Whether you are just getting started in your social work studies or have been in the business for a while, it’s probably no surprise to you that the nation is facing a desperate shortage of trained behavioral health workers.
But there’s one state where that shortage is on the way to being reversed: Illinois.
The story behind how it has happened is a monument to social workers doing what they do best, within their own industry. It’s a demonstration of the unique ability for introspection, analysis, and action that comes with the right social work education. And it’s a result that will benefit thousands of Illinoisans in the short term, and perhaps millions of Americans as the lessons spread.
Social Workers in Every State Face the Consequences of Fewer Behavioral Health Workers Despite More Mental Health and Wellness Crises
Although it’s an area where stigma often overshadows accurate statistics, most researchers agree that somewhere around fifty percent of Americans will have a behavioral health issue at some point in their lives. Those can range anywhere from a mild mood disorder to a full-blown crisis of substance use.
But according to SAMHSA, the Substance Abuse and Mental Health Services Administration, fewer than half of individuals with a mental illness were able to access care for that disability. The numbers were even worse for those with substance use disorders.
Issues of access are complex, particularly for mental health issues. Social workers understand better than anyone all the individual and systemic problems that create accessibility issues, from transportation trouble to Chicago snow-storms keeping older patients from leaving the house.
But according to 2023 data from the National Center for Health Workforce Analysis, shortages of clinical providers nationwide has lead to a situation where half the population lives in an area where there’s just not enough people to provide treatment.
That includes places from Central Chicago all the way down to little Putnam county.
And that’s a gap that has hit Illinois social workers where it hurts.
Why Are Illinois Social Workers So Wrapped up in Behavioral Health Provider Shortages?
It might surprise some people to learn that social workers make up the single largest chunk of the mental health services work force in America. According to a Bureau of Labor Statistics report from 2023, 728,600 social workers were on the job in 2022. That was nearly as many workers as the next two highest categories (counselors and human service assistants) combined.
Social workers are all part of the broad safety net that social workers throw out to catch folks that fall through other parts of the human service and health care sectors.
Clinical social work practitioners in the state often perform mental health assessments that can lead to patients getting the treatment they need. Social workers are often the crucial connection between identifying a problem and finding a resource to address it. In other cases, they may offer direct clinical counseling for specific behavioral health problems.
On top of that, advocacy is always an important role played by social workers in community wellness. Big-picture processes like lining up funding for community clinics, outreach programs, and screening systems all fall to social workers in every corner of Illinois.
It’s easy to see how falling numbers of licensed social workers could lead to even worse treatment and outcomes in the Illinois mental health system.
Illinois Social Worker Shortages Were Made Worse by an Unexpected Injustice
According to Bureau of Labor Statistics time series data from 2019 (the most recent available), full-time social workers across the country were in decline after two years of growth. Hit hard by the stressors of the COVID-19 pandemic, the workforce is still facing challenges. Everything from canceled college classes to delayed testing schedules put a plug in the pipeline of fresh social work students entering the workforce. Early retirements from those who gave their all weren’t easily replaced.
In Illinois, as elsewhere, another ugly problem reared its head: first-time pass rates for the ASWB (Association of Social Work Boards) masters and clinical examinations (required for licensure in most states) revealed enormous disparity between White and BIPOC candidates.
A 2022 analysis from ASWB found that White candidates passed the masters exam at a rate of nearly 88 percent, while Black candidates only achieved 50 percent. Hispanic and Latino candidates were at a little over 66 percent.
For a field that is all about social justice and equity, it was tough data to confront. But just as critically, it was hurting both those populations and others by choking off important entry points for new social workers to the behavioral health system.
How Illinois Social Workers and Law Makers Stepped up To Solve Critical Workforce Crises With Social Justice Efforts
The Illinois chapter of the National Association of Social Workers jumped in quickly. In 2021, two legislative members of the chapter, Senator Karina Villa and Representative Lindsey LaPoint, introduced legislation to remove the ASWB testing requirement from the path to becoming a Licensed Social Worker (LSW) in the state.
SB 1632 passed the Illinois General Assembly and was signed by Governor JB Pritzker in August of 2021.
While LSWs can’t offer independent clinical social work in Illinois, they can offer that service under the supervision of a Licensed Clinical Social Worker. LSW entry barriers are lower in most other respects, requiring only a Bachelor of Social Work and three years of field experience. Candidates who do hold a Master of Social Work (MSW) can skip the field experience entirely.
In either case, LSWs are both a key part of the behavioral health treatment system in the state, and a stepping stone to full LCSW licensure. Unclogging that pipeline, everyone hoped, would benefit thousands of at-risk individuals across the state.
A Clear Win for Social Justice, Social Workers, and At-Risk Communities
The results of the repeal of the LSW test requirement have exceeded even the wildest hopes of the people who proposed it.
By the end of 2023, just a short two years after SB 1632 became law, the Illinois chapter of NASW reported that the number of licensed non-independent social workers in the state had doubled since the end of 2021. More than 10,000 new LSWs entered the workforce in that time.
Just as important, more than 10 percent of those licensed professionals came in from out-of-state, showing that the change has been effective at drawing in trained expert social workers from states that may still have disparate licensing standards.
Illinois’ success story in streamlining social worker licensing may be a model for other states facing similar problems.
It’s a clear demonstration of some of the core principles of social work: that by destroying systemic inequities in existing social systems, the system as a whole benefits, not just the people who were discriminated against.
The fix worked so well that NASW-Illinois decided to go even further: in the spring of 2023, sponsored legislation was passed to create an alternative pathway to licensure for LCSWs that also bypasses formal ASWB examination.
It’s too soon to see any effects from this other big change, but it’s far to say that Illinois social workers are leading the way in exploring ways to both accomplish their core missions in social justice and expand their assistance to Illinoisans in need.
