What’s New in Psychology

Health Service Psychology Has Manpower Crisis      

Jim Windell

            APA and state-level psychological associations have for decades wondered exactly what to do with master’s-level psychology professionals.

            PhD psychologists understandably wanted to protect themselves and their roles as licensed psychologists. In many states, those with master’s degrees were afforded lesser status and allowed to practice – as long as they were supervised by licensed psychologists. But there was no universal appreciation for the role of the master’s level psychology professional or their training. This was a classic instance of Nero fiddling while Rome was burning.

            Now it seems that the manpower crisis in psychology has reached critical mass – and there should no longer be a delay in recognizing the importance of master’s-level psychology professionals.

            APA has the statistics to support this. In a recent document entitled “APA Health Service Psychology Workforce Optimization: A Strategic Response to National Need,” those statistics are made clear:

           “The United States is experiencing an unprecedented mental health crisis. By 2037, we project a shortage of nearly 80,000 health service psychology (HSP) professionals – leaving us at only 55% adequacy to meet public need. This gap extends across the behavioral health workforce, with similar shortages projected for school counselors, mental health counselors, marriage and family therapists, addiction counselors, and psychiatrists.”

           The problem as pointed out in the document that appears on the APA website on the Graduate and Postgraduate Education page is that health service psychology professionals are fragmented. Although 19 states currently recognize master’s-level HSP professionals, there are no national standards or guidance. As a result, there is an inconsistent patchwork of licensing regulations and professional titles. Additionally, HSP graduates and employers face confusion about qualifications and scope of practice that vary dramatically from state to state. “This fragmentation undermines professional standards, public protection, and the integrity of psychology as a unified discipline,” the APA article states.

           It goes on to state that in 31 states and Washington, DC, individuals with master’s degrees cannot be licensed to practice HSP in their communities. Many of these graduates – 22,681 in 2023 alone, compared with just 3,895 doctoral graduates – are forced to seek licensure in other behavioral health professions, taking their psychology training and perspective with them. “Psychology hasn’t provided appropriate pathways for a high percentage of psychology graduates interested in behavioral health careers, weakening our professional presence in behavioral health,” the articles declares.

           What is APA’s strategic response to the situation?

           The answer to this question is the crux of the document. The document indicates that APA’s HSP workforce optimization initiative represents a mission-driven response to these converging challenges. Rather than allowing the current fragmentation to continue or ceding master’s-level HSP practice to other professions, “APA is establishing unified guidance that will strengthen psychology’s impact while meeting urgent societal needs.”

           Since there are hundreds of institutions currently offering master’s degrees in HSP, many with established faculty and training programs, APA’s Commission on Accreditation (CoA) approved standards for HSP master’s programs in 2021, defining the discipline-specific knowledge and profession-wide competencies that distinguish HSP education from other behavioral health training. In 2024, the CoA accredited its first HSP master’s program and at present four programs are accredited and one is under review. It is expected that with this beginning, CoA will continue moving HSP master’s programs through the accreditation process.

           If APA wants to provide leadership in the behavioral health industry’s evolution, what happens to doctoral HSP psychologists? The document suggests that PhD psychologists can continue expanding into leadership roles. This means that licensed PhD psychologists can oversee program development, evaluate population needs, coordinate provider teams, and leverage technology innovations – while master’s-level HSP professionals deliver evidence-based health services grounded in psychological science.

           The scope of practice for master’s-level HSP’s will include independent HSP practice, consistent with other licensed mental and behavioral health professionals holding master’s degrees. APA indicates that this competitive positioning is essential for master’s-level HSP professionals to engage in similar services and compete effectively with other master’s-level behavioral health professionals.

           To help bring all this about, APA’s Board of Professional Affairs has appointed a task force to revise APA’s Model Licensure Act, last updated in 2010. The task force began work in June, 2024, and will develop updated requirements and scope of practice for both doctoral and master’s degree professionals in HSP. It is expected that APA’s revised Model Licensure Act will provide states with consistent guidance to address the fragmentation that exists for master’s-level HSPs. APA hopes that the updated act will go to APA’s Council of Representatives for review and approval in February, 2026, and after that APA will work with individual jurisdictions that wish to update their licensing laws to incorporate the new recommendations.

           To read the “APA Health Service Psychology Workforce Optimization: A strategic response to national need,” find it at: https: //www.apa.org/education-career/grad/national-standards-masters