Context

Illinois residents seeking mental health care face a harsh reality: the state’s workforce can meet only 22% of existing mental health needs. With a patient-to-provider ratio of 349:1, over one-third of adults with co-occurring mental health and substance use disorders receive no treatment at all.

Behind these statistics are real people: families in crisis, veterans struggling with trauma, teenagers facing depression. The ripple effects touch every corner of state government: overwhelmed schools, overcrowded jails, and rising healthcare costs that strain already tight budgets.

To address this challenge, the Illinois legislature created the Illinois Behavioral Health Workforce Center (BHWC) in 2023 to recruit, retain, and expand the state’s behavioral health workforce.

Founded as a hub-and-spoke model, the Center was tasked with developing a shared vision, strategy, and operating model. Southern Illinois University and the University of Illinois Chicago, serving as the two academic hubs, partnered with Afton and enlisted the expertise of a cross-agency working group, to embark on their first ever strategic planning process in 2025.

Goal

BHWC needed more than a strategic plan. It needed an actionable blueprint that could transform how the state develops, supports, and retains behavioral health professionals. The document balanced immediate wins with longer-term infrastructure: some initiatives launching within months, a plan built for the next 3-5 years, others projects laying systems foundations for the next decade. Success meant unifying university partners, satisfying legislative reporting requirements, and establishing measurable targets that would hold everyone accountable for results.

Approach

This project brought together a unique set of voices:

• State legislators who originally championed the bill
• Department of Human Services stakeholders who fund behavioral health programs across the state
• State Board of Education folks who oversee higher ed pipelines
• University reps from both academic hubs
• Advocacy and research orgs

There’s Power and Productivity in Proximity

Our best conversations were made possible because of proximity. Funders and implementers worked side-by-side, thoughtfully discussing tradeoffs through the lens of their real lived experiences and expertise.

When a good idea was proposed, elected officials could immediately comment on legislation or relevant initiatives. DHS representatives clarified why, how, and what they would fund. Universities identified how their ecosystems and programs might contribute.

This working group’s makeup empowered us to talk practically about concrete realities and focused our conversations around what was realistically possible.

The development and implementation of the BHWC strategic plan will be instrumental in laying the foundation for future work of the Center. Afton’s guidance and expertise allowed the working group to clearly define goals and priorities that are important to all stakeholders, ensuring we’ve got a focused roadmap to advance the Center’s mission. Afton’s staff was professional, highly responsible, and collaborative throughout these facilitated discussions.

Gina Larkin, Director of Strategic Development at SIU School of Medicine

The 2024 Election Happened Halfway Through This Project

When the new federal administration took office, “diversifying the workforce” (literal language from the Center’s legislative mandate) became highly controversial. The universities immediately offered guidance about what could and couldn’t appear in public documents. We needed to preserve our commitments to equity while supporting them to navigate these new language stipulations.

Our extensive wordsmithing felt delicate, even frustrating, but it protected both the Center’s values and its political viability. The strategic plan had to survive in the real world, not just the ideal one.

Building Trust Through Truth

The planning team’s SWOT encouraged hard conversations about uncomfortable realities. Programs face unsustainable funding. Universities compete for the same grants. Pipeline programs produce graduates who immediately go into private practice instead of serving public programs because of low wages.

But these direct conversations built trust. Which gave us the opportunity to address root causes of systemic issues: training gaps in the field, disparities in reimbursement rates, and lack of exposure to behavioral health careers, among others. By surfacing and validating uncomfortable realities, the group could move toward solutions.

Outcomes

Illinois now has its first strategic plan for behavioral health workforce development. You can view it here. 113 specific actions organize around six strategic goals, each with assigned responsibilities, timelines, and success metrics

Illinois has a Replicable Blueprint for Behavioral Health Workforce Development

This plan addresses the entire pipeline:

• Early admission programs link high schools to behavioral health careers
• Stackable credentials provide a pathway from certificates through doctoral programs
• Illinois’ first rural residency in psychiatry will be launched
• Financial barriers are tackled through targeted loan repayment in underserved regions
• New rural clinical training sites with evidence-based curricula ensure graduates are well-trained and stay local

States should note the comprehensive approach: recruit early, remove financial barriers, train locally, support continuously.

Accountability Drives Results

Every goal has metrics tracked with progress reports going directly to legislators who control funding. Biennial reporting requirements will outlast election cycles. The governance structure keeps legislators, funders, and educators aligned, positioning IL to leverage federal funding with clear evidence of impact. Without accountability to resource controllers, strategic plans become shelf documents.

Three Lessons for Social Service Strategic Planning

1. Put funders and implementers together from day one. Abstract discussions become concrete when legislators and state agencies clarify what’s fundable.
2. Protect values while adapting to political shifts. When changes outside of our control threatened core language, we still preserved intent.
3. Acknowledge hard truths to build trust. Admitting unsustainable reimbursement rates created space for real solutions.

Illinois’ 78% coverage gap won’t close overnight, but the state finally has a funded, measurable path forward — bringing hope to thousands waiting for care.