Scoping review of behavioral health education pathway intervention programs in the United States

The U.S. faces persistent, severe shortages across the licensed behavioral health (BH) workforce. One strategy to address shortages is career education pathway programs. Our research questions were: What BH education pathways have been implemented? Which programs are effective at helping students: accumulate credits toward completion of credential, license, or degree; obtain a degree; and earn industry-recognized credentials and/or licensure? Are there common effective factors among BH pathway programs? Following the PRISMA Extension for Scoping Reviews and the What Works review protocol for evaluating postsecondary career and technical education interventions, six databases were searched for articles on post-secondary BH pathway programs in the U.S. leading to eligibility to practice (including teaching and research) since 2004. Articles must have included an intervention. Exclusion criteria were: opinion, commentary, abstract-only, conference presentation, retention-focused, focused on specialized content (e.g., collaborative care), delivery modality (e.g., remote mentoring), specific training technique, or components that would not move an individual closer to graduation (e.g., wellness programs). The initial search yielded 2,068 articles after de-duplication; 97 full-text articles were reviewed and seven met all criteria. Psychiatry programs were the most frequently evaluated. Formats varied but consistently integrated a combination of didactic instruction, clinical or community-based experiences, mentoring, and scholarly or research activities. All programs were university-based and in-person, but varied widely in type, number of participants, length of intervention, and funding. A variety of outcome measures were reported. Evaluation based on the What Works protocol was hampered by incomplete data. While BH education pathway programs are frequently recommended as a means of addressing provider shortages, few studies have examined their efficacy as a whole, looking for commonalities across programs. Robust evaluation, stronger methodology, and consistent data reporting are needed to truly evaluate pathway program efficacy and return on investment.