Career Prospects in Community-based Mental Health in Maryland

There is a lot of prospect in community-based mental health careers both in the state of Maryland and all over the country. This is because for years now, there has been a lot of emphasis on prevention and reduction of inpatient hospitalization for all illnesses, including mental illness. This might primarily have been intended for cost control, it has also facilitated quality and access. The second reason why career prospects in community mental health are many is that there is currently a severe shortage of mental health workers in all sectors. The 2007 Maryland Mental Health Workforce White Paper revealed that the number and complexity of mental health problems experienced by children and their families have increased over the past decade. It further said, “At least one in five children and youth, or 20%, experience a mental health disorder. The crisis of mental health in the United States is such that 75-80% of youth with mental health diagnoses receive no services, and services received are often inadequate”. Thirdly, there is inadequate diversity among the few mental health workforce. For example, 28% of Maryland population is of ethnic minority but only 12% of mental workforce is of ethnic minorities. Furthermore, there is an acute shortage of African American males in mental health workforce.

 1. Outpatient Mental Health Clinics (OMHC)

Outpatient mental health clinics provide therapy, counseling, medication management, social skills teaching, and case management services to individuals with severe and chronic mental health problems. Career prospects available in OMHC include:

Therapists and Counselors: New regulations require therapists and counselors in OMHC to have a minimum of a Masters degree and a license (such as LGSW, LCSW, LCSW-C, LGPC, LCPC, RNC, APRN/PMHN) in nursing, social work, psychology, counseling, or psychiatric rehabilitation. Also, an RN without a Masters degree but with an RNC from ANCC can be employed as a therapist. Salaries are very attractive.

2. Psychiatric Rehabilitation Programs (PRP)

PRP programs are an extension of the services provided to the patient in the OMHC. A PRP may stand alone or be an additional service to an OMHC. The purpose of PRP is to promote the rehabilitation, integration and improved quality of life for the patient at home, school, work and community. It aims at helping the patient to function at his or her optimum best in life. The counseling can be done at the Program office (onsite) or at the patient’s home (offsite). PRP counseling could be about a wide range of topics, including anger management skills, social skills, assertiveness skills, medication compliance, coping with symptoms, managing peer pressure, taking a bus, determining bus route, drug and alcohol, gang prevention, sex education, STD education, accessing community resources such as food stamps, affordable housing, bus pass, ID card, driver’s license, job search, preparing for job interview, keeping a job, improving attention in school, completing homework and school projects, respect of authority, etc.     

Even though a mere one-year work experience in a mental health setting or having an AA degree qualifies one to be a PRP counselor, PRP programs prefer to employ persons with a BS degree in any health or mental health related field such as nursing, social work, counseling, psychology and rehabilitation. PRP counselors are usually paid $14 or more per counseling session. Each client receives 2 to 8 counseling sessions per month.

3. Expanded School-Based Mental Health (ESBMH)

In addition to the school clinic, some schools also have an ESBMH clinic. A therapist assigned from an OMHC manages each of such clinics. Apart from providing therapy to troubled kids sent to the therapist’s office from the class or principal’s office, the therapist also serve as a resource person to the school staff regarding particular children, issues or topics related to mental health. 

4. Crisis Response Programs (BCRI, BCARS)

Mental health professionals are also needed in crisis centers where services are provided for anyone in mental health crisis. The two main centers in Baltimore are Baltimore Crisis Response, Inc. (BCRI) and Baltimore Child and Adolescent Response System (BCARS). For employment inquiries, please call 410-433-5255. There are positions that do not need a Masters degree.

BCARS website provides the following information about what they do: 

BCARS is a mobile crisis response service that provides emergency contact with mental health professionals throughout the city. Dedicated crisis clinicians staff the program as part of a continuum of clinical care provided by the Catholic Charities.  The Johns Hopkins Division of Child and Adolescent Psychiatry provide psychiatric consultations to the program.  BCARS assists children and families facing psychiatric and psychosocial crises by providing hospital diversion and immediate intervention and respite. For information or assistance, please call the BCARS hotline (410) 752-2272. It is available 24-7. 

BCRI web site provided the following information: about what they do:

HOTLINE: The telephone crisis “hotline” (410-752-2272) is available 24 hours a day and is staffed by trained counselors who have the ability to provide information and referral to the network of human services in the Baltimore metropolitan area. The counselors also provide supportive counseling, dispatch emergency assistance and link callers with more intensive BCRI services.  In FY 2004 – 34,852 and FY 2005 – 30,257 calls were received on the Hotline.

MOBILE CRISIS TEAMS: Mobile crisis teams are comprised of mental health professionals including psychiatrists, social workers and nurses who can be dispatched to community locations to provide immediate assessment, intervention and treatment. Teams operate from 7:00am till midnight seven days per week. Currently the teams average over 2000 responses per year.

IN HOME SUPPORT: Persons experiencing a mental health crisis can often be maintained in the community through regular visits from the BCRI mobile crisis teams. An average of 350 people a year is cared for in this manner.

RESIDENTIAL CRISIS BEDS: Baltimore Crisis Response, Inc. operates 18 psychiatric crisis beds. Crisis beds are not new to Maryland. However, since its inception, BCRI has operated with an average length of stay of 4.5 days compared with the historical statewide average of 16.5 days.

PUBLIC EDUCATION AND TRAINING: BCRI provide public and professional education and training on a wide range of mental health related topics including: suicide prevention, crisis intervention, mental illness, and stigma.  Training has also been provided to members of the Baltimore City Police Negotiation Team, over 3,000 patrol officers, Housing Police and Sheriff’s officers. Through special grants and contracts, BCRI has provided training to Baltimore City Public School teachers and guidance counselors, clergy, 911 operators, shelter care staff and others.  Public education is also provided via a cable television program called “Mental Health Matters”.  This program provides practical information regarding mental health issues and community resources.  BCRI has also offered professional training conferences, workshops and symposia.

ADDICTIONS SERVICES: In response to the growing need for addictions treatment services BCRI has expanded and now provides a 10-day residential detoxification program for chemically addicted and dually diagnosed persons.  There are currently 16 beds operated for this purpose.

5. Group Homes

Direct care staff and counselors are needed in group homes to manage, care and support the residents in the areas of activities of daily living, behavior management, life progress, and community living. Employment preference is usually given to individuals who have a degree related to health or mental health. Salary rates are very attractive. New regulations now mandate each group home especially for children to be managed by a Program Administrator (PA) who must possess at least a BS degree in any field but preferably in a health or mental health related field. Program Administrators are very well paid, depending on their education and experience and the size and intensity of the group home. 

6. Private Practice

There are a lot of prospects for licensed mental health professionals with at least a Masters degree to establish their own private practice. The practice could be in the area of clinical, research, educational, or consultancy.