Licensing Desert / Brain Drain

IMMEDIATE ACTION REQUEST:

ADOPT PSYPACT AMENDMENT 11 to S.3178

Stop Massachusetts from being a behavioral-health licensing island

Massachusetts has an urgent behavioral-health workforce and access problem.  Joining the Psychology Interjurisdictional Compact (PSYPACT) is a practical, ready-made step that expands access to qualified psychologists, strengthens continuity of care, and makes the Commonwealth more competitive in recruiting and retaining clinicians — without weakening Massachusetts licensing or consumer-protection standards.

22%

full-time vacancy rate for independently licensed clinicians—the highest of all client-facing roles

50%

of providers with client-facing vacancies reported longer waits for services

15–16%

vacancy rates for full- and part-time client-facing positions, versus a 3.3% statewide job-opening rate

1. The shortage is already harming patients

Massachusetts providers report that vacancies are increasing waiting times, expanding waiting lists, limiting new admissions, and disrupting continuity and quality of care.  The Commonwealth’s own behavioral-health licensure research concludes that Massachusetts does not have enough practicing mental-health and substance-use clinicians to meet demand.

2. Massachusetts is putting its own psychologists at a regional disadvantage

Every other New England state has enacted PSYPACT.  So has almost the entire rest of the country (45, soon to be 46 other states, are already members).
A psychologist whose home state participates in the compact can seek authority to provide telepsychology across the compact network.  A psychologist based in Massachusetts cannot.
When an MA patient travels or relocates, even temporarily, they have to stop therapy.  When a patient needs specialty care that a MA psychologist could provide, they aren’t allowed to.

Keeping MA as a licensure desert creates a direct incentive for new graduates and border-area clinicians to leave MA and establish their professional homes almost anywhere else in the country.

3. PSYPACT expands access without lowering standards

PSYPACT does not replace state licensure or allow unregulated practice.  Participating psychologists must hold a full, unrestricted doctoral-level license and maintain a clean disciplinary history in order to become authorized to conduct telehealth under the compact.  Massachusetts retains full authority over standards of practice involving Massachusetts patients, and the compact coordinates automatic communication of disciplinary information across participating states.

4. This is a low-burden workforce solution Massachusetts can use now

The compact uses an established national regulatory framework and practitioner-funded authorization process.  Massachusetts does not need to invent a new licensing system, set up any new IT infrastructure, or hire any new staff.  It reduces the burden on the Board of Registration to deal with redundant paperwork, improving their ability to do their real work of protecting the public.  Adoption will improve access to specialists, support continuity when patients travel or relocate, and strengthen recruitment and retention while longer-term workforce investments take effect.

Bottom Line: Please advocate to adopt PSYPACT Amendment 11 in the economic development bill.  Massachusetts is experiencing severe vacancies in independently licensed clinical positions, while every neighboring state gives its psychologists access to the interstate compact.
PSYPACT is a targeted, standards-preserving way to help MA residents maintain access and continuity of care, and to stop penalizing law-abiding clinicians who choose Massachusetts as their professional home.

Prepared for Massachusetts Senate outreach • July 2026.   Sources: UMass Donahue Institute & Providers’ Council, Stretched to Capacity (2026); Blue Cross Blue Shield of Massachusetts Foundation & William James College, Behavioral Health Professional Licensure in Massachusetts (2025); Massachusetts S.1487 sponsor summary; PSYPACT Commission.