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| Congressman Patrick Kennedy (foreground) and Congressman Jim Ramstad at the briefing. |
Workforce issues—certification, salary levels, turnover, and the absence of clear career paths—threaten the quality of drug and alcohol treatment programs throughout the country. Easing the career path for people coming out of recovery and making it possible for them to become counselors in residential programs would be a boon to the system and improve the quality of care. These were the main points made at a June 22nd Phoenix House briefing in Washington, D.C. for members of the Congressional Addiction, Treatment, and Recovery Caucus and other legislative leaders.
Rep. Jim Ramstad (R-MN), co-chair of the bi-partisan caucus, opened by emphasizing the importance of a qualified treatment workforce, noting his debt to counselors at the program where he underwent treatment years ago. Rep. Patrick Kennedy (D-RI), the caucus’s other chair, followed, stressing the efficacy of “talk” therapy and the need for more counselors. "I've got no higher priority than bringing insurance equality to behavioral health, but of course for insurance coverage to mean something, people need to have access to quality care,” said Kennedy. “If we don't have substance abuse counselors able to provide the treatment people need, then parity will be an empty promise."
Residential programs, like those at Phoenix House, provide what is often the treatment of last resort, for people who have tried and failed before. These programs have extremely high annual staff turnover—50 percent throughout the field—which negatively impacts quality while raising costs. Contributing to high turnover are burnout, long hours, and weekend work. Salary levels are a major culprit, particularly for residential programs where limited dollars are stretched to provide intensive levels of service 24 hours a day.
Certification is also a key issue. Onerous certification requirements pose barriers for people coming out of treatment, eager to become counselors but lacking the necessary education or burdened by a criminal record. Rarely is there a career track for them. Zarine Gilbert, a senior counselor with Phoenix House, explained that after five years she is still working to meet New York’s state requirements. She told how important it is to have people like her as counselors, how she is able to empathize with clients because she’s “been down the same road and [knows] what it’s like” and how she serves as an example, “proof that treatment can turn your life around.”
The policy-makers were told of several options. They can declare substance abuse treatment a “distressed industry,” designating federal funding to support higher salaries and other measures that might attract and keep people in the field. They can also look at creating a career ladder with several steps to certification that will help people coming out treatment to enter and stay in this field.
In the final analysis, the briefing pointed out, substance abuse treatment can only be as good as the people who provide it.
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