Minnesota has spent years encouraging people to talk openly about depression, screen themselves early and ask for help. That message is working. The problem is what happens next: Too often, the system on the other end can’t answer in time.
The numbers are stark. In 2024, 38% of psychiatrist positions in Minnesota sat vacant, according to the state’s Job Vacancy Survey. Nine of the state’s 11 geographic regions are designated mental health shortage areas, NAMI Minnesota notes. Of roughly 800,000 Minnesota adults living with mental illness, about 200,000 still don’t get the care they need. In many cases, that’s not because they didn’t ask, but because no one could see them.
Minnesota isn’t an outlier. Nationally, the latest survey by the federal Substance Abuse and Mental Health Services Administration found that 20.6% of U.S. adults, or 54.6 million people, experienced a mental illness in the past year, and about half received no treatment. Need is also getting more complex. Centers for Disease Control and Prevention data show that about half of health center visits by young people with an anxiety disorder also involved another diagnosis, such as ADHD or depression.
More people coming forward to a system with less capacity to receive them is not a sustainable combination.
The instinctive answer is to train more therapists and recruit more psychiatrists. That’s necessary, but it’s slow. Training pipelines take years to expand and longer to graduate new providers. Meanwhile, practices compete for the same limited pool of clinicians and lose many of them to burnout, long before a shortage of graduates becomes the limiting factor.
That points to the lever we can pull now: keeping the clinicians we already have in the field, and in direct patient care rather than buried in administrative work. Every experienced therapist who leaves the profession takes years of capacity with them.
At LynLake, we’ve learned to treat clinician retention as an access problem, not a human resources problem. Two things have mattered most.
The first is autonomy and growth. Clinicians are more likely to stay in the work when they have real control over their caseloads, funded continuing education and a clear path from paid internship through licensure.
The second is removing administrative weight. Every hour a clinician spends on billing, payer negotiation or marketing is an hour not spent with patients. When that work is handled centrally, clinicians can do what they trained to do.
Neither idea is novel. What’s missing is treating them as core infrastructure for access to care rather than as nice-to-have perks.
This shift isn’t only a job for individual practices. As Minnesota legislators and health systems look at the mental health workforce, they should weigh retention alongside recruitment. That means supporting paid training pathways that keep early-career clinicians in the state, reducing the administrative and documentation burden that drives burnout, and making sure reimbursement reflects the real cost of keeping experienced clinicians in practice.
The fix isn’t a single campaign, hire or bill. It’s a decision to stop treating clinician retention as a soft workplace issue and start treating it as the access-to-care problem it is. Minnesota is rightly telling more people to ask for help. We owe them a system that can say yes.
Lori Quist, Ph.D., is CEO of LynLake Centers for WellBeing, a Minneapolis-based behavioral health practice and a partner practice of ARC Health, a national network of behavioral health practices.
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