The economic impact of investing in Oklahoma's behavioral health workforce

February 28, 2024

A strategic investment in the state’s behavioral health workforce this legislative session would add more than 500 jobs and about $96.5 million to Oklahoma’s economy over the next 14 years.  

Additionally, the new providers added to the workforce in the proposed funding package would create $1.8 billion in taxpayer benefits for Oklahomans by providing evidence-based mental health treatment to over 1 million more people in the next several decades.  

Ensuring more Oklahomans can access mental health treatment when they need it not only increases individuals' own earning potential and spending power, but it also reduces government costs of treating people in more restrictive and expensive settings like hospitals or jails.

These figures represent the benefit of funding hundreds of new behavioral health professionals to receive advanced training and provide evidence-based mental health treatment in Oklahoma through a one-time state appropriation of $36.8 million.

Healthy Minds’ recent workforce research highlighted serious shortages of nearly all types of behavioral health professionals in Oklahoma. This mismatch in supply and demand is most acute for professionals with some of the highest levels of training — psychiatrists, psychologists, and advanced practice nurses.

Supply vs. need for Oklahoma behavioral health professionals

Our research also uncovered shortcomings in Oklahoma’s pipelines to train and educate new behavioral health professionals. For example, the state lacks enough psychiatry residencies and internships for psychologists-in-training to support Oklahoma residents’ growing mental health needs.  

The $36.8 million appropriations request, informed by Healthy Minds’ recommendations, includes funding for additional residency and internship slots for psychiatrists and psychologists, scholarships for social workers and advanced practice psychiatric nurses, loan repayment programs for critically needed professionals, and grants to fuel private-sector innovation that can attract, grow, and retain Oklahoma’s workforce.

These initiatives would result in an additional 272 providers being trained and expected to stay and practice in Oklahoma, as shown in the following table.

Professionals trained in Oklahoma through proposed workforce initiatives

Jobs created and new providers’ impact on Oklahoma’s economy  

An analysis by the Tulsa Regional Chamber estimated that the proposed investment in Oklahoma’s behavioral health workforce would contribute over $96.5 million to the state’s economy by 2037.

This analysis, which focused on the jobs and increased spending power created by the proposed funding, also shows the ripple effects of these benefits.  

Economic impact of proposed workforce funding

The Chamber’s analysis breaks down the employment and income generated directly by the funding, as well as the indirect and induced impacts of the proposed funding. Indirect impacts include the resulting additional business-to-business spending, and induced impacts on hiring that stem from people spending their household income.

The funding to grow Oklahoma’s behavioral health workforce would directly create 272 jobs. It would also be responsible for another 267 indirect or induced jobs, for a total of 539.

From the city to federal level, the appropriation would generate $12.1 million in tax revenue, including $7.1 million that could be directly attributed to the behavioral health workforce funding package.

Tax revenue generated by proposed workforce funding

The Chamber’s calculations are based on Healthy Minds’ estimates for how many professionals trained in-state through the proposed workforce initiatives would also stay and practice in Oklahoma. The calculations also consider these professionals’ salaries using median Oklahoma salaries from the Bureau of Labor Statistics.

For example, the median salary in Oklahoma for a psychiatrist is $240,588. Adding more psychiatrists to the workforce, with their relatively high salaries, has a significant economic impact.  

However, the calculations of the impact of these providers on the state’s economy are conservative estimates, because Bureau of Labor Statistics data do not consider recent salary increases for master’s-level providers (such as licensed professional counselors and licensed clinical social workers) in the community mental health system. We used $49,875 as the median Oklahoma salary for all master’s-level behavioral health providers, but it’s not uncommon for these professionals to be hired at salaries over $70,000 at community mental health centers across the state.  

Taxpayer benefits generated by funding new providers

Separately, Healthy Minds calculated a total of $1,882,141,096 in taxpayer benefits stemming from the treatment impact of about 200 behavioral health professionals — just a portion of those who would benefit from the appropriation — serving Oklahomans over the course of their entire careers.  

This estimation focuses on higher tax revenue and reduced government spending that results from more people receiving mental health treatment because of an increased number of providers. When more Oklahomans are receiving mental health treatment and therefore are mentally healthy, more Oklahomans will be able to hold jobs and participate actively in the workforce.

Projected taxpayer benefit of behavioral health investment

Our calculation of $1.8 billion in taxpayer savings is a conservative estimate, based on only the 205.4 full-time professional trainee slots or scholarships that would be fully and directly funded by the state appropriation.  

While our analysis focuses on professionals fully funded by the appropriations request (and of those, professionals likely to stay and work in Oklahoma), the funding package would benefit and support at least 500 new behavioral health professionals.

