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Staff Retention in Behavioral Health: Your Questions Answered

From counseling individuals with mental health disorders to helping vulnerable children and families access critical resources, your organization and the behavioral health professionals you employ perform a wide range of important work. But while there’s no question that these professionals are an irreplaceable part of every community, far too many go without their services  due to the mental health workforce shortage.

As demand for behavioral health providers increases across the U.S., shortages of behavioral health providers have left many individuals without access to the resources they need to lead safe, healthy lives. To help behavioral health administrators recruit and retain employees and meet the needs of the communities they serve, comprehensive strategies are needed.

The workforce shortage in behavioral and mental health

The behavioral and mental health workforce in the U.S. is facing an escalating crisis as demand increases and supply decreases. These problems are particularly evident in rural counties — more than half do not have a single psychiatrist available.

Recent research has shown that in locations designated as Health Care Professional Shortage Areas (HPSAs), only 28% of mental healthcare needs are being met. It would take 6,559 providers to meet this demand.

Predictions made before the COVID-19 pandemic emphasized a shortfall of tens of thousands of behavioral health professionals. This new evidence suggests that the pandemic will continue to have long-term effects on staffing, leaving emotional and psychological trauma in its wake.

The Substance Abuse and Mental Health Services Administration (SAMHSA) predicts that, by 2025, the U.S. will have shortages of:

  • 78,050 school counselors
  • 57,490 psychologists
  • 48,540 social workers
  • 26,930 mental health counselors
  • 15,400 psychiatrists
  • 10,470 marriage and family therapists

According to the National Council for Mental Wellbeing, demand for behavioral health services will increase by the following percentages by 2030:

  • Addiction counselors: 21-30%
  • Mental health counselors: 18-20%
  • Psychiatric nurse practitioners and psychiatric physician assistants: 17%
  • Social workers: 15%
  • Psychiatric technicians and psychiatric aides: 13-16%
  • Marriage and family therapists: 14%
  • Psychologists: 7%
  • Psychiatrists: 6%

At a time when nearly one in five Americans lives with a mental health condition, and more people than ever are interested in seeking behavioral health support, this lack of access to qualified behavioral health professionals stands to jeopardize the well-being of individuals and communities across the country.

Why is there a behavioral and mental health workforce shortage?

A variety of factors have contributed to the behavioral and mental healthcare workforce shortage, making mental health provider recruitment and retention particularly challenging.

One reason for the shortage is increasing awareness and understanding of behavioral healthcare services. According to a report published by the Centers for Disease Control and Prevention, the percent of Americans who attributed major depression to neurobiological causes increased by 13% between 1996 and 2006. Similarly, a larger percentage of people endorsed the benefits of treatment for people with major depression in 2006 (91%) than in 1996 (78%).

Other causes of the shortage are less positive. Behavioral health professionals are aging out of the profession faster than they can be replaced, leading to a retirement drain on the industry. In 2019, more than 61% of practicing psychiatrists were over the age of 55 — a percentage higher than many other healthcare specialties.

Behavioral health providers are also frequently paid less than other professionals in health care and beyond. This disparity is part of a larger problem. It often begins on the client side, as those in need of behavioral care are often unable to receive coverage or unable to obtain reimbursements from their insurance providers, and thus don’t seek out behavioral healthcare – meaning less money is coming into behavioral health organizations.

On the provider side, this causes organizations to face financial barriers (many of which, like poor funding, are outside of their control) that prevent them from offering competitive salaries or benefit packages that could entice and retain employees.

The lack of recognition and low pay are sacrifices that individuals must be willing to make before entering the behavioral health workforce. These sacrifices are significant and often deter new employees from entering the field.

Why is it important to retain behavioral health providers?

Despite the efforts of many educational institutions, there simply aren’t enough individuals entering the behavioral healthcare field to meet demand. When behavioral health administrators attain high-quality staff, they must strive to hold on to them as best as possible or risk finding themselves struggling to hire new, qualified staff from a very limited candidate pool.

Retaining staff and reducing turnover can also help healthcare organizations save money. Turnover can cost organizations anywhere from one-half to two times an employee’s salary to replace. It also impacts the quality of care they provide, as new hires take time to adjust to the organization’s specific practices and the nuances of the community they serve.

How to retain behavioral health providers

Retaining behavioral health providers is easier said than done — especially when many facilities lack the resources to offer significant monetary incentives. Fortunately, there are several steps organizations can take to increase the chances that their providers will remain invested in their organization.

Provide opportunities for advancement and growth

Behavioral healthcare professionals have a strong desire to learn and grow their careers. Relias surveys show that most respondents are more likely to stay with their current organization if given better training and career growth opportunities.

Provide staff members with training that will allow them to excel in their current position while also growing their career for the future.

To learn more, read our post, “Why Employee Wellness Should Include Training”.

Prioritize employee wellness

Since the COVID-19 pandemic, employees across all industries have reevaluated what happiness at work means. And perhaps no field has seen as much burnout as health care and behavioral healthcare. As an employee’s sense of wellness decreases, they are more likely to leave the organization, feeling that their mental health is not worth loyalty to an organization.

To mitigate burnout and other work-related mental health conditions in your organization, you must prioritize employee wellness programs. These can take a variety of forms, from extra days off to company-provided counseling sessions. To ensure whatever type of program(s) your organization decides to use is working, routinely survey staff on their wellness levels and the efficacy of the programs at their disposal.

Encourage communication and feedback

As the saying goes, people don’t leave bad organizations, they leave bad managers. The ability to provide feedback on and communicate with one’s supervisor is a crucial part of the employee experience. Staff that are not comfortable communicating with their supervisor and/or do not have a safe avenue by which to give feedback on their supervisor are more likely to leave their current organization.

To increase staff retention, consider providing the supervisors in your organization with training on communication and leadership strategies.

Build a sense of purpose

Behavioral healthcare professionals are mission driven and care about the outcomes of their organization. To keep this passion alive, make sure your staff understands the difference their work makes. One great way of achieving this goal is to set up one-on-one meetings with supervisors to discuss positive client outcomes.

By routinely taking the time to discuss the positive impact a staff member has had on the lives of others, your organization can help them retain the sense of purpose that drove them into the field in the first place.

To learn more, read our post, “Creating a Learning Culture in Human Services: An Expert’s Advice.”

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