美国首批儿童行为健康本科从业者获执照路径

If you or someone you love is struggling with thoughts of suicide, help is available. View the suicide hotline for your country or call your local emergency number for immediate assistance. 

In spring 2026, students from the United States’ first cohort of undergraduates majoring in child behavioral health walked across the stage to receive their diplomas from the Ballmer Institute for Children’s Behavioral Health at the University of Oregon. These students completed rigorous training as undergraduates that prepared them to enter the workforce in a new behavioral health role that is now eligible for a professional license in multiple states.

The United States has never trained undergraduates to become behavioral health providers before, although this approach has shown great promise for increasing access to behavioral healthcare in European countries. Alongside state-level credentialing pathways, the creation of a standardized bachelor’s-level pathway to become a behavioral health provider stands to reshape the nation’s mental health workforce as it expands to other universities.

Current needs exceed provider capacity

According to the Centers for Disease Control and Prevention, the mental health of young people in the United States has deteriorated over the past decade, with rising rates of depression, suicidal thoughts, and anxiety. As mental health problems have increased, the availability of clinicians trained to work with children and adolescents has not, creating nationwide shortages in youth mental health providers.

Together, the erosion of youth mental health and widespread provider shortages have led experts and national health organizations to pronounce the youth mental health crisis to be a national emergency. The causes of worsening mental health in young people are hotly debated. What is not disputed, however, is the need for more well-trained youth mental health providers. Here, we describe an innovative approach to accomplish this through a new type of bachelor’s-level behavioral health workforce.

Task shifting increases access

It is challenging to increase the number of providers through existing graduate training pipelines. Numerous reports have documented financial dynamics related to the cost of graduate training relative to earning potential, as well as increasing challenges retaining mental health providers in the workforce. An alternative approach for expanding access to mental health services that has gained traction globally and is advocated for by the World Health Organization is to transition the delivery of some types of services to providers who require less-intensive training—a process sometimes referred to as task shifting.

From Novel Training to Transformational Workforce Development

The child behavioral health program at the Ballmer Institute is a model for creating a new credentialed bachelor’s-level behavioral health profession, grounded in evidence-based practices, that is positioned for the national scale. Building a training program is not sufficient, however, to create a new profession. Doing so requires parallel policy work to create a credentialing pathway for program graduates and regulatory work to ensure that services delivered by these new providers can be billed to healthcare payers. This work is already underway, with Oregon and Nevada being the first states to create an aligned credentialing pathway and billing mechanisms for this new provider—termed a Licensed Behavioral Health and Wellness Practitioner (BHWP).

Each state implemented a deliberative approach to stakeholder engagement, coalition building, and legislative advocacy to create these policies. In Oregon, the Ballmer Institute partnered closely with two legislators to advance this work: Senator Lisa Reynolds, a pediatrician, and Representative Tawna Sanchez, a social worker. Creation of this new provider role involved extensive stakeholder engagement over multiple years to solicit feedback and ensure this new role met the needs of youth and families as well as employers. In Nevada, the Ballmer Institute partnered closely with Senator Rochelle Nguyen, an attorney and nonprofit leader. She was joined by cosponsors Senator Carrie Buck, an educator and longtime school leader, and Senator John Steinbeck, a longtime firefighter and former Clark County Fire Chief. These partnerships with legislative champions were essential to the successful passage of policies supporting a new bachelor’s-level behavioral health provider role in each state.

Legislation enacted in each state formally created the BHWP role. This legislation passed with overwhelming bipartisan support in Nevada in 2025 and in Oregon in 2026. The bills were supported by a broad coalition of advocacy organizations (e.g., National Alliance on Mental Illness Oregon, Children’s Advocacy Alliance), behavioral health employers, organizations representing existing behavioral health professionals (e.g., the Oregon Psychological Association, the Oregon chapter of the National Association of Social Workers), and numerous community-based organizations that serve youth and families (e.g., Communities in Schools Nevada, BeHere Nevada, Native American Youth and Family Center, Latino Network, and REAP).

“This bill was a slam dunk for Oregon legislators,” said Senator Lisa Reynolds, sponsor of the legislation in Oregon. “I am so proud to lead this work as a State Senator. And, as a pediatrician, I see the value for my patients, including those heading to college interested in the field of behavioral health.”

Legislation is a necessary but not sufficient step to creating new behavioral health providers. To ensure sustainability of the new profession, BHWPs need to be recognized as providers that can be reimbursed for the services they deliver. BHWPs can currently bill Medicaid for services in both Oregon and Nevada. Navigating the process to allow them to bill private insurance is a critical next step that each state has begun.

The bill creating the BHWP role in Oregon comes into effect in January 2027. At that time, graduates in the first cohort of the Ballmer Institute training program will become the first behavioral health and wellness practitioners to be licensed anywhere in the United States.

