10.3 Behavioral Health Careers

Anne Nichol

10.3 Behavioral Health Careers

There are many career paths for people interested in behavioral health as that connects with the criminal justice system. Careers in behavioral health have a range of educational and certification or licensing requirements, and, like criminal justice careers, roles can be found to fit a variety of priorities and interests. Many of the roles described in this section can be performed within correctional environments—jails or prisons—as well as in secure psychiatric settings, such as hospitals, or in the community. The Oregon Department of Corrections, for example, is regularly looking to hire professionals specializing in behavioral health, developmental disabilities, and mental health care, emphasizing the Department’s constitutional obligation to provide continuous care consistent with community standards (Oregon Department of Corrections, n.d-a). Overall, behavioral health professionals are more likely to be female (69%) and white (67%), with people of color represented as follows: Hispanic (12%), Black (11%), Asian (3%), and Native American (0.4%) (Zippia, 2024a).

Mental Health Professionals

Most behavioral health jobs require some type of certification as a way of establishing that the person who holds the certification possesses and is maintaining certain knowledge, skills, and abilities (Indeed Editorial Team, 2023). Certifications vary by state, and these requirements are in addition to any education and experience requirements for particular jobs, although certifications may also require baseline levels of education and experience. For example, the QMHP (Qualified Mental Health Professional) and QMHA (Qualified Mental Health Associate) are two certifications issued by the Mental Health and Addictions Certification Board of Oregon (MHACBO) that allow a person to work at public facilities in Oregon such as jails or health organizations. The QMHA can be obtained without a bachelor’s degree, while the QMHP usually requires a bachelor’s degree and some graduate work. Two other Oregon certifications, the certified drug and alcohol counselor (CADC) and certified recovery mentor (CRM) are both discussed more in the next section. Although they may have slightly different names and requirements, similar certifications exist in other states, and there is some transferability among the states. If you are interested in the many types of mental health professional positions available in Oregon and would like to explore what certifications they may require, take a look at the MHACBO job listings [Website], or find the equivalent site in the state of interest to you as a way to get acquainted with the requirements there. This is a good starting place for considering education and work pathways that will lead you where you want to be.

Substance Use Counselors

Mental health professionals who specialize in substance use issues will obtain certification specific to that area of work. Again, certifications and their requirements vary by state. Many states have some variation on Oregon’s version of certification for substance-use professionals, the certified alcohol and drug counselor (CADC). States with similar requirements often allow reciprocity—meaning that people who move between states may be able to transfer their certification to the new state (Mental Health and Addiction Certification Board of Oregon, 2023). CADCs can be certified at different levels (I, II, or III) depending on their education and experience. The CADC I requires some coursework, along with a set minimum number of hours of supervised experience; the CADC II requires at least an associate’s degree; and the CADC III requires a graduate degree. Each level of certification involves an increased minimum of hours of supervised work, as well as passage of certification exams (MHACBO, 2023).

If you are interested in a little more information about obtaining the CADC certification in Oregon, take a look at the Portland Community College program in Addiction Counseling [Website], which offers multiple pathways to the CADC certification. Additionally, consider watching the optional video linked in this section (figure 10.10) to hear from an experienced drug and alcohol counselor who works at the Oregon State Hospital. The counselor describes the importance of the programs where he works and what he believes makes him successful in this role.

https://www.youtube.com/watch?v=IAjhBnyRp4U

Figure 10.10. This optional video describes the work of a drug and alcohol counselor who has obtained the NCAC-I (National Certified Addiction Counselor) certification, a voluntary national certification indicating a high level of experience in this field (Association for Addiction Professionals, 2024). Transcript.

Peer Support Workers

The important and unique role of peer support in the context of incarceration and reentry was discussed in Chapter 7 and Chapter 8 of this text. Like other behavioral health professionals, peer support workers, or peers, can be certified with various titles to indicate their levels of training and experience in the work that they do, including their lived experience. Peers have the key qualification of lived experience in the relevant area(s) in which they serve: as a mental health treatment consumer, as a person in recovery from a substance use disorder, or as a person with criminal justice system involvement. As with other certifications, peer certifications vary by state and are sometimes transferable to other states (MHACBO, 2023).

In Oregon, the Oregon Health Authority (OHA) oversees the training and certification required for people to serve as professional peers. If you are interested in more information about that process, take a look at the information provided by OHA about certification of these professionals [Website]. NAMI (the National Alliance on Mental Illness) is one OHA-approved provider of peer training. NAMI regularly offers training to people with lived mental health experience, and some of the trainings are aimed at specific groups (e.g., veterans or people who identify as LGBTQIA+) so their particular challenges and expertise can be highlighted. All of NAMI’s peer training is offered at no cost and includes an emphasis on trauma-informed care and cultural humility (National Alliance on Mental Health, n.d.).

