There is already a severe shortage of providers in the mental health field. There simply are not enough licensed mental health clinicians to meet demand. The acuity of client needs is increasing while the number of youth and adults seeking services continues to simultaneously increase, thus making the shortage worse. In addition to a shortage of qualified providers, behavioral health positions have very high turnover rates in public and community settings. Burnout is extremely common among behavioral health workers. That leads to people exiting the field or scaling back their hours. 

CPST requires more highly trained/licensed clinicians. But getting people through the process is slow. Educational requirements, clinical supervision requirements, credentialing, and meeting state and local requirements takes time. This means that even when there are potential applicants for positions, it can delay when a clinician can actually see clients. These delays mean positions may sit empty or be underused. Rural, underserved, or remote communities also have greater challenges hiring and retaining clinical staff. Specialty areas (ex: crisis services) are especially hard to staff, but for CPST you need clinicians who can manage higher acuity cases. This increases likely challenges with appropriate staffing. When staffing is unstable, clients can have inconsistent service: clinicians leaving means gaps in care, shifting caseloads, disruption in therapeutic relationships, which undermines outcomes. CPST, given its more intensive, personalized nature, is especially sensitive to such disruptions. CPST handles crises and high-need clients. That requires clinicians with higher training, more oversight, and greater readiness to respond in less structured settings (due to the focus on community based support instead of clinic based). These are exactly the types of providers in shortest supply and highest burnout risk.

Because of these workforce realities—scarcity of qualified providers, high burnout and turnover, licensing/credentialing delays, and uneven geographic / specialty distribution—staffing a CPST program well (i.e. enough staff, with sufficient training and supervision, with manageable caseloads) is a substantial challenge