Raising the Bar in Virginia’s Community Mental Health Care: A Bold Call to Action

Community mental health providers in Virginia are at a crossroads. The quality of care has slipped, fidelity to best practices has been lost, and it’s time for bold, direct action to set things right. We cannot keep doing the same things and expect better outcomes for our clients. This blog is a call to increase the quality of care across our community mental health services by honing clinical skills, embracing collaboration, and holding each other accountable. It’s about actively listening to clients, being trauma-informed, pursuing continuing education, and fostering a culture of teamwork over competition. The mental health scene in Virginia needs reform – now – and we as professionals must lead the charge.

Honing Essential Clinical Skills: Active Listening and Empathy

Quality care starts in the therapy room (or home visit, or crisis call) with fundamental clinical skills. Active listening – truly hearing and understanding our clients – is non-negotiable. When we listen actively, we stay engaged with clients in a positive way, making them feel heard, valued, and respected . This isn’t just a “soft skill” – it’s the foundation of effective therapy. Research confirms that active listening builds trust and strengthens relationships, showing the client that they matter . Every provider should routinely practice skills like open-ended questioning, reflection, and withholding judgment, as these techniques signal empathy and foster a deeper connection with those we serve . In short, if you’re not actively listening, you’re not truly treating.

Being trauma-informed is equally critical. Trauma-informed care means recognizing that many clients have a history of trauma and approaching every interaction with that awareness. It’s a strengths-based approach delivered with compassion and clear boundaries, aiming to avoid triggering trauma responses . A trauma-informed provider understands that trauma is pervasive and can profoundly affect mental and physical health . We must prioritize safety, trustworthiness, choice, collaboration, and empowerment in our services – core principles of trauma-informed care . By doing so, we help clients feel secure and respected, which in turn improves engagement and outcomes. Every agency should train staff in trauma-informed practices and cultural humility. No more excuses: every interaction – from intake to discharge – should reflect an understanding of trauma and its impact.

Commitment to Continuing Education and Excellence

Professional skills don’t develop in a vacuum or stop evolving after a degree is earned. To truly improve quality, community mental health workers must embrace lifelong learning. Continuing education is not just a bureaucratic requirement – it directly correlates with better patient outcomes . When counselors, QMHPs, social workers, and other providers stay up-to-date on the latest evidence-based practices, they can tailor interventions to clients’ needs and deliver more effective treatment . On the flip side, if we stagnate or rely on outdated knowledge, our clients suffer the consequences.

Every mental health agency should encourage and fund ongoing training for their staff. This means providing access to workshops, CEU courses, in-house trainings, and conferences. By engaging in ongoing learning, professionals enhance their skills and competence, which ultimately leads to improved client well-being . The research is clear: clinicians who continually educate themselves can provide the highest standard of care and even increase client satisfaction . In practice, this could mean getting certified in an evidence-based therapy, attending a trauma workshop, or simply keeping abreast of new state regulations and treatment innovations. Excellence requires effort – and our clients deserve nothing less.

Collaboration Over Competition: End the “Secret Sauce” Mentality

Too often, providers and agencies behave as if mental health care is a zero-sum game. There’s a toxic mentality among some community providers of guarding knowledge – the “secret sauce” – or trying to be the sole expert in town. This must stop. Our clients benefit most when we work together, not when we operate in silos. Research on healthcare delivery consistently shows that coordination and collaboration lead to better outcomes and higher quality care  . When therapists, case managers, doctors, and peer support specialists communicate and align their efforts, clients experience more comprehensive and effective support.

Collaboration among community providers is like fitting together pieces of a puzzle – it creates a fuller picture of care.

In Virginia, we should be forming local coalitions, cross-agency teams, and referral networks to ensure no client “falls through the cracks.” Hoarding resources or refusing to refer out to protect your caseload is unethical and ultimately harms consumers. It’s time to replace competition with cooperation. For example, if one agency has a great family support program, others should know about it and be able to refer appropriate clients, rather than each agency trying to reinvent the wheel. Sharing best practices, consulting with peers, and coordinating care plans are marks of a high-functioning community system. In fact, effective care coordination – such as between behavioral health and medical providers – improves quality, outcomes, and even reduces costs . The message is clear: we’re all on the same team, and our common opponent is mental illness, not each other.

