Social workers on front lines ask lawmakers for support, reinforcements

Social workers are on the front lines of Maine’s mental health crisis, but low pay and high student loan debt are making it hard to find enough of them to treat the growing number of desperate people waiting months for help with depression, addiction and suicidal thoughts.

Ask Kate Marble, a licensed clinical social worker in Auburn, if she would do it all again – earn a master’s degree in social work that cost her $75,000 – and she hesitates. She loves her job, but she thinks of what she gives up to hold such a low-paying job.

“It’s very difficult for me to say yes,” Marble told state lawmakers Friday. “When I have a young person sitting in my office saying they want to be a social worker and trying to figure out how to tell them it’s a really hard road, even though I know we desperately need them.”

The average clinical social worker in Maine owes $74,557 in student loans and earns $60,000 a year, according to the National Association of Social Workers. Salaries vary by experience and geographic region. The lowest salaries are paid to new graduates working in rural areas.

Rep. Lydia Crafts, D-Newcastle, has introduced a bill, L.D. 632, to remedy the social worker shortage by fully funding a loan repayment program established in 2011. Crafts, a licensed social worker, wants to offer 100 awards of up to $20,000 a year and expand who is eligible to apply.

The bill requires applicants to serve a vulnerable population, such as the elderly, disabled, veterans or the poor, or work for an employer serving the vulnerable, like a child welfare agency, a public childcare facility, a nonprofit, or a correctional facility.

Award recipients would be required to work a job serving Maine residents for at least three years.

“Our state is facing a labor shortage of mighty proportions, and mental health service providers are not immune,” Crafts said. “Agencies and job boards report hundreds of openings, often in some of the most critical roles working with Maine’s most vulnerable residents.”

Without enough providers, children end up on long waiting lists. As of December, 679 children were on the waiting list for home and community-based treatment services, according to the Maine Office of Children and Family Services. The average child on the list had waited 215 days, or seven months.

The number of children and time spent on a waiting list varied greatly across the state. In Washington County, there were 11 children who had been on a list for an average of 435 days. In Penobscot County, 143 children had waited an average of 208 days.

Maine is funneling $36.8 million in state and federal funding to behavioral health providers, and another $19.7 million in state money for youth residential care, community treatment, case management and outpatient therapy. Matching federal dollars bring total behavioral health funding to $65 million.

Most Mainers seeking mental health support start in outpatient counseling or case management, the majority of which is provided by social workers, Crafts said. This helps minimize the need for hospitalizations, law enforcement involvement and child protective services.

LOW WAGES DRIVE SHORTAGE

The social worker shortage is driven by low wages, low MaineCare reimbursement rates and high student loan debt, said Sandy Butler, the director of the University of Maine’s School of Social Work, one of the state’s two social work programs.

“Maine can ill afford the loss of these workers,” Butler warned.

The salaries that social workers earn make it hard to repay their student loans while supporting their families, Butler said. The average pay for bachelor’s level social workers in Maine is $47,000 a year; those with master’s degrees earn about $13,000 more.

Many social work majors are non-traditional students who go to school while working, often full-time, and raising families, Butler said. They rarely have scholarships or grants to cover their tuition, so they are unusually dependent on student loans to fund their education.

According to a survey by the National Association of Social Workers, nine out of 10 Maine social workers carry student loan debt. The average debt load grew with a practitioner’s education: $50,624 for a bachelor’s degree, $74,557 for a master’s degree, and $117,500 for a doctorate.

The debt situation was better but still dire for University of Maine social work graduates: 70 percent of bachelor’s level graduates carried an average student debt of $27,500 and 94 percent of master’s level graduates carried student debt that averaged $46,500.

“Funding this bill will have a significant impact for hundreds of social workers currently struggling to pay their bills while serving children, families, older adults, new Mainers, and people with substance use disorders, or struggling with health and mental health concerns,” Butler said.

Workforce shortages in behavioral health have consequences, Butler said: long wait lists for mental health services, long stays in hospital emergency rooms when no residential beds are available, and teens being treated out of state due to the lack of services in Maine.

An inadequate response to such profound health concerns hurts all of Maine, Butler said. The economy suffers when the mental or behavioral health needs of workers or their loved ones go unmet. Distracted workers are less productive.

Madison Courtois of Old Orchard Beach, a senior social work student at the University of Maine, is interning as an adult case manager at a local nonprofit until she graduates. She would like to continue doing this kind of work in southern Maine, but doesn’t know if she can afford it.

FACING A DIFFICULT DECISION

“I am unsure about whether or not it will be possible for me,” Courtois said. “Due to student loan debt and low pay in this line of work, I will be faced with the difficult decision of whether or not I should go to another state or profession with better pay.”

Therapist Lisa Dezso of Pittsfield wants to stay and help Maine win its battle against the opioid epidemic, but she noted that she and her colleagues also are in a fight to win their battles with staggering student loan debt. She graduated owing $110,000 in student loans.

“The work that I do is important, not only individually to the people I serve, as their lives are valuable to me and they are worthy of help, but to the state of Maine as a whole,” Dezso said. “My colleagues and I need help. The state needs help and more providers. The people you serve need help.”

Student loan debt has forced many qualified would-be therapists to avoid the field, Dezso said. This avoidance has created a state and nationwide shortage of providers. Her clients, for example, must wait five months before they can get a therapy session with Dezso.

Alicia McConkey of Bangor will graduate with a master’s degree in social work from the University of Maine with $80,000 in student debt. She is so broke she had to catch a ride to Friday’s legislative hearing with a professor because she couldn’t afford the gas to drive herself.

Maine asks us to solve the state’s mental health problems, but nobody wants to help us, she said.

“I will never be able to buy a house, I will never own a new car, and though I would like to adopt kids out of the foster system, that too may be too expensive for me to do with a social worker’s salary and student loan debt,” McConkey said. “Help social workers help the state of Maine.”