Interstate Compacts Gain Ground in Expanding Access to Mental Health Care

Interstate compacts for practitioners in the professions of psychology, counseling, and social work can help increase access to mental health care. Here’s what to know.

What Are Mental Health Interstate Compacts?

With state-based licensure required for all U.S. mental health practitioners, interstate compacts make it easier for clinicians to practice in multiple states without requiring them to apply for licensure in each additional state which is cumbersome, costly, and time-intensive.

The goal of interstate compacts is to reduce barriers and increase access to mental health care throughout the U.S. while addressing practitioners’ desire to provide face-to-face services and teletherapy to clients across state lines.

For psychologists, the Psychology Interjurisdictional Compact (also known as PSYPACT), allows eligible psychologists licensed in a participating state to apply to practice telepsychology and/or temporary in-person psychology sessions across state lines in participating states.

Following in the footsteps of PSYPACT, the Counseling Compact and the Social Work Licensure Compact were created for practitioners in the professions of counseling and social work.

Each of these three interstate compacts have been gaining ground. Read on for the benefits of interstate compacts, the list of interstate compact states, and the latest updates on the Counseling Compact, the Social Work Licensure Compact, and PSYPACT.

Benefits of Interstate Compacts

According to the National Center for Interstate Compacts’ website about the Counseling Compact, the Compact will help to improve access and continuity of care such as when clients or counselors travel or relocate across state lines.

The site also points out that the Counseling Compact can help to enhance public safety by requiring member states to rapidly share investigative and disciplinary information and cooperate in investigations of misconduct by practitioners. 

According to the National Association of Social Workers (NASW), the advantages of the Social Work Compact are that it “increases access to care (especially in areas that are underserved, geographically isolated or lack specialty care) by increasing the efficiency of becoming licensed across state lines.”

Counseling Compact

As of May 1, 2023, legislation adopting the Counseling Compact has been passed into law in 23 U.S. states 

On April 26, 2023, Montana became the twenty-third state to ratify the Counseling Compact.

States that have adopted the Compact include: Alabama, Arkansas, Colorado, Delaware, Florida, Georgia, Kansas, Kentucky, Maine, Maryland, Mississippi, Montana, Nebraska, New Hampshire, North Carolina, Ohio, Louisiana, Tennessee, Utah, Virginia, West Virginia, Washington, and Wyoming. 

What’s more, 16 additional states have pending legislation. 

Under the Counseling Compact, licensed counselors in compact states will have a streamlined process for obtaining practice privileges in other compact states. 

However, it’s essential to understand that those privileges in other compact states are not automatic. 

Counselors still need to apply for practice privileges in each additional compact state where they wish to practice. 
They may also need to pay additional fees, complete other states’ laws and ethics exams (also sometimes called a jurisprudence exam), or fulfill other requirements.

Counselors will be able to apply for compact privileges in early 2024. When applications open, counselors can apply on the Counseling Compact website.

It’s important to be aware that not all compact states may be active when applications first open, as some compact states will need to complete additional regulation or rulemaking before they are able to fully participate.

Social Work Licensure Compact

The Social Work Licensure Compact is the newest interstate compact in mental health care. 

The National Center for Interstate Compacts has been working with the Association of Social Work Boards (ASWB) and the U.S. Department of Defense to craft compact language. 

Unlike the Counseling Compact, the current language for the Social Work Compact would enable social workers in participating states to receive a multistate license, allowing them to work in all participating compact states, rather than requiring them to apply for additional practice privileges one state at a time.

The compact requires that individual applicants pass a Qualifying National Exam and complete additional requirements including passing a background check to receive multistate licensure. 

Currently, the only national licensing examination is the Association of Social Work Boards (ASWB), which has come under scrutiny for alleged racial bias.

As of May 1, 2023, according to the Counsel of State Governments, nine states (Georgia, Kentucky, Missouri, New Jersey, North Carolina, Ohio, South Carolina, Tennessee, and Vermont) have pending legislation that would adopt the Social Work Licensure Compact. 

No states have passed such legislation into law so far.

PSYPACT

For Psychologists, the Psychology Interjurisdictional Compact (PSYPACT) is an interstate compact designed to make it easier for eligible psychologists licensed in a participating state to apply to practice telepsychology and/or temporary in-person psychology sessions across state lines in participating states.

Approved in 2015 by the Association of State and Provincial Psychology Boards (ASPPB), PSYPACT became operational in 2019 when at least seven states enacted legislation and entered into the compact. 

PSYPACT legislation is now enacted in 36 U.S. jurisdictions.

As of July 1, 2020, PSYPACT applications are now open to eligible psychologists. Here is information on how to apply.

At present, no interstate compact exists yet for marriage and family therapists. 

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