PTTC Post Article - January 2024

A “BOLD” Approach to Diversifying the Prevention Workforce

Author: Cele Fichter-DeSando, MPM

As we begin 2024 with celebrations and awareness of Martin Luther King Day and Black History Month, this PTTC Post highlights the PTTC Network’s BOLD Prevention Fellowship Program and its contributions to increasing the number of prevention professionals working within Black/African American Communities.

The PTTC Network’s BOLD Fellowship Program

The Building Our Leadership and Diversity (BOLD) Prevention Fellowship Program was funded by SAMHSA and operated by the PTTC Network and the PTTC Regional Sites. The BOLD Fellowship program focused on increasing the number of prevention professionals working within Black/African American communities and building their capacity to identify and chronicle programs, practices, and policies proven effective in reducing substance misuse risk factors and consequences and promoting mental health and protective factors or assets in Black/African American communities. The BOLD fellows receive mentorship from prevention staff in a state, territory, jurisdiction, national organization, and/or federally recognized tribe or other American Indian/Alaska Native (AI/AN/) community associated with their placement and were exposed to the day-to-day workings of the site.

Overview: The Need for Access to Care

43% of U.S. adults who say they needed substance use or mental health care in the past 12 months did not receive that care, and numerous barriers to access stand between them and needed treatment, according to a 2022 national survey of more than 2,000 U.S. adults conducted online by The Harris Poll on behalf of the National Council for Mental Wellbeing (National Council, 2022.) The 2022 Access to Care Survey lists cost, availability, wait times, a lack of diversity, and proximity to care as factors that represent significant obstacles for all those seeking care for substance use and mental health challenges and can make a difference in those who were able to access care and those who were not (National Council, 2022). 

The Need for Workforce Development and Diversity

The 2022 Access to Care Survey and the 2021 Behavioral Health Workforce Report highlight the need to address the diversity of care, the training and education needs of practitioners, and to gather data on the current numbers and trends within practitioner fields. (National Council, 2022; SAMHSA, 2021.) The Access to Care Survey Respondents cite a lack of providers available to address cultural needs (National Council, 2022):

  • 13% who didn’t get needed mental health care cite that it was because they couldn’t find a provider who was a good cultural fit, and 17% who didn’t get needed substance use care say the same.
  • 17% who received mental health care in the past 12 months say they struggled to get care because they were unable to find a provider who was a good cultural fit, and 24% who received substance use care say the same.
  • 61% of U.S. adults overall feel there are not enough mental health care providers who are trained to address issues specific to race, ethnicity, sexual orientation, or socioeconomic status.

SAMHSA’s African American Behavioral Health Center of Excellence in its brief on Diversifying the Behavioral Health Workforce: The Need to Promote Equity in Recruitment and Retention Strategies notes “For the success and survival of the field, behavioral health organizations must make:

  • a concerted effort to research, plan, implement, evaluate, and report innovative suggestions for the recruitment of diverse candidates into the behavioral health workforce; and 
  • necessary changes to ensure that employees from diverse racial, ethnic, and socioeconomic backgrounds are recruited and retained (Ware 2021).”

The BOLD Fellowship Experience

PTTC Prevention Fellows worked with each of the Prevention Centers in the different regions to increase diversity, build capacity, and promote assets and protective factors in Black/African American communities. A few of the fellowship projects are highlighted below. 

A higher education prevention program was implemented in two Missouri campuses by prevention fellow Shanelle Moore. Shanelle was a fellow with the Mid-America PTTC | Prevention Technology Transfer Center and her experience is outlined in a paper Experience of a Prevention Fellow in Higher Education. One of Shanelle’s takeaways from the experience is that “culture is a significant factor in how prevention programs can be implemented in a community and how they can be successful. Prevention professionals must be aware of cultural humility as they are developing and implementing prevention programming (Moore, 2023.)” 

Great Lakes PTTC fellow, Tyiesha Trina, worked with the Illinois Department of Human Services Division of Substance Use Prevention on the Chicago Strategic Action Plan. Rebecca Buller, MPA, CPP, Program Coordinator at Great Lakes PTTC, described her experience working with Great Lakes Fellow Tyiesha: “My heart was full when after hours of work, training, and dedication – our fellow found a position in public health in Illinois where she will be working on prevention in her community!  This is exactly what we hoped for and worked toward, and a testament to a focused effort to build diversity in our prevention workforce.”  

Southeast PTTC had two fellows, Candace Williams and Paife Salters. Candace Williams was matched with the Alabama NPN, Beverly Johnson, to oversee a Historically Black Colleges and Universities (HBCU)-focused substance misuse prevention needs assessment. Paige Salters was matched with the North Carolina NPN, Jessica Dickens, to manage the implementation of the State Opioid Response (SOR)-3 grant, which sought to increase opioid misuse prevention programming in historically underserved communities in North Carolina.

Future Directions

The success of the fellowship program and hopes for its future are summarized by Mark Wolfson, Region 4 Co-Director and Deborah Nixon Hughes, Region 3 Project Director respectively. Mark writes “our experience at the Southeast PTTC was that the fellowship program was a great win-win for the fellows and for the centers.  The fellows had a good immersion experience in the world of substance misuse prevention, coming away with solid experience, skills, and knowledge to continue their careers in prevention.  Our center benefited greatly from the fellows’ fresh insights and knowledge, which has informed our programming moving forward.  I believe that it will be very helpful for the field for years to come if collectively we can find a way to institutionalize the fellowship program.”  Deborah Nixon Hughes, Project Director at the Central East PTTC, shares “The master's and doctoral fellows new to prevention in our region provided a fresh and authentic perspective and new energy in an approach and identifying new partnerships to address the prevention needs in African American communities in response to the lack of evidence-based interventions for this community.  I hope we can repeat the BOLD fellowship program in the future.”


National Council on Wellbeing, 2022. More than 4 in 10 U.S. Adults Who Needed Substance Use and Mental Health Care Did Not Get Treatment. National Council News, National Council Organization, 2022.

National Council on Wellbeing, 2022. 2022 Access to Care Survey Results. National Council Organization, 2022. 

Substance Abuse and Mental Health Services Administration, 2021. Behavioral Health Workforce Report. 2021 Annapolis Coalition Organization. 

Moore, Shanelle, 2023. Experience of a Prevention Fellow in Higher Education, 2023. 

Ware, Corey, 2021. Diversifying the Behavioral Health Workforce: The Need to Promote Equity in Recruitment and Retention Strategies. African American Behavioral Health Organization, 2021 

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