Rural Mental Health Workforce Development in Hawai'i and the US-Affiliated Pacific Islands

Introduction

Hawaiian chant for bringing insight, clarity, and collaboration (to be sung three times, each time raising the vocal pitch one-half step) by Edith Kanaka`ole via Papa Ola Lōkahi.

Within the U.S., international and national initiatives exist aimed at improving the mental health workforce. The vast majority of regulation and impact, however, is derived from the individual states, not the federal government. Each state is responsible for the licensing and categorization of mental health providers eligible to practice in that state, and licensure requirements vary widely between the states (emphasizing the necessity of state-level coordinated workforce development efforts). The use of mental health services in the U.S. is generally driven by three inter-related concepts, which are the quality, access, and cost of mental health care. Furthermore, multiple dimensions influence these concepts on a workforce-level. Examples of these dimensions are licensure requirements, scopes of practice, quantity of workforce members, wages, and provider types (Heisler & Bagalman, 2015). The purpose of this chapter is to inform the reader on the types of mental health care practitioners in Hawaiʻi, the policies that regulate a professional’s ability to practice mental health care, the psychological and behavioral health disparities of the U.S.-Affiliated Pacific Islands, and what is being done to address workforce shortages in this field. Through examining current and past programs, initiatives, and activities, recommendations are provided for workforce professionals.