TY - JOUR
T1 - Factors Influencing Turnover and Attrition in the Public Behavioral Health System Workforce
T2 - Qualitative Study
AU - Hallett, Eliza
AU - Simeon, Erika
AU - Amba, Vineeth
AU - Howington, Devin
AU - McConnell, K. John
AU - Zhu, Jane M.
PY - 2024/1/1
Y1 - 2024/1/1
N2 - Many states are experiencing a behavioral health workforce crisis, particularly in the public behavioral health system. An understanding of the factors influencing the workforce shortage is critical for informing public policies to improve workforce retention and access to care. The aim of this study was to assess factors contributing to behavioral health workforce turnover and attrition in Oregon. Semistructured qualitative interviews were conducted with 24 behavioral health providers, administrators, and policy experts with knowledge of Oregon's public behavioral health system. Interviews were transcribed and iteratively coded to reach consensus on emerging themes. Five key themes emerged that negatively affected the interviewees' workplace experience and longevity: low wages, documentation burden, poor physical and administrative infrastructure, lack of career development opportunities, and a chronically traumatic work environment. Large caseloads and patients' high symptom acuity contributed to worker stress. At the organizational and system levels, chronic underfunding and poor administrative infrastructure made frontline providers feel undervalued and unfulfilled, pushing them to leave the public behavioral health setting or behavioral health altogether. Behavioral health providers are negatively affected by systemic underinvestment. Policies to improve workforce shortages should target the effects of inadequate financial and workplace support on the daily work environment.
AB - Many states are experiencing a behavioral health workforce crisis, particularly in the public behavioral health system. An understanding of the factors influencing the workforce shortage is critical for informing public policies to improve workforce retention and access to care. The aim of this study was to assess factors contributing to behavioral health workforce turnover and attrition in Oregon. Semistructured qualitative interviews were conducted with 24 behavioral health providers, administrators, and policy experts with knowledge of Oregon's public behavioral health system. Interviews were transcribed and iteratively coded to reach consensus on emerging themes. Five key themes emerged that negatively affected the interviewees' workplace experience and longevity: low wages, documentation burden, poor physical and administrative infrastructure, lack of career development opportunities, and a chronically traumatic work environment. Large caseloads and patients' high symptom acuity contributed to worker stress. At the organizational and system levels, chronic underfunding and poor administrative infrastructure made frontline providers feel undervalued and unfulfilled, pushing them to leave the public behavioral health setting or behavioral health altogether. Behavioral health providers are negatively affected by systemic underinvestment. Policies to improve workforce shortages should target the effects of inadequate financial and workplace support on the daily work environment.
KW - Access to Care
KW - Burnout
KW - Mental/Behavioral Health
KW - Public Policy Issues
KW - Research/Service Delivery
KW - Workforce
UR - http://www.scopus.com/inward/record.url?scp=85180142852&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85180142852&partnerID=8YFLogxK
U2 - 10.1176/appi.ps.20220516
DO - 10.1176/appi.ps.20220516
M3 - Article
C2 - 37386878
AN - SCOPUS:85180142852
SN - 1075-2730
VL - 75
SP - 55
EP - 63
JO - Hospital and Community Psychiatry
JF - Hospital and Community Psychiatry
IS - 1
ER -