral health workforce, barriers to entry, and the cost of closing the workforce gap.
Additionally, behavioral health patients in need of inpatient psychiatric care presenting in emergency departments are experiencing transfer delays to the appropriate care setting due to insufficient psychiatric bed capacity.
The report estimates that Maryland needs to expand capacity to train, employ, and retain an additional 7,000 professionals in eight behavioral health occupations over the next five years. Based on cost estimates for each target occupation, the report estimates that $149 million is needed to close the behavioral health workforce gap over the next five years.
The price tag for these initiatives—estimated at $149 million over five years—is substantial. Legislators must weigh the cost against the long-term societal and economic toll of untreated mental health and substance use disorders. However, addressing these needs will be extremely difficult in light of Maryland’s ongoing budget shortfalls. With competing priorities for limited state funds lawmakers must navigate competing priorities for limited state funds, making tough decisions to allocate resources while ensuring they do not sideline critical investments in behavioral health.
Maryland Matters recently outlined the issue in an article quantifying some of the shortages. From the Maryland Matters article:
“The report said that in 2023, Maryland had 34,613 people working in various areas of the behavioral health field, but it said that number was 18,222 workers shy of what is currently needed. And that doesn’t take into account the additional 14,565 workers who are expected to be needed by 2028 to meet the growing need for behavioral health care, it said.”
Legislators passed a handful of bills in 2023, including a new law that went into effect establishing the Behavioral Health Workforce Investment Fund. The Investment Fund lays the groundwork for a robust response. In its October 2024 report, the Maryland Health Care Commission proposed prioritizing paid training and education for new and existing workers alongside measures to improve job quality, such as flexible schedules and career advancement opportunities. These steps aim to overcome significant barriers like unpaid internships, which have discouraged students from completing degrees in behavioral health fields.
As covered previously on the Conduit Street blog, the report shows Maryland must expand its behavioral health workforce by 50% to meet growing demand, a critical challenge that will intensify without action. Like many states, Maryland continues to struggle with rising mental health challenges, drug overdoses, and health disparities. This problem is exacerbated by the recent $12 million July budget cuts to local health departments. This $12 million reduction in funding to local health departments is nearly a 10% cut to already inadequate funding for today’s needs. Cuts in funding makes it difficult to hire staff and may result in staff cuts and scaled-back outreach efforts directly affecting vulnerable populations.
The 2025 legislative session could be an obvious time to continue working toward additional solutions.
