SHERIDAN — Northern Wyoming Mental Health is struggling to fill open staff positions, which CEO Paul Demple said reflects a statewide trend.

“Over time there have been more [openings for] mental health jobs in Wyoming,” Demple said. “As the number of mental health jobs has grown, it’s outpaced the available people who are qualified to be treatment professionals for mental health and substance abuse.”

In Sheridan County, Demple said he has two open clinical positions out of eight total. He also said he very recently hired a clinical county manager in Sheridan County, and filling that role took about a year. In Johnson County, Demple said there are three open clinical positions out of five total. And the need for clinical mental health providers may be even more dire throughout the rest of the state.

“In talking to other directors, I’m hearing they are at critical levels in terms of shortage of staff; they’re getting pretty desperate to find people,” Demple said.

Karl Cline, the executive director of Peak Wellness Center in Cheyenne, which serves four counties, said Peak Wellness has over 40 openings on a staff that would ideally include about 220 employees.

“In Cheyenne, we used to enjoy being able to recruit people here easier than most of the rest of the state,” Cline said. “That’s not the case anymore. We have a hard time recruiting.”

Openings for mental health and substance abuse professionals have increased nationwide over the last 10 or so years primarily due to an increased demand for those services.

Demple said that is due in part to the development of more sophisticated mental health treatment in the country, as well as an increased willingness among patients to seek mental health treatments.

“In previous generations — my generation and even the generation before me — people didn’t speak out and say that they were struggling,” Demple said. “Now people are much more apt to say they need some help.”

The increased awareness and understanding of mental health care is helping both patients and providers identify opportunities for treatment, but so far there have not been enough mental health care providers to realize those opportunities, especially in Wyoming.

Erin Johnson, the executive director of the Wyoming Association of Mental Health and Substance Abuse Centers, said because of wide demand, smaller, more remote communities are having trouble competing with larger metropolitan areas. Because every state is essentially seeing the same increase in demand, Wyoming finds itself competing with nearby states to attract mental health care providers.

“Quite a few years ago, Colorado wasn’t very competitive salary-wise and it had fewer positions available than they do now,” Demple said. “What’s happened in probably the last five-plus years is their salaries have become much more competitive, there’s more job availability… And so those people who have come [to Wyoming] in the past, aren’t.”

And it is unlikely the competition will ease up in the near future.

“As we’re addressing more of the opioid issues and mental health issues and everything else, it’s going to become even more competitive going forward,” Demple said.


Coping with

 As a result of the smaller number of providers, Demple said less populated areas are only able to offer generalized care. Ideally, certain providers would specialize in mental health care, or even the treatment of specific mental health issues, while others focused on substance abuse.

“In Sheridan, we can specialize a little bit more,” Demple said. “In smaller counties…those people really have to deal with everything that comes through the door.”

That said, Demple and his staff understand how imperative the services they provide are and have strived to do more with less.

At Peak Wellness, Cline said his staff is covering services in all of the counties the center serves, but the shortages are stretching it thin.

“It’s real tough to keep things moving along when everyone’s schedules are full and they’re pulling overtime,” Cline said. “…We shift people around a lot and because of our size we’re able to do that, but it’s getting tougher and tougher.”

Technology has also given state health care providers more range in treating patients. Though it is not ideal, Demple said mental health care offices throughout the state are equipped with versions of Skype that are encrypted to ensure comliance with privacy and security standards.

Demple recalled a recent instance where a teenager in one of the smaller counties was experiencing a mental health crisis, but the teen’s counselor was working in another town. Within 15 minutes, staff were able to connect the teenager to a clinical supervisor through Skype and deal with the crisis. In that case, Demple said, digital counseling was effective.

“What it’s really about is, how do you develop multiple ways to ensure access,” Demple said. “Even with all our shortages and everything, we’re working very hard to get everybody in and keep that access unaffected.”

As the state continues to explore how it will accommodate decreased revenues and a growing budget deficit, mental health care is yet another crucial service for which it will have to carve out a future.