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Vt. Looks to Attract Substance Abuse Treatment Workers



Valley News Staff Writer
Tuesday, April 18, 2017

Randolph Center — Melinda Lussier had been through treatment for opioid addiction three times, and arrested four times, before her sobriety stuck. When it finally did, the Franklin County native decided to pursue a career in addiction recovery services.

“I definitely had a master’s degree in opiate addiction firsthand,” Lussier, who now works as a staffer at the Turning Point addiction recovery center in St. Albans, Vt., said at a daylong summit on Monday.

But she was met with a lack of opportunity for educational and professional development — a common problem for many aspiring mental health and substance abuse workers, and a major topic of discussion at the Governor’s Summit on Vermont’s Substance Use Disorder Workforce held at Vermont Technical College’s Randolph Center campus.

“We’ve all witnessed the tragedy of (the opioid addiction) crisis,” said Vermont Gov. Phil Scott, who spoke at the event and who has publicly announced substance abuse treatment as a top priority of his time in office.

Last year, more than 100 people in Vermont died as a result of opioid abuse, he said, and roughly 10 percent of the population “misuses or abuses” alcohol and other substances on a regular basis. And while few of those people are currently seeking treatment, those numbers are increasing: 4,000 people in Vermont participated in treatment for substance use disorders in 2014. Now there are more than 6,000 Vermonters in treatment, with “still more waiting in line,” Scott said.​

A. Kathryn Power, the regional director for the Substance Abuse and Mental Health Services Administration, attributed this rise in people seeking treatment to health care reforms that have increased insurance coverage for vulnerable populations.

In part because of this increased coverage, people are starting to think about behavioral health as having both physical and mental components, she said.

“You don’t just want (a medical provider) who’s strong in assessing your blood pressure,” Power said in an interview with the Valley News. “You also want someone who can assess you in terms of your drinking patterns, in terms of your trauma — all of you.”

Power later delivered the summit’s keynote address on best practices in mental health and substance abuse initiatives, which she said would focus heavily on this “integrative” philosophy of care.

The increasing demand for treatment has in turn created a high demand for clinical workers, but the logistical difficulties of getting qualified Vermonters to work in the field — coupled with a generally low pay and high burnout rate — means that the industry is not prepared to meet that demand, Scott said.

The demand isn’t just found in the Twin States. Employment for substance abuse and mental health counselors is projected to rise 22 percent from 2014 to 2024, which is greater than the average of 6.5 percent projected growth for all occupations, according to the U.S. Bureau of Labor Statistics.

There are between nine and 11 different professions within the mental health and substance abuse field, said Colin Benjamin, director of the Vermont Office of Professional Regulation.

These jobs run the gamut from substance abuse counselors — who may require any of three different levels of certification — all the way up to psychiatrists and other prescribers, who require advanced degrees.

But only a handful of Vermont colleges offer degrees in mental health and substance abuse work, said Michael Harrington, deputy commissioner of the Vermont Department of Labor — which makes it harder for aspiring substance abuse workers to establish roots in-state.

Several panelists recommended unifying the process of getting licensed to work in the field, so that every worker would need to earn the same basic certification in mental health and substance abuse counseling before pursuing a specialty.

This could potentially streamline the process of getting more substance abuse workers “into the pipeline of talent,” Harrington said.

“When you start thinking about managing that pipeline, we’ve got a challenge ahead of us, because we know we’ve got a shortage, and that shortage is going to come more quickly than we get people into that pipeline,” he said.

This shortage is likely to be felt particularly hard in the coming years, said Melissa Bailey, commissioner of mental health at the Vermont Agency of Human Services.

“About one-third of people currently in the field are either looking to retire, or leave the human services field entirely, in the next five years,” she said.

But recruiting the next generation of mental health and substance abuse workers is a challenge — and not just because of obstacles in earning certification.

Several panelists said they were saddled with student loan debt, since mental health professionals are not eligible for the same loan forgiveness policies that many primary care practitioners benefit from, said Shara Tarule, a nurse practitioner at the Howard Center Chittendale Clinic in South Burlington.

“I love my job. I love what I do — which is unusual, because I get yelled at a lot — but I desperately love my job,” Tarule said.

Mental health counselors in Vermont earned an average salary of $41,160 last year, according to the U.S. Bureau of Labor Statistics.

Tarule’s clinic is one of the largest “methadone hubs” in Vermont, she said, adding that she is the only clinician who works there five days a week, and deals with up to 750 caseloads per week.

But, despite her passion for her work, she finds herself mired in a “black hole of student loans with no eligibility for reimbursement,” she said.

This can be a daunting prospect for those on the brink of entering the industry, said Victoria Pollard, a senior at Castleton University who wants to be a substance abuse clinician because she has “always wanted to help people.”

But she said she was not prepared for the financial troubles she would encounter, even after she secures a degree in her chosen field, because her college coursework did not align with state certification requirements.

“I wish I had known earlier. Now, the livable wage just isn’t there for me,” she said. “Either I will have to work two jobs, or give up my passion … and veer off into a paper-pushing career in a business office — which is definitely not what I want to do,” she added.

Still, Vermont remains ahead of the national curve in terms of dealing with the opioid crisis, said Rick Barnett, a psychologist and alchohol and drug counselor.

“We have to look at the Vermont recovery network as a tremendous resource in enhancing our ‘addiction IQ,’ ” he said. “What we already have is an amazing achievement and one that I believe should be supported more, both financially and in terms of a growing workforce.”

Or, as Lussier put it, if the opioid crisis is a snowstorm, then “Vermont is the snowmobile that breaks the trail.”

EmmaJean Holley can be reached at eholley@vnews.com or 603-727-3216.