Engage with State Initiatives and Collaborative Training

Another way to break out of isolation is for agencies to plug into state-led initiatives and training opportunities. Virginia’s Department of Behavioral Health and Developmental Services (DBHDS) and other state bodies regularly offer resources, pilot programs, and learning collaboratives aimed at elevating care standards. Unfortunately, not all providers take advantage. This is a huge missed opportunity. Agencies should actively participate in state trainings on topics like person-centered planning, evidence-based practices, crisis intervention (e.g. CIT programs), and more. Such involvement not only builds staff expertise but also fosters a culture of consistent, high-quality service delivery across the state.

The Commonwealth is making moves to improve quality – we should be part of that movement, not ignore it. For instance, the DBHDS has a division specifically focused on improving the quality of care in community programs , and recent regulatory changes reflect higher expectations. As of 2025, Virginia updated its regulations for Qualified Mental Health Professionals, now requiring formal didactic training for new QMHPs and mandatory training for QMHP supervisors . These changes signal that the state expects better training, supervision, and fidelity to best practices. Rather than view this as a burden, agencies should see it as aligned with our mission – a chance to ensure every provider has baseline competency and support. If your agency isn’t keeping up with statewide standards and opportunities, ask why not. We need to collaboratively raise the bar, not cling to the status quo.

Restoring Fidelity and Professional Accountability

Let’s address the elephant in the room: accountability. Many in the field whisper that “the mental health scene in Virginia has lost its fidelity.” What does this mean? It means too many providers are cutting corners, getting lax with clinical standards, and failing to deliver evidence-based care consistently. Fidelity – sticking to proven models and ethical guidelines – has eroded amid rapid expansion and perhaps the chase for billing revenue. This is unacceptable. We must each hold ourselves and our colleagues accountable for providing high-fidelity services. If you see a co-worker or supervisee straying from ethical practice or delivering subpar care, it’s your duty to speak up and course-correct (respectfully and constructively).

Accountability also means using data and supervision to keep quality on track. Agencies should employ quality assurance measures – chart reviews, peer consultations, outcome tracking – to ensure services maintain integrity. The state is watching too: Medicaid and licensing bodies have tightened oversight in response to quality concerns in community mental health. In fact, Virginia’s own workforce task force observed significant inconsistency in provider skill levels and inadequate training at the direct care level . Front-line staff often had the least education and training, despite bearing the most client contact . This kind of gap leads directly to uneven quality. Moreover, high turnover fueled by low pay and high caseloads has plagued our sector  – further undermining fidelity as experienced workers leave and agencies scramble to fill slots.

We simply cannot allow our services to devolve into a check-the-box exercise. Every provider should practice with intention and adherence to their therapeutic models, ethical codes, and program standards. Supervisors and senior clinicians must enforce this. Remember, our clients pay the price for our lack of fidelity. If a certain evidence-based practice (EBP) is claimed, ensure staff are trained and delivering it properly. If a treatment plan is written, follow through with the interventions as described. Holding each other accountable isn’t about policing – it’s about protecting the trust our communities place in us. Virginia’s mental health professionals need to reclaim pride in doing things the right way.

Elevating the QMHP Role: Training, Stability, and Investment

Qualified Mental Health Professionals (QMHPs) are the backbone of community services in Virginia – they are often the ones in homes, schools, and neighborhoods working directly with clients. Yet, we’ve allowed the QMHP role to become undervalued and stretched thin. It’s not uncommon to find a QMHP working for two or even three agencies at once just to make ends meet. This practice is problematic. When a practitioner is splitting their focus and energy between multiple employers, can they truly give 100% to any one program? Burnout is a real risk here, and research shows burnout leads to reduced job commitment, poorer performance, and increased turnover . We need to change the expectations and incentives so that QMHPs can commit to a single agency (or at most one full-time role) and build their skills within that team.

Agencies, this is a call to you: pay your QMHPs a livable wage and provide them full-time opportunities, so they aren’t forced to juggle multiple jobs. Offer growth pathways – such as senior QMHP positions, supervisory tracks, or assistance in obtaining higher licensure – to reward commitment. Consider tuition reimbursement or stipends for those pursuing further education or certifications. Increasing incentives for QMHPs isn’t just kindhearted – it improves continuity of care. A stable workforce means clients aren’t constantly handed off to new faces, and providers can truly develop expertise in their roles. High turnover and constant new hires, often a result of low pay and burnout, directly undermine service quality . Let’s break that cycle by investing in our front-line staff.