Often, the types of professionals mentioned in this section will work in teams where each member offers their expertise. In the video linked in this section, you will hear from several behavioral health professionals and an incarcerated person participating in a co-occurring disorders program at the Columbia River Correctional Institution in Oregon (figure 10.11). The program serves people who will soon be released from custody and is a great example of the impactful professional opportunities available at the crossroads of behavioral health and criminal justice. The video includes professionals with the QMHA and QMHP certifications, one of whom is a formerly incarcerated peer professional now working at the same facility where he was incarcerated. As you watch, consider the challenges and rewards associated with working in a program like the one described.

https://www.youtube.com/watch?v=f2iNv9zejlo

Figure 10.11. This required video shares the perspective of a participant and several differently-certified professionals working in a prison behavioral health program that treats both substance use disorders and mental health disorders with evidence-based approaches. Transcript.

If the role of a peer professional is interesting to you, consider also watching an optional video that shares the experience of a peer mental health recovery specialist at the Oregon State Hospital (figure 10.12). Peers can have a significant impact when working with people who are housed in a controlled environment, in part because of the peer’s ability to identify with the difficult circumstances inherent in this environment.

https://www.youtube.com/watch?v=ZdTckVr0hwY

Figure 10.12. This optional video describes the experience and work of a professional peer serving people receiving psychiatric care at the Oregon State Hospital. Transcript.

Mental Health Counselors and Social Workers

A mental health counselor is a professional providing treatment to someone with a mental disorder. This title is typically reserved for a state-licensed person who has at least a master’s degree, along with a few years of supervised practice. Requirements for licensure vary by state. Mental health counselors may be known by slightly different titles depending on the state where they are licensed (Cherry, 2022b; OOH, 2024m). In addition to state licensure that allows a person to act as a mental health counselor, there are national certifications that indicate various levels of training and expertise. Specialized certification, such as certification to engage in addiction counseling, is available as well (National Board for Certified Counselors, 2024).

Like other mental health professionals, mental health counselors who want to work with justice-involved populations can do so in many different environments, including correctional facilities, hospitals, and community clinics. Mental health counselors can diagnose mental disorders, as well as treat these disorders via therapy, goal-setting, problem-solving, and more (Cherry, 2022b).

A social worker is another professional who, in general terms, works to help people cope with various issues and problems in their lives. In this role, social workers may provide advocacy, counseling, case management, or other support to people with mental disorders who are involved in the justice system. Social workers specializing in mental health or substance abuse can both assess and treat people with these problems, engaging in therapy, skill-building, and rehabilitation services (Cherry, 2023). Social workers in these roles would have a master’s degree in social work, along with a period of supervised practice and a license in social work according to the law of the state where they practice (OOH, 2024l). There are also social work-related professional roles that do not require licensing.

The optional video linked in this section (figure 10.13) relates the educational and career path of a social worker at the Oregon State Hospital. The speaker is certified as a CSWA, or clinical social work associate. This certification is for a person who is in the supervised practice stage of their career and on the path to gaining a license as a social worker who can practice independently (State of Oregon, Board of Licensed Social Workers, n.d.).

https://www.youtube.com/watch?v=oBmFs8dmF5E

Figure 10.13. This optional video offers insight into the role of a social worker at the Oregon State Hospital, including the rewarding prospect of helping people leave the hospital to succeed in the community. Transcript.

Psychologists

Psychologists who are interested in working with justice-involved clients might take one of a few different pathways. Clinical or counseling psychologists are focused on the diagnosis and treatment of clients, while forensic psychologists more typically work with lawyers and the courts to help clarify the psychological aspects of a legal case by completing assessments and offering expert opinions (OOH, 2024b). In the overlap with the justice system, psychologists may work to support people with mental disorders and help them solve their problems. Also, they are frequently engaged to review information about a person, interview them, and offer an opinion or evaluation to a court, to the person’s attorney, or to others on the person’s treatment team to answer particular questions. For example, a psychologist may be called upon to perform an assessment to determine if a person is competent to stand trial or qualifies for the insanity defense (as discussed in Chapter 6). Psychological evaluations are critical to determinations such as whether a person may be civilly committed, as discussed in Chapter 9. Psychologists also perform evaluations that inform treatment and explain the risk of future danger (e.g., sex offender evaluations, stalking evaluations, or evaluations to look for things like signs of brain injury). Psychologists may be called upon to testify on their findings in court, or their findings may be used for treatment, or both (Cherry, 2022a).

Psychologists must be licensed to practice in the state where they work, and they typically have a doctoral degree, either a Ph.D. or Psy.D (OOH, 2024k). Forensic psychology has increased in popularity in recent years, and although there are master’s-level programs available, practitioners advise that, as a practical matter, jobs in this field typically require a doctorate rather than just a master’s degree. So if forensic psychology is your interest (and it is interesting) be ready to go the distance in your schooling (Cherry, 2022a).

Watch the 5-minute video in figure 10.14 to hear from a licensed psychologist working in the restrictive setting of a psychiatric hospital. What stands out to you in this person’s description of their work? Is this work that would appeal to you?

https://www.youtube.com/watch?v=6g8NoIAIDrg

Figure 10.14. This optional video describes the role of a clinical psychologist who works at the Oregon State Hospital, where a primary focus is on helping people progress in managing their mental health. Transcript.