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The San Diego County area faces a significant behavioral health worker shortage. A new report by the San Diego Workforce Partnership, completed at the request of the County Supervisor Chair Nathan Fletcher, says by 2027 the San Diego region will need 18,500 more workers to meet the mental health and addiction treatment needs of the community. The report also offers detailed solutions to address the issue including the establishment of a $128 million workforce training fund and developing regional training centers. 

“We have invested at unprecedented levels in new mental health and addiction treatment services, but finding enough trained behavioral health workers has proven to be difficult,” said Chair Fletcher. “To create a robust continuum of care that offers a better way for patients to receive treatment, we need the right type of workers and right now the behavioral system region wide is woefully understaffed.” 

“With the data in this report and the recommendations it outlines, our region now has a roadmap to scale-up and diversify the workforce. To get it done, we need the support of the private sector, nonprofits and government,” Chair Fletcher continued. I am looking forward to working with other regional leaders to build a new pipeline for careers in behavioral health.”  

The report, Addressing San Diego’s Behavioral Health Worker Shortage: A needs assessment and vision to attract and retain essential behavioral health professionals report highlights that by 2027, the San Diego region needs an estimated 27,600 total behavioral health workers to meet unmet behavioral health needs while keeping pace with population growth. Based on current trends, an estimated 7,800 behavioral health workers are expected to leave their professions by 2027. Starting from the nearly 17,000 workers in the field today, the San Diego region needs to educate, train, attract, employ, and/or retain 18,500 professionals between 2022 and 2027. 

“Some of what this report says might seem shocking. The sheer size of the necessary growth in workforce sets a massively ambitious target,” said Luke Bergmann, Director of County Behavioral Health Services. “But we have to be ambitious if we want behavioral health to be what it should be: on at least equal footing with the rest of healthcare. This report is an anchor for work that will transform behavioral health in San Diego County.”   

Proposed Solutions to Address Workforce Shortage

  • Invest in Competitive Compensation: San Diego professionals across occupations are paid less than their counterparts in most California counties. 55% of workers surveyed were dissatisfied with pay.  
  • Pursue Administrative Relief: Streamlining documentation requirements is a top priority for current frontline professionals and a major reason why some leave the field. The report outlines 12 issue areas and 29 actions to reduce administrative requirements.
  • Establish Regional Training Centers of Excellence: Multi-partner sites that serve the public, specialize in expanding training and supervision programs, and provide research opportunities on training and behavioral health staffing best practices. 
  • Build a Regional Workforce Training Fund: This report provides a financial framework with investment priorities for an initial $128M down payment to train 4,250 professionals, including:
    • $6M to recruit, place, certify and provide on-the-job-training for 600 certified peer support specialists.
    • $3M for a regional apprenticeship program to train 600 community health workers.
    • $8.5M in scholarships and 0% interest loans to recruit, train, place and certify 1,150 substance use disorder counselors.
    • $1.3M to establish a psychiatric technician program with regional community colleges.
    • $7.8M for stipends for 260 master of social work students to complete paid internships in BH settings.
    • $7M to create 280 new supervision slots for associate social workers to accrue the 3,000 hours for LCSW licensure.
    •  $64M to train 84 psychiatrists and 200 psychiatric mental health nurse practitioners to work in integrated teams in community settings.
    • Loan forgiveness and down-payment assistance in exchange for public service for diverse professionals to build wealth, live and work in San Diego long term.

“Addressing the behavioral health workforce shortage in our region must be our shared priority,” said Peter Callstrom, CEO of the Workforce Partnership. “Throughout the country, the imperative to build this essential workforce is critical. This report, informed by input from over 1,600 workers and healthcare professionals, provides our region with a data-informed opportunity, imperative, and clear vision. Together, we can strategically build and support the skilled, diverse, and resilient behavioral health workforce our region needs, now and for years to come.” 

Why This Report is Different

What makes this report different from others that have been done across the country is

  • Multiple occupations: The report focused on 11 key behavioral health occupations. Many studies nationally or statewide are focused on one occupation (e.g., psychiatrists)
  • Local context: It is focused on the San Diego County behavioral system and was developed with knowledge of local priorities such as homelessness crisis, local operating context, such as the contracted service model, and local economic and demographics needs, such as the high cost of living and the need for language competencies to meet the needs of the region’s diverse populations.  
  • Worker input:  1,600 workers and students participated in surveys or focus groups from across disciplines to inform the recommendations
  • Specific, action-oriented recommendations: the report outlines how specific partners and stakeholders from government, philanthropy,  health systems, universities and colleges, and community-based organizations can play a role in addressing the worker shortage.

Review the entire report at and the executive summary at 


Since 2019, Chair Fletcher has worked hard to bring new County mental health and addiction treatment programs online, but the implementation at times has not moved as quickly as Chair Fletcher would have liked because of a lack of workers. Chair Fletcher during his 2021 State of the County Address highlighted the need to expand the region’s behavioral health workforce and promised action.

A San Diego Behavioral Health Workforce Steering Committee generously volunteers hundreds of collective hours to help guide the understanding of the behavioral health system and shape the final report.  

The report was completed by the San Diego Workforce Partnership with financial support from the County of San Diego Health and Human Services Agency and the Alliance Healthcare Foundation.