The workforce shortage has been felt keenly in the behavioral health field (BHECON, 2018). To effectively address this shortage, we must identify its root causes, understand dynamics that result in staff resignation decisions and connect the perceived impact on business sustainability while continually improving our culture and practices to recruit and retain staff.
The COVID-19 pandemic, along with its variants, was and still is a crisis (Abdool Karim, de Oliveira & Loots, 2021). When the COVID-19 pandemic first penetrated the United States in March 2020, health, employment, education, childcare, elder care, and basically every function of human life was disrupted (Godinic, Obrenovic & Khudaykulov, 2020). Employers had to pivot to establish remote access and distribute equipment to staff so they could continue to work, but remained optimistic that this crisis would be over in a matter of few short weeks (Kniffin, Narayanan, et Al 2021; Fragala, Goldberg & Goldberg, 2021; Zompa & Bompiedi, 2021). The weeks became months, and the strain on employers and staff grew. As if the nation thought it could not get worse, racial injustice, and the murder of George Floyd in Minneapolis on May 25, 2020, took its toll on employers and staff (Thelwall & Thelwall, 2021). Racial injustice, coupled with COVID-19, challenged the mental health and human needs of our nation almost minute by minute (Weine, Kohrt, et Al, 2020; Thelwall & Thelwall, 2021).
Employers struggled with the effects of business operations (Fragala, Goldberg & Goldberg, 2021; Thelwall & Thelwall, 2021). There was a shared strain on employers and employees; each attempting to assure the other that we were going to get through this but silently concerned about uncertainties (Zompa & Bompiedi, 2021).
Employers, especially in local healthcare and social services settings, had to adapt to new or different ways of conducting business. The new normal of Zoom and Teams became the way to connect not only about business matters but as a daily check in on staff – to feel the pulse of staff and ensure they were okay during this crisis (Zompa & Bompiedi, 2021). As working in the office every day became a thing of the past, so did traditional work settings and schedules (Sander, 2014; Beno, 2021). But what does this mean now for employers and workforce going forward? Workforce behavior is changed (Beno, 2021; Eifling, 2021).
The workforce crises have a particular impact on service organizations, including behavioral health service providers such as the Mental Health Association of Westchester (MHA). Staff retention is an ongoing challenge that pre-dates the pandemic, given the emotional demands of our work, salaries that are historically less than in the private sector, and more than often, the “need to do more with less.”
MHA manages these challenges in multiple ways. We had applied for permanent waivers at all of our clinic sites prior to the pandemic and due to pandemic restrictions, then applied for additional waivers for many other services to continue providing care. With these emergency waivers, we addressed our own staff shortages by recruiting geographically more widely to fill program needs.
During the pandemic, staff shared that the multiple challenges they faced left them feeling overwhelmed, anxious about personal commitments, unsure if they could remain working in their current position without accommodations and, for some, contemplating retirement. Like many organizations, we experienced multiple resignations that forced us to assess critical needs of our programs, re-deploy staff, and innovate ways to attract and sustain new staff, especially during this time of increased demand for services.
Supporting worker wellness has been a long-time priority at MHA. For example, staff may work a flexible schedule that meets program and client needs, while enabling the staff to maintain a sustainable work-life balance. MHA offers tuition reimbursement, robust staff training opportunities, a designated space in the offices as a “wellness room” that staff can use for a quiet place as needed, and a flexible summer schedule, which emphasizes staff emotional and physical wellness.
Also prior to the pandemic, MHA created an enhanced staff support team to provide targeted support in response to difficult staff experiences at work. The team is trained in a peer model that provides short-term assistance to a colleague. Staff grieve the deaths of their clients and during COVID, these losses multiplied. MHA engaged the Bereavement Center to provide support to those staff members. Several of our programs organized program-wide memorial services following the death of a client, moments that were essential in helping staff honor the individual and address their own grief.
Other components of our worker wellness initiatives are MHA’s softball team, and, at the time of writing, we are completing a good-natured competitive fitness challenge, where staff can safely participate and engage in physical activities, track progress and more.
Last year, we set up a series of “drop-in” virtual meetings for staff, creating space for discussion about isolation, pandemic-related challenges, and racial injustice. Staff also participated in weekly family/pet remote calls to stay connected.
Our Executive leadership team has invested a significant amount of time analyzing staff needs, identifying ways to retain staff based on feedback and industry research. This practice has become embedded into our agency culture as it is critical in addressing current challenges, but also investing in the workforce of the future. We have been able to provide sign-on bonuses for hard-to-fill positions and provide hero pay for some positions.
MHA is an organization that is thoughtful and intentional about the needs of the staff. We routinely survey staff satisfaction and utilize the responses to inform practices and policies. During the pandemic, we enhanced our survey to add items that pertained to COVID. Of equal importance is communicating how administration plans on addressing the needs and the changes that have been made based on recommendations and feedback. The questions on the survey were intended to cover a diverse array of areas including, but not limited to: staff enjoyment of agency culture, tools needed to be successful, meaningful ways to stay connected, communications and identifying areas that are important in career advancement.
During the height of the pandemic, we hired new staff who had not seen the physical locations of the site they would be affiliated with or the main administrative offices. Our new hire orientation was fully remote. The personal nature of orientation was greatly impacted. But as always, we adapted and adjusted. It was important for administration to assess the quality of this new process. Our human resources department devised the new 31-day new staff survey. It was given to all new staff hired during the pandemic and asked questions related to the quality of new hire orientation, including: Were your questions answered? Do you have sufficient information to do your job? Did you receive enough information on COVID guidelines? Are you receiving individuals /group supervision? What is your overall impression of MHA and your job? Currently, we are practicing a hybrid model of care. Once staff came back to physical sites, all new staff were given a “re-introduction” to agency practices and physical tours. Something as little as knowing where the supply closet is or where do I go to pick up my laptop was not insignificant in nature.
Ongoing informative communication with staff about the agency’s mission, values, direction, and challenges is essential, but became more critical during COVID. We continually strive to improve communication to staff. There are several mechanisms through which we aim to do this: quarterly town halls with the CEO at which she addresses current issues, agency updates and invites questions; Weekly Wrap Up Newsletter, a digital newsletter that highlights essential news, upcoming internal trainings, and other agency recaps; quarterly staff newsletter that offers a deeper dive into agency news celebrating staff honors and achievements and spotlighting agency programs including all back office departments; and creation of an agency pandemic response team, which included administrative staff from human resources, innovation and facilities department. Communication from this team included frequent updates about rapidly changing regulations related to COVID or agency changes needed. Staff could access this team to answer any questions related to physical space, PPE, technology, health screening practices, etc.
MHA is not alone in our determination to provide the best possible services despite the challenges of staff recruitment and retention. We continue to learn from our own successes and challenges, from the input of staff and colleagues, as we strive to be a “best place to work.”
Stacey Roberts, LCSW, is Chief Operating Officer and Dr. Dottie Ann Stevenson, Ed.D, sHRBP, is Chief of Human Resources at MHA Westchester.