Among them are 250 professionals who would receive $25,000 each in educational loan repayments, which our taxpayer benefit calculations exclude. Although we conservatively estimate that only 50 of these professionals would otherwise not stay and work in Oklahoma without this incentive, if we added their potential contributions to taxpayer savings, the figure would approach $2 billion.

Finally, the proposed funding package also includes upskilling support for paraprofessionals and licensure exam preparation for master’s level students, but the economic impact of these initiatives is not included in our calculations. (This is why earlier we cited 272 behavioral health worker positions created, versus the approximately 205 that were used in calculating taxpayer benefit.) If we were able to account for these initiatives' impact, the true taxpayer savings would likely be much higher.  

Expanding access to mental health treatment

The additional behavioral health providers funded by the proposed workforce appropriations package would expand access to mental health treatment for hundreds of thousands of Oklahomans.  

Over the course of their careers, the professionals who benefit directly from these workforce incentives — psychiatrists who filled newly funded residency slots, psychologists who filled new predoctoral internships and postdoctoral slots, as well as social workers and advanced practice nurses who received scholarships — would serve more than 1.4 million Oklahomans who otherwise would not have received care. Over a 30-year period, this would mean about 49,000 more Oklahomans a year receiving evidence-based behavioral health treatment.  

In this table, we estimate the number of patients served over providers’ careers, only accounting for the portion of providers who will stay in Oklahoma to work and those who are expected to provide evidence-based practices.  

Additional patients served in Oklahoma by providers funded through workforce investment

The data in the table above show that through the Collaborative Care Model, in which psychiatric providers work as consultants to primary care providers on patients' behavioral health needs, psychiatrists and advanced practice psychiatric nurses can serve vastly more patients than they would in a typical practice.

Our calculations conservatively estimate that only 10% of psychiatrists and advanced practice psychiatric nurses would adopt the Collaborative Care Model. If significantly more psychiatric prescribers work in this model than we estimate here, the economic and treatment access benefits would be even greater.

Behavioral health workforce innovation grants

The proposed workforce appropriations package includes $4 million for grants to fuel private-sector innovation that can attract, grow, and retain Oklahoma’s workforce. These innovation grants will be administered by the Oklahoma State University Medical Authority (OSUMA), and its counterpart at the University of Oklahoma, the University Hospitals Authority and Trust (UHAT).

The grants are an expansion of a pilot workforce development program created by the passage of House Bill 2036 in 2023.  

While the grantees have not yet been announced, the pilot program is set to distribute $1 million in its first year. We estimated the providers added through the pilot program and their corresponding taxpayer benefits to project a taxpayer benefit of $183,345,568 for future workforce innovation grants over the course of providers’ careers.

How we calculated taxpayer benefits

Our estimation of taxpayer benefits focuses on reduced government spending and higher tax revenue that will result from additional patients receiving evidence-based mental health treatment — as opposed to going without treatment or receiving treatment that isn’t evidence-based.  

By increasing the number of behavioral health providers, more people can access mental health treatment and, therefore, experience better mental health and be more likely to participate in the workforce. In our analysis, we calculate increased tax revenue from this greater workforce participation and patients’ ability to spend money on goods and services in the state. Greater workforce participation also means less government spending on unemployment benefits, for example.

To estimate the dollar value of these taxpayer benefits, we used results from the benefit-cost model developed by the Washington State Institute for Public Policy (WSIPP), which was created by the Washington State Legislature to make nonpartisan, science-based estimates of the benefits and costs from government-funded programs. These estimates are based on controlled studies of each proposed program combined with a sophisticated benefit-cost model developed using extensive state data. The estimates are reported on a per-client or per-patient basis, so while they are Washington-specific, they are the best available estimates of outcomes in other states.

Increasing the number of graduating psychiatrists, psychiatric nurse practitioners, psychologists, and licensed clinical social workers also will result in more Oklahoma patients receiving evidence-based care. We estimated the number of additional patients the state’s workforce would serve based on the number of graduates likely to practice in Oklahoma, a typical practitioner caseload, and how many years they would practice over their entire career, as well as the taxpayer savings per patient treated.

The most common mental health conditions of adults in Oklahoma are anxiety disorders, major depression, and post-traumatic stress disorder. Of the three, the taxpayer savings from treating major depression with evidence-based practices are the smallest, so to avoid potentially overstating the taxpayer benefits, we made our calculations based on the savings from depression treatment. For example, treating just one patient with depression using cognitive behavioral therapy generates $10,549 in taxpayer savings over the patient’s lifetime, according to a WSIPP estimate.