Behavioral Health Fellowship Shows Lasting Workforce Impact
A University of Maryland School of Social Work (UMSSW) analysis has shown that a federally funded fellowship to increase social workers and counselors is successful at developing students into professionals who continue to work in the field.
The 2024-25 Cohort of the Behavioral Health Workforce Integration Service and Education (BHWISE) Fellowship.
More than a decade after its launch, the Behavioral Health Workforce Education and Training (BHWET) program demonstrated the power of federally funded fellowships to grow the behavioral health workforce. At the UMSSW, the local version of the program was called the Behavioral Health Workforce Integration Service and Education (BHWISE) Fellowship.
To evaluate the program’s long-term impact, a team led by Paul Sacco, PhD, professor and principal investigator of the BHWET grant at UMSSW, conducted a follow-up study with graduates from Maryland and two partner programs in Missouri and Kansas. The results show that nearly 90 percent of graduates continue to work in social work, and 95 percent hold professional licensure.
“Ten years out, the one thing our students always said was that the fellowships make a huge difference,” Sacco said.
Sacco presented his findings on Oct. 24 at the Council on Social Work Education Annual Conference in Denver.
BHWET is supported by the Health Resources and Services Administration (HRSA), with its roots in 2014 in response to President Barack Obama’s Now Is the Time initiative. The initiative was developed after the Sandy Hook tragedy to expand the nation’s mental health workforce. HRSA’s involvement led to the creation of training grants aimed at increasing the number of social workers, counselors, and psychologists working with youth and families in need.
Building a Pipeline for Behavioral Health Providers
Through three consecutive grant cycles (2014–2017, 2017–2021, and 2021–2025), UMSSW received more than $6 million in HRSA funding. Each cohort of social work fellows received a $10,000 stipend, completed specialized coursework, and participated in interprofessional training experiences, focused on preparing students to serve high-need populations.
The fellowship combined classroom learning with field placements in clinics and community-based settings that serve youth and families. Monthly seminars and required interprofessional education projects helped fellows build confidence working alongside medical, nursing, and pharmacy students, an approach Sacco said is now a hallmark of social work education at UMB.
“I look for more opportunities to collaborate with area agencies and providers to offer an integrated approach to care,” one participant wrote in their survey.
More than half of respondents were employed at organizations in medically underserved or mental health shortage areas with nearly three-quarters in at least one. That’s encouraging, though Sacco believes there is room for growth.
“If it were 80 percent, I’d be happier,” he said. “But even 50 percent represents real impact given how few incentives exist to practice in high-need communities.”
One surprising finding from the study was the rise of telebehavioral health work among study participants. A subset of fellows, particularly those based in Maryland, now conduct much of their work virtually. While that model expands access, it complicates HRSA’s geographic designations to determine if someone provides care in an underserved community.
“Some of these people, their location was not in a high need area, but we don't know whether they were or were not still working with people in high-need areas,” Sacco said.
The study also revealed some racial disparities in career status. African American graduates were employed in high need areas at lower rates. More research is needed to understand these graduates’ decisions for where they decided to work. Debt burden also played a factor; nationally, African American students incur a total educational debt of about $85,000 compared to white students at $55,000 for their studies from undergraduate through completion of their MSW degree, according to a 2020 Council on Social Work Education (CSWE) study. Yet, the median social work salary was only $47,100, according to CSWE.
What remains to be seen is whether a federal fellowship could be designed or adjusted to encourage or require students to move to high-need areas, particularly rural communities as most students in this study stayed relatively close to their school or where they lived. The BHWET program only required a commitment letter to work in behavioral health.
“If you go to Northampton, Massachusetts, the number of social workers per square mile may be quite high,” Sacco said. “And then there are other areas like Kansas where there likely aren't enough.”
Although the HRSA funding for UMSSW’s BHWET program has concluded, Sacco hopes the evidence gathered over the past decade will inspire continued support for similar initiatives nationwide.
