The sector that is responsible for the care and treatment of individuals with behavioral health conditions is vital. It is directly involved with the patients and their families. Yet, this sector faces an extraordinary problem that is not seen in other healthcare sectors: very high and persistent turnover rates. Staff members in the behavioral health sector often are satisfied with their jobs. Yet, several specialists and direct care staff leave their positions long before they reach retirement age (Hallett et al., 2023).
From the counselor to the president of a large organization, staff members in the behavioral health sector are a hardworking, dedicated group of individuals who are committed to improving the organizational lives of their patients and their families.
In response, numerous behavioral health organizations are considering alternatives to boost retention, a key goal in workforce development. Several of these, often discussed alternatives include raising pay, improving benefits, and expanding career development opportunities. But how much, if at all, do these influences affect individuals’ intentions to stay within the organization and, thus, reduce turnover? This article explores the evidence, pays some necessary attention to pipeline development, and offer some practical recommendations for managers to address retention challenges effectively.
The Retention Crisis in Behavioral Healthcare
People who work in the field of behavioral healthcare operate in emotionally demanding environments, often managing the kinds of complex cases that require more time and attention than even the most dedicated professional can give. We know from recent studies that behavioral healthcare organizations are struggling to retain staff. According to Miriam Delphin-Rittmon, assistant secretary for mental health and substance use at HHS and the administrator of Substance Abuse and Mental Health Services Administration (SAMHSA), by 2025, the U.S. will be short about 31,000 full-time equivalent mental health practitioners (Plescia, 2023).
There are lots of reasons employees might choose to leave, but pay, perks, and professional growth opportunities are consistently top of mind. Here’s how those three significant factors influence retention.
The Impact of Higher Wages on Retention
Pay is basic to job satisfaction. That is especially true for behavioral healthcare workers, who often make less than people in other healthcare sectors, even though the demands on them are just as high, if not higher, in terms of emotion and intellect. Up to now, studies have found only one antidote to this problem: competitive pay.
Previous research has shown that salary levels play a significant role in job turnover and retention among behavioral health care employees, including clinicians. Similarly, a study by Athman et al. (2025) found that clinicians’ perceptions of being fairly compensated are connected to their intentions to stay in their jobs. Evidence from other health care professions indicates that perceived pay fairness is a stronger predictor of expected turnover than the actual amount of compensation.
On the other hand, pay that is too low and the sense that one is not being valued can lead to financial stress and prompt workers to look for better-paying jobs. Although increasing wages is necessary, it is not sufficient. Compensation must be part of a larger strategy that tackles a variety of workplace requirements.
How Benefits Support the Whole Employee
Salary is not the sole reason why people work; their wellbeing is also at stake. And the wellbeing of workers is achieved, for the most part, through benefits that go far beyond the paycheck (Hallett et al., 2023). A comprehensive benefits package, including health insurance, retirement plans, training and skill development opportunities, and adequate mental health support, sends a powerful message: This organization cares about more than just your working hours. It cares about your life.
Behavioral healthcare workers face emotional exhaustion and need access to mental health resources and flexible scheduling. The best organizations tend to give their staff decent access to that kind of support. They offer effective Employee Assistance Programs (EAPs). They provide the type of well-carved-out, family-friendly policies that help staff balance work and home. They are the kind of organizations you want to work for.
According to a 2023 survey by the National Council for Mental Wellbeing, nearly half (48%) of behavioral health workers say the impacts of workforce shortages have caused them to consider other employment options. Thus, to ease the burden, they proposed an introduction of more telehealth options, student loan forgiveness, and apprenticeship programs. (National Council for Mental Wellbeing, 2023).
Career Development and Pathways to Growth and Fulfillment
Career development opportunities are strong retention factors. Behavioral healthcare professionals are typically motivated by a desire to make a difference and grow their expertise. When organizations offer structured training, mentorship, and advancement opportunities, employees feel valued and see a future with the organization.
Professional identity and professional belonging foster a perception of the job that is not just a temporary stop on the way to something else. This perception is influenced in part by the fact that some companies have clear career ladders. Some companies also offer a variety of development programs for their employees. If your company has both of those things, it is a relative haven in which to work.
Pipeline Development and Securing the Future Workforce
To ensure a constant inflow of qualified professionals, it is not enough to work on retention. It is equally important to put in place strong pipeline development strategies. Pipeline development means attracting, training, and supporting new behavioral healthcare workforce members. Effective pipeline strategies include partnerships with educational institutions, internships, scholarships, and community outreach programs. These initiatives can directly support the recruitment of underrepresented populations and communities that typically lack access to behavioral health careers. Also, it’s great that these communities aren’t just being recruited; they’re also being retained. And finally, these communities are adding to the diversity and cultural competence of the behavioral health workforce (Hubbard et al., 2022).
Organizations can work with universities to set up practicum placements that afford authentic experience and mentorship. They may also offer tuition assistance or program particulars (e.g., loan forgiveness) to reduce the financial barriers that prevent students from pursuing degrees in behavioral health. A resilient pipeline not only renews staff but also reduces burnout among current employees by eliminating understaffing.