A substantial evidence base suggests that nonspecialist providers can effectively deliver mental health services. Some of this evidence comes from global mental health work in contexts that lack a workforce of specialty mental health providers (Singla et al., 2017). Perhaps the most promising evidence comes from efforts in the United Kingdom over the past 15 years to expand access to evidence-based mental health services through the Talking Therapies program (Clark, 2018). This initiative has expanded the mental health workforce through a systematic approach to training bachelor’s-level providers to deliver brief, structured low-intensity interventions emphasizing skill building as opposed to long-term psychotherapy. Alongside a high-intensity workforce trained at the graduate level, these providers deliver empirically supported interventions paired with measurement-based care. Critically, evidence consistently shows that interventions delivered by these low-intensity providers have positive impacts on access to care and the mental health of service recipients, with effects on mental health outcomes that are large in magnitude and similar to those observed for high-intensity providers (Wakefield et al., 2021). The Talking Therapies initiative is one of the most successful programs ever implemented to increase access to evidence-based mental health care and improve rates of recovery from mental health problems among those who receive services.

A well-trained bachelor’s-level behavioral health workforce is a promising solution to widespread provider shortages in the United States, where a systematic approach to training undergraduate students in evidence-based behavioral health intervention has never been undertaken. Despite this, bachelor’s-level providers already practice in many states through a patchwork set of state-level regulations that allow them to bill Medicaid for services. This workforce is largely untrained, exhibits rapid turnover, and varies widely in the services they provide across states. A key lesson from the Talking Therapies program is that enacting system-level change to increase access to evidence-based mental health care does not just require more providers; it requires more well-trained providers. In a recent paper published in Current Directions in Psychological Science, we argue that rigorously trained bachelor’s-level mental health providers could serve a distinct role within the U.S. behavioral health system, helping to increase access to care and improve mental health among young people nationwide (McLaughlin et al., 2026).

Training bachelor’s-level providers

The Ballmer Institute for Children’s Behavioral Health at the University of Oregon is leading innovative work to create this new type of bachelor’s-level provider. These new providers are trained to identify behavioral health challenges early and deliver low-intensity interventions that can prevent those challenges from worsening to the point that more intensive intervention is required. This new role emphasizes early identification of mental health concerns (e.g., through screening) and behavioral health promotion, prevention, and time-limited intervention services, delivered under the supervision of a licensed mental health provider at the master’s or doctoral level.

These providers are trained to work in schools, primary care, mental health agencies, and community-based organizations—settings where children and families already spend time—to ensure that more youth get access to the services they need at an earlier point in time. Even after licensure, these new providers will require ongoing supervision by a licensed mental health provider at the master’s or doctoral level and will notengage in diagnosis of mental disorders, manage medications, administer neuropsychological assessments, or deliver long-term psychotherapy.

This pioneering undergraduate program in child behavioral health involves specialized coursework and applied training in measurement-based care and evidence-based behavioral health interventions that are effective for a wide range of common mental health problems. Students spend their first 2 years completing general education requirements. This allows them to spend the final 2 years entirely on coursework and applied training in the child behavioral health program, including 700 hours of applied training delivering supervised behavioral health interventions in the same community settings where they will ultimately practice (e.g., schools, primary care, and mental health agencies). The child behavioral health curriculum follows a competency-based framework that trains and evaluates students in three broad domains of evidence-based practice: foundational skills and knowledge; measurement-based care; and interventions to support behavior change.

Going national

Building a new behavioral health profession requires coordinated efforts with other universities interested in launching training programs, to ensure alignment. Efforts to replicate the child behavioral health training program at other universities are beginning and will be rooted in a shared competency framework. The Ballmer Institute is entering an exciting new phase of this work through the launch of the Catalyst Center. This center will provide seed funding to selected universities interested in partnering in the collaborative work of building a new behavioral health profession. In addition to seed funding, the Catalyst Center will provide partner universities with implementation and alignment support, oversee a shared impact evaluation, develop clinical training innovations to support program sustainability, and help to advance policy and advocacy work to support a credentialing pathway for graduates in each state that launches a program. 

Together with partner universities around the country, the Ballmer Institute is leading an innovative approach to grow the youth behavioral health workforce to increase access to care and improve mental health and well-being for young people nationwide. Our goal is to transform the youth mental health system and ensure that young people everywhere have access to the support they need to thrive.

If you or someone you love is struggling with thoughts of suicide, help is available. View the suicide hotline for your country or call your local emergency number for immediate assistance. 

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References

Clark, D. M. (2018). Realizing the mass public benefit of evidence-based psychological therapies: the IAPT program. Annual Review of Clinical Psychology, 14(1), 159–183.

McLaughlin, K. A., Bearman, S. K., & Zalewski, M. (2026). Transforming the youth mental health workforce. Current Directions in Psychological Science.

Singla, D. R., Kohrt, B. A., Murray, L. K., Anand, A., Chorpita, B. F., & Patel, V. (2017). Psychological treatments for the world: Lessons from low-and middle-income countries. Annual Review of Clinical Psychology, 13, 149–181.

Wakefield, S., Kellett, S., Simmonds‐Buckley, M., Stockton, D., Bradbury, A., & Delgadillo, J. (2021). Improving access to psychological therapies (IAPT) in the United Kingdom: A systematic review and meta‐analysis of 10‐years of practice‐based evidence. British Journal of Clinical Psychology, 60(1), 1–37.