Behavioral health programs may be especially compatible with earn-and-learn strategies as the federal government and some individual states adopt stricter, measured-value accountability frameworks.
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The country’s only nonprofit accredited university dedicated to apprenticeship degrees is opening a health-care college, it announced Thursday. Reach University, which launched in 2020, has thus far been focused on education, helping incumbent workers in K–12 schools earn degrees to become teachers while they continue to work full-time, typically as paraeducators.
Just as Reach’s debt-free teacher apprenticeship model is designed to address a critical shortage of educators, the Apprenticeship College of Health is set to address a critical shortage of health-care workers—starting with those in behavioral health. The program will launch in Washington State, initially offering Reach’s existing associate of arts degree in liberal studies with a focus on social science, embedded within a behavioral health apprenticeship that prepares learners for careers as substance use disorder professionals.
Subject to accreditor and state approval, Reach expects to add stackable bachelor’s and master’s degree pathways in health-care fields.
The National Center for the Apprenticeship Degree, housed at Reach, recently helped the College of New Jersey launch its own master’s-level registered apprenticeship for clinical mental health counseling, the first in the U.S. Aspiring counselors earn their degree while gaining paid, hands-on clinical experience.
Behavioral health “suffers from the same types of labor shortages that we’ve seen in teaching and, of course, across other occupations in health care,” said Reach president Joe Ross. “It also has a lot of front-line workers—care case workers, addiction counselors, behavioral health technicians—who could be the talent pool for licensed counselors in the future. So we really want to build out that talent pool because, currently, licensed counseling is something you do with a master’s in social work or a master’s in counseling. And the typical pathways into those fields are very, very expensive, with very, very high tuition.”
Behavioral Health Care Shortages: By the Numbers
The National Center for Health Workforce Analysis projects the following provider shortages in behavioral health by 2038:
- 77,050 addiction counselors (master’s degree level)
- 99,780 mental health counselors
- 99,840 psychologists
- 43,810 psychiatrists
- 33,840 marriage and family therapists
- 39,680 school counselors
Estimates address only current usage rates. Factoring in unmet need results in more severe shortages. The center estimates that an additional 136,350 psychologists would be required by 2038 to meet all unmet need, versus 99,840 for current use levels, for example.
Ross said Reach is not trademarking the Apprenticeship College of Health so that other institutions can follow suit.
A recent report by New America found that teaching and registered nursing are relatively well represented among the country’s roughly 600 degree apprenticeship programs. But behavioral health programs may be especially compatible with earn-and-learn models as the federal government and some individual states adopt stricter, measured-value accountability frameworks. Under the One Big Beautiful Bill Act, which takes effect July 1, academic programs that do not meet a new “do no harm” earnings threshold for graduates risk losing access to federal direct loan funding.
The new federal program-level earnings bar is relatively low: Some 95 percent of offerings are estimated to clear it, with undergraduate certificate programs, such as those in cosmetology, disproportionately at risk. But preliminary data on at-risk degree programs point to potential problems in some caring fields, including behavioral health. At the two-year degree level, 48 percent of programs in human development, family studies and related services are estimated to fail the earnings test, according to an analysis by the American Enterprise Institute. Four-year degree programs will largely pass, but 64 percent of master’s degree–level programs in mental and social health services and allied professions could fail.
Another recent analysis of outcomes for Texas graduates flagged negative, cost-adjusted financial returns on investment for graduate degrees (excluding Ph.D.s) in social work, clinical psychology and psychology, as well as curriculum and instruction.
Preston Cooper, a senior fellow at AEI and author of the preliminary earnings-test analysis, told Inside Higher Ed that the apprenticeship model “can be very well suited for some of these fields of study where the earnings might be a little bit lower, but we still think that the program is valuable because it’s filling a societal need.” Additionally, he said, “you need a lot of hands-on experience if you’re going to get really good at these professions.”
Reach has grown from 67 candidates in 2020 to more than 3,400 learners across eight states. Washington makes nine. Federal Pell Grant–eligible students have a graduation rate of 72 percent, according to Reach, higher than for similarly situated peers.
Higher Ed Solutions to Market Problems?
As for whether it’s higher education’s responsibility to address the larger market problem of low wages for high-need jobs, Cooper said, “We can have a multipronged strategy here.” Reach and other institutions can build debt-free training options via apprenticeships while, in the longer term, “If we believe that we need more teachers or social workers, then the right answer is probably to pay them more and attract more people to the profession.” Rethinking licensing requirements or expectations tied to advanced degrees in lower-paying fields might also be in order, he said.
The earnings data required under OBBBA can help illuminate some of these issues and force “difficult conversations” beyond higher education, Cooper also said: “It can be a wake-up call to policymakers to say, ‘Wow, this program’s earnings outcomes are not great, and maybe we should try to do something about the fact that people are taking on a whole lot of debt when they’re not really earning enough to justify that.’”
Colleges and universities are increasingly leaning into apprenticeships, adding apprenticeship degrees, delivering related technical instruction for nondegree programs and serving as administrative sponsors for registered apprenticeships. Apprenticeships in general have grown in the U.S. over the last decade, but they haven’t yet scaled as they have in peer nations. That’s due in part to challenges with employer buy-in. This could be changing, however, amid accelerating federal interest in and funding for apprenticeships in high-need areas, including health care. Reach is working with the Training Fund, a union-based, multi-employer organization to scale its behavioral health program.
According to federal data, there are currently 16,847 active participants in registered health care and social assistance apprenticeships.
