The Impact of U.S. Federal Loan Repayment Programs on the Behavioral Health Workforce: A Scoping Review

Objective: Federal loan repayment programs are one strategy to address the U.S.’s shortage of behavioral health providers. This scoping review aims to identify and characterize the evidence of federal loan repayment programs’ impact on the behavioral health workforce in the U.S. Methods: A scoping review was conducted in accordance with the Joanna Briggs Institute’s methodology for scoping reviews. Databases searched were Ovid Medline, Web of Science, PsycInfo, EconLit, PAIS Index, and Embase; grey literature was also reviewed. Two coders screened each abstract and full-text and extracted study data. Findings were narratively synthesized and conceptually organized. Results: After full-text screening, the search yielded 17 articles that met eligibility criteria. Of these, 8 were peer-reviewed publications, and all but one article evaluated the National Health Service Corps (NHSC) loan repayment program. Findings were conceptually organized into six categories: 1) descriptive studies of NHSC behavioral health needs and the NHSC workforce (k=4); 2) providers’ perceptions of and experiences with the NHSC (k=2); 3) associations between NHSC funding and the number of NHSC behavioral health providers (k=4); 4) NHSC behavioral health workforce productivity and capacity (k=3); and 5) federal loan repayment program recruitment and retention (k=4). Conclusions: The scientific literature on federal loan repayment programs and their impact on the behavioral health workforce is relatively limited. Though federal loan repayment programs are an important and effective tool to address the workforce shortage, additional federal policy strategies are needed to attract and retain behavioral health providers and to diversify the behavioral health workforce.