Because nearly 80% of Montgomery Cares patients speak Spanish, the job descriptions for Montgomery Cares Behavioral Health Program positions include a requirement that staff be bilingual in English and Spanish. It’s one way the Primary Care Coalition (PCC) takes seriously our commitment to providing culturally and linguistically appropriate care.* But finding the licensed mental health professionals—or registered nurses with behavioral health experience—to fill these roles is hard.
A 2024 state-commissioned report on the behavioral health workforce, projected Maryland needs more than 12,000 new counselors and clinical social workers by 2028. It noted that Latino behavioral health professionals are in particularly short supply, with less than 5% of behavioral health professionals identifying as Latino versus nearly 12% of Maryland residents. Reported proportions are even more stark in Montgomery County, where 21% of residents identify as Latino but only 10% of behavioral health workers do. Of course, not all bilingual workers identify as Latino, but Psychology Today’s therapist directory lists only 353 therapists operating in Montgomery County after filtering for Spanish-speaking professionals. That’s roughly 12% of the more than 3,000 therapists the platform counts serving the county overall.
“Recruiting the behavioral health staff our patients need is hard,” says Sarah Frazell, Director of Behavioral Health at PCC. “There simply aren’t enough Spanish-speaking providers in the area, and PCC is competing with hospitals, county government, or private practice platforms and businesses. We’ve always had to be creative about recruitment.”
To address that challenge, MCBHP has built a pipeline approach to hiring by supervising recent graduates who have completed a master’s degree in social work. In Maryland, these graduates must first pass the master’s-level licensing exam to become licensed master social workers before they can begin counting the supervised clinical experience required for the licensed certified social worker-clinical credential (LCSW-C). To progress from LMSW to LCSW-C, they must complete at least two years and 3,000 hours of supervised clinical social work experience, including substantial face-to-face client contact and documented weekly clinical supervision by a qualified LCSW-C supervisor, then pass a clinical licensing exam.
For developing clinicians, that supervision is essential. Full licensure allows social workers to independently diagnose and practice without clinical supervision, but getting there requires access to both practice hours and qualified supervisors. PCC’s current behavioral health team includes several clinical social work supervisors, allowing PCC to offer both. In prior years, PCC was also able to offer a similar model for graduate-level mental health counselors through a partner health center, but that partner no longer has counseling supervisors on staff. Without in-house clinical supervision capacity, professionals in training often have to pay for outside supervision, which can be cost prohibitive.
The model of providing in-house supervision for new graduates benefits PCC as well as the clinicians it supports. Graduate-level staff gain the clinical practice they need while getting to know the Primary Care Coalition and the day-to-day experience of working in the safety net. Many find it a good fit and continue with PCC after completing their supervised hours. Even so, natural turnover can still create long vacancies on the behavioral health team, prompting current supervisors to look for additional ways to attract and support developing professionals.
Additionally, PCC is reintroducing its internship program to strengthen the pipeline of social work interns. Since PCC first began partnering with interns in 2014, the organization has hired seven former interns as behavioral health care managers. Over the years, PCC has worked with programs including UMBC at The Universities at Shady Grove and the University of Maryland School of Social Work, and is currently exploring a new partnership with Trinity University. Two social work interns are expected to join the team for the upcoming school year.
One next step is expanding that supervisory capacity beyond social work. PCC’s Director of Behavioral Health and two other care managers—all clinical social workers—have begun the application process and an 18-credit training program that will allow them to support licensed graduate professional counselors (LGPCs). Once credentialing is complete, they will be able to supervise half of the hours required for LGPCs to become fully licensed clinical professional counselors (LCPCs).
For emerging bilingual clinicians, opportunity is growing at PCC—not just for a job or practicum, but for mentorship, meaningful clinical experience, and a pathway to long-term impact in the community.
*Some partner health centers provide integrated behavioral health care with their own staffing, which allows coverage for other language needs. For example, the CCACC Pan-Asian Volunteer Health Center offers counseling in Mandarin.
A 2024 state-commissioned report on the behavioral health workforce, projected Maryland needs more than 12,000 new counselors and clinical social workers by 2028. It noted that Latino behavioral health professionals are in particularly short supply, with less than 5% of behavioral health professionals identifying as Latino versus nearly 12% of Maryland residents. Reported proportions are even more stark in Montgomery County, where 21% of residents identify as Latino but only 10% of behavioral health workers do. Of course, not all bilingual workers identify as Latino, but Psychology Today’s therapist directory lists only 353 therapists operating in Montgomery County after filtering for Spanish-speaking professionals. That’s roughly 12% of the more than 3,000 therapists the platform counts serving the county overall.
“Recruiting the behavioral health staff our patients need is hard,” says Sarah Frazell, Director of Behavioral Health at PCC. “There simply aren’t enough Spanish-speaking providers in the area, and PCC is competing with hospitals, county government, or private practice platforms and businesses. We’ve always had to be creative about recruitment.”
To address that challenge, MCBHP has built a pipeline approach to hiring by supervising recent graduates who have completed a master’s degree in social work. In Maryland, these graduates must first pass the master’s-level licensing exam to become licensed master social workers before they can begin counting the supervised clinical experience required for the licensed certified social worker-clinical credential (LCSW-C). To progress from LMSW to LCSW-C, they must complete at least two years and 3,000 hours of supervised clinical social work experience, including substantial face-to-face client contact and documented weekly clinical supervision by a qualified LCSW-C supervisor, then pass a clinical licensing exam.
For developing clinicians, that supervision is essential. Full licensure allows social workers to independently diagnose and practice without clinical supervision, but getting there requires access to both practice hours and qualified supervisors. PCC’s current behavioral health team includes several clinical social work supervisors, allowing PCC to offer both. In prior years, PCC was also able to offer a similar model for graduate-level mental health counselors through a partner health center, but that partner no longer has counseling supervisors on staff. Without in-house clinical supervision capacity, professionals in training often have to pay for outside supervision, which can be cost prohibitive.
The model of providing in-house supervision for new graduates benefits PCC as well as the clinicians it supports. Graduate-level staff gain the clinical practice they need while getting to know the Primary Care Coalition and the day-to-day experience of working in the safety net. Many find it a good fit and continue with PCC after completing their supervised hours. Even so, natural turnover can still create long vacancies on the behavioral health team, prompting current supervisors to look for additional ways to attract and support developing professionals.
Additionally, PCC is reintroducing its internship program to strengthen the pipeline of social work interns. Since PCC first began partnering with interns in 2014, the organization has hired seven former interns as behavioral health care managers. Over the years, PCC has worked with programs including UMBC at The Universities at Shady Grove and the University of Maryland School of Social Work, and is currently exploring a new partnership with Trinity University. Two social work interns are expected to join the team for the upcoming school year.
One next step is expanding that supervisory capacity beyond social work. PCC’s Director of Behavioral Health and two other care managers—all clinical social workers—have begun the application process and an 18-credit training program that will allow them to support licensed graduate professional counselors (LGPCs). Once credentialing is complete, they will be able to supervise half of the hours required for LGPCs to become fully licensed clinical professional counselors (LCPCs).
For emerging bilingual clinicians, opportunity is growing at PCC—not just for a job or practicum, but for mentorship, meaningful clinical experience, and a pathway to long-term impact in the community.
*Some partner health centers provide integrated behavioral health care with their own staffing, which allows coverage for other language needs. For example, the CCACC Pan-Asian Volunteer Health Center offers counseling in Mandarin.
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