Integrating Retention and Pipeline Strategies
Retention and pipeline development are inextricably linked. High turnover can dishearten new entrants, while a strong pipeline can bolster a staffing shortage and reduce overworked, burned-out staff. Organizations that align retention with pipeline development create a sustainable ecosystem with a steady state of new entrants and a state of grace for the career-long staff (Galbreath, 2025).
How Managers Should Address Retention Issues
- Perform Routine Assessments of Employee Compensation: Benchmark salaries with regional and sector standards to ensure you’re in the competitive ballpark. Account for cost-of-living differences and make good use of clear, trust-building communication around the rationale for your pay structure.
- Improve Benefits to Align with Employee Feedback: Identify the benefits that employees value most by using surveys and focus groups. Ensure that your benefit offerings include not only mental health support but also flexible work arrangements, childcare assistance, and wellness programs that are relevant to behavioral health professionals. These are the kinds of benefits most shown to be directly correlated with workplace satisfaction and, thus, retention (National Council for Mental Wellbeing, 2023).
- Build Well-Defined Progression Paths: Create clear progression paths within your organization, with explicit nuclei of defined competencies, training prerequisites, and criteria for promotions.
- Invest in Your People: Put money and resources into developing your employees. Use well-thought-out programs with good content and good delivery. Consider investing in the very leadership programs that are often found to be lacking in many organizations if you want to retain internal candidates.
- Create a More Diverse Talent Pool: Stop trying to hire just people who already have had the experience of working in your kind of organization. Use strategies and tactics that have been shown to work for building more diverse talent pools (Galbreath, 2025).
- Create a Supportive Work Environment: Administer routine oversight, support staff in the formation of peer support groups, and create opportunities for debriefing sessions to reduce the likelihood of experiencing burnout. Recognize and celebrate their contributions to the workplace to bolster morale and promote a culture of belonging.
- Invest in Pipeline Partnerships: Work with academic institutions, community organizations, and professional associations to establish internship, scholarship, and recruitment initiatives aimed at attracting diverse candidates (Galbreath, 2025).
- Use Technology for Training and Support: E-learning platforms and virtual mentoring provide accessible and ongoing professional development for all our teachers.
- Exit and Stay Interviews: Implement exit surveys along with the others. According to (Fukui et al., 2025), exit surveys can effectively reveal why employees leave, helping organizations design targeted interventions.
- Advance a Work-Life Balance: Support good employee health by managing reasonable caseloads, flexible scheduling, and time-off policies that respect the personal lives of employees (National Council for Mental Wellbeing, 2023).
Conclusion
The societal wellbeing of the United States is directly linked to the work of the behavioral healthcare workforce, which has an astonishing 40% turnover rate, according to National Council for Mental Wellbeing. Retention and turnover have two primary drivers: satisfaction and commitment. To increase both, we must improve the pay, the benefits, and the career development that we offer our staff. These activities are a list of very good things that cover the basis for what we need to do to retain and keep people. However, failing to do these things will lead to a violation of the commitment part and increase the turnover part. So far, most readers are thinking to themselves, “Yeah, that’s all well and good! But what about my facility’s budget?” These challenge our organizational culture in a way that makes us vulnerable to turnover.
For leadership, ensuring a bright future requires investments in pay and perks, developing in-house talent, acknowledging efforts large and small, and forging collaborations that nurture the next generation of behavioral health practitioners. Such steps seem elementary. Yet the not-so-obvious truth is that they aren’t being carried out with even a minimal sense of urgency in most cases.
Isaac Mawuko Adusu, DHA, MSNPM is a Policy Advocate and Assistant Vice President of Adult Services at Seven Hills Foundation, Rhode Island. For more information, contact Isaac at IAdusu@sevenhills.org, ikemawuk@gmail.com, or (774) 823-7151.
References
Athman, D. E., de Saxe Zerden, L., Konrad, T. R., et al. (2025). Job assessments and the anticipated retention of behavioral health clinicians working in U.S. Health Professional Shortage Areas. BMC Health Services Research, 25, 592. https://doi.org/10.1186/s12913-025-12698-6
Galbreath, L. (2025). Key strategies for strengthening the behavioral health workforce. National Academy for State Health Policy. https://nashp.org/key-strategies-for-strengthening-the-behavioral-health-workforce/ (nashp.org)
Hallett, E., Simeon, E., Amba, V., Howington, D., McConnell, K. J., & Zhu, J. M. (2024). Factors influencing turnover and attrition in the public behavioral health system workforce: Qualitative study. Psychiatric Services (Washington, D.C.), 75(1), 55–63. https://doi.org/10.1176/appi.ps.20220516
Hubbard, A., Sudler, A., Alves-Bradford, J. E., Trinh, N. H., Emmerich, A. D., & Mangurian, C. (2022). Building a diverse psychiatric workforce for the future and helping them thrive: Recommendations for psychiatry training directors. The Psychiatric Clinics of North America, 45(2), 283–295. https://doi.org/10.1016/j.psc.2022.03.007
National Council for Mental Wellbeing. (2023). New study: Behavioral health workforce shortage will negatively impact society. https://www.thenationalcouncil.org/news/help-wanted/
Plescia, M. (2023). How SAMHSA is tackling the mental health workforce shortage. Med City News. https://medcitynews.com/2023/03/how-samhsa-is-tackling-the-mental-health-workforce-shortage/
