The United States is grappling with a behavioral health crisis worsened by workforce shortages, which restrict access to treatment. States are responding by creating new roles and expanding existing ones within the behavioral health workforce. However, misalignment in training, regulation, and payment policies undermines the effective deployment of these roles to address needs.

This article discusses why training, regulation, and payment are envisioned as a “3-legged stool” that is essential, how misalignment of these 3 factors occurs in the behavioral health workforce, and how states can align them to meet community behavioral health needs.