Simplifying Complexity

Offering a simple framework for discussing our mental health workforce

I stood at the front of the room already knowing what was coming. It was a better space than most — no dizzying carpet patterns pretending to hide coffee spills. Just a muted sand tone, fitting for a room planted firmly in the desert.

Inside were some of the Mountain West’s sharpest health policy minds. Commissioners, lawmakers, people who actually read the reports they cite. They were there to talk mental health, and I was there to talk workforce.

And like clockwork, it came.

“How do we get more mental health clinicians?”

Not those exact words, of course. The delivery was polished, carefully threaded through the fabric of regulatory language.

“Our state is exploring all policy options, including reducing regulatory barriers, to help increase the number of providers delivering mental health care across the diverse landscape of our state.”

You get the idea.

We could have spent the rest of the hour answering that question head-on. But that would’ve missed the real issue: it’s the wrong question.

If “more” alone fixed the problem, we’d be done by now. And yet, here we are.

So let’s shift the lens. I want to do two things in this piece today: First, outline a better way to think about workforce. Second, clear up a few myths we keep dragging around.

Nearly four years ago, Dr. Anita Burgos and I wrote a paper on this. We argued that capacity is about more than supply. It's about structure, support, and whether the people doing the work are still willing to show up.

Because more isn't enough. It never was.

If we only ask how to get more clinicians, we’ll keep missing the point. The better question is, how do we use the people we have wisely, and build something they want to be part of?

That led us to a simple framework.

First, widen the lens. The workforce isn’t just psychiatrists and psychologists. It includes peers, community health workers, and primary care teams. If they’re doing the work, they count.

Second, support the ones already in the field. Burnout isn’t a footnote. Training, career paths, and decent supervision aren’t just nice-to-haves, they’re truly foundational.

Third, rebuild the system around them. Where care happens, how teams work, what we expect from people in rural or stretched-thin areas, yup you got it, all of it needs rethinking.

Flooding the system with more people doesn’t work if the system itself is broken.

And then there are the myths.

The first one: we just need more providers.

It’s the classic fix-it answer. But it assumes every provider operates at the same level, works full-time, and is in the right place. They don’t.

Capacity isn’t headcount. It’s who’s working, where, with what tools, and for how long. More without redesign just means faster burnout.

Second myth: the pipeline is the problem.

The conversation often focuses on future supply. More training programs. Streamlined licensing. Scholarships. That’s all useful, but it ignores the thousands of trained professionals who’ve already walked away from clinical work.

Retention is bleeding us out. No pipeline fills a bucket full of holes.

Third myth: only licensed clinicians can provide care.

This one’s persistent. It shapes funding rules, job descriptions, and what we call “real” treatment. But it keeps us boxed into a model that can’t scale.

Care isn’t a fixed shape. It can come from all kinds of places in all shapes and sizes. A narrow definition of who can help is a fast way to keep failing.

So no, the question isn’t how to get more clinicians. It’s what kind of system we’re inviting them into, and why they'd want to stay.

The more and more I talk about this issue the more and more I see this isn’t a people problem, it’s an imagination one.

We can keep rehearsing the same debate, or we can finally build a workforce model that reflects the messy, diverse, real world we live in.

Because if we treat this like a headcount issue, we’ll just keep running in circles.