QMHPs themselves must also take ownership of their professional growth. If you’re a QMHP, strive to be more than just a “body” filling a billing requirement. Seek out trainings (many are free or low-cost through state programs or online platforms), attend workshops, and read up on best practices for the services you provide. When you invest in your own development, you become a more effective clinician and a stronger advocate for your clients. Additionally, experienced QMHPs can pursue the new supervisor training now required in Virginia  – positioning themselves to mentor the next generation. The bottom line: being a QMHP is a career, not just a job. Treat it like one, and demand that your employers do the same by providing the support you need to excel.

Coordinating Care and Leveraging Community Resources

Quality mental health care doesn’t happen in isolation from other supports. A client’s progress might depend on housing assistance, school interventions, medical treatment, or peer support groups. That’s why learning the community resources and coordinating care is so important. As providers, we should all be mapping out the network of services around us – from local nonprofits and NAMI chapters to social services, shelters, and vocational programs – and actively connecting clients to those supports. Coordination of care across different providers and settings improves the quality of care for patients . It ensures everyone is working from the same page and that the client’s needs are met holistically.

Every QMHP and clinician should become familiar with the community resource landscape: know who to call if your client needs a food pantry or how to refer to a substance abuse program or which clinic offers sliding-scale psychiatric consults. This is part of being a competent community-based practitioner. It might mean spending a bit of time networking or compiling a resource binder, but it pays off when you can quickly link a family to help that falls outside your agency’s scope. Remember, collaboration isn’t only with other mental health professionals, but with any service providers that can play a role in recovery. Innovative partnerships – even non-traditional ones – can significantly improve outcomes. In fact, creative collaboration with community partners has been shown to improve healthcare outcomes for clients by addressing social determinants and gaps in care . Coordination of care is simply part of quality care.

Additionally, always obtain proper consent and communicate with your clients’ other providers (primary care doctors, psychiatrists, etc.). This communication (with releases in place) prevents duplication of efforts and promotes a unified care approach. It’s frustratingly common for a therapist and a case manager, or two different agencies, to work with the same person in parallel universes, unaware of each other’s plans. We can do better. A quick phone call or case conference can align strategies and prevent working at cross purposes. United we stand, divided we fall – that applies to how we support our community members’ mental health.

A Call to Action: No More Excuses

Improving community mental health care won’t happen with wishful thinking – it requires each of us to act. If you are a provider or agency leader reading this, consider this a challenge and an invitation. Starting today:

• Practice active listening and empathy in every client interaction. Make people feel heard and valued .

• Embed trauma-informed principles in your work. Ensure safety and trust, avoid practices that could re-traumatize .

• Pursue continuing education relentlessly – and urge your colleagues to do the same. Strive for mastery and stay current .

• Stop the silo mentality. Reach out to other providers, share knowledge, collaborate on cases, and participate in community networks.

• Engage with state trainings and initiatives. Be present in the broader effort to raise standards (Virginia is watching and offering support).

• Hold your team accountable. Demand fidelity to treatment models and ethical standards. Don’t tolerate corner-cutting or complacency.

• Value and support QMHPs. If you supervise or employ them, pay them fairly, supervise them well, and encourage their growth. If you are one, invest in yourself and choose employers who invest in you.

• Coordinate care actively. Don’t be the lone ranger – involve doctors, schools, families, and community resources in treatment plans for holistic impact .

This is a bold call to action because anything less will not shake our system out of its rut. The mental health professionals in Virginia have an ethical obligation to rise to the occasion. Our clients – often among the most vulnerable Virginians – depend on us to give our best. It’s time to revive our collective fidelity to quality care. Let’s listen deeply, learn continually, collaborate generously, and work accountably. By doing so, we can restore trust in community mental health services and truly make a difference in people’s lives. The era of doing the bare minimum or operating in isolation is over. Together, let’s raise the bar and set a new standard of excellence in community mental health care.

The work is hard, but the cause is worthy. Virginia’s communities are counting on us – let’s not let them down. The change starts now, with each one of us taking action.