In the face of rising demand for behavioral health care and persistent workforce shortages, NYC Health + Hospitals has made workforce development a central lever for system transformation. Through a suite of programs focused on recruitment, retention, training, and expanded career pathways, we are reshaping how care is delivered and how public service careers are perceived. Since launching our three-year workforce development strategic plan in 2024, we have made significant progress in strengthening and stabilizing our behavioral health workforce. This comprehensive approach addresses immediate staffing needs while building long-term sustainability—expanding capacity, improving access to care, and laying the groundwork for a resilient, well-supported workforce prepared for future challenges.
Elevating Our Public Role Through Comprehensive Recruitment
Recruitment initiatives have expanded our reach and brought in new talent across disciplines, while enhanced training programs ensure that new staff are equipped with the skills and confidence to deliver high-quality care in a rapidly evolving environment. Externally, NYC Health + Hospitals are gaining recognition as an employer of choice in public behavioral health, a notable shift from pre-pandemic trends. Applications are increasing, hiring timelines are shortening, and the system is drawing attention for its commitment to staff development and wellbeing. In the last 12 months, NYC Health + Hospitals has hired nearly 600 behavioral health staff, filling longstanding vacancies and supporting strategic growth, marking our most effective recruitment season to date and building on a strong performance in the past 2 years. These developments further strengthen our reputation as a public institution capable of innovation and impact.
- A Mission-Driven, Multichannel Recruitment Strategy: A key lesson from prior years is that recruitment cannot be passive, it must be intentional, targeted, and visible wherever potential candidates are. Reflecting this, our recent campaigns have leveraged every available channel, from digital outreach to out-of-home advertising to cable media, ensuring broad and consistent visibility. This deliberate approach is producing results. Thanks to the social work campaign and more focused systemwide recruitment efforts, we have been able to hire more than 400 social workers since January of 2024. In fall 2025, we applied these same principles to the refreshed PSYCHDOCS4NYC1 campaign to recruit psychiatrists and psychiatric mental health nurse practitioners. We sharpened our message to center the core mission of NYC Health + Hospitals, articulating who we are and why our work matters in a way that truly resonated with applicants. A new campaign video featuring behavioral health leadership added authenticity and purpose, helping bring the message to life. Early indicators are strong: interest has increased significantly, with many candidates explicitly citing the mission-driven focus as their reason for applying. This momentum reinforces our growing reputation as an employer of choice in behavioral health, with several facilities now reporting no psychiatrist vacancies.
- Creative sourcing to build an inclusive workforce: Alongside traditional recruitment strategies, we are also expanding the pool of who belongs in the behavioral health workforce. Programs like The Peer Academy and the Psychiatric Social Health Technician (PSHT) Care Corps are creating entry points for individuals with lived experience, offering free training and paid internships that expand both the workforce and the connection to the communities we serve. These programs are already achieving tangible results: on average nearly 70% of our (50) annual Peer Academy graduates are hired into permanent roles in our system, and 50% of the (30) PSHT Care Corps graduates to date have secured employment within just two months of program completion, with more hires underway.
- Building a Behavioral Health Physician Assistant (PA) Pipeline: To address a long-standing challenge in behavioral health hiring—namely, that physician assistants graduate with strong general training but little to no experience in psychiatry—NYC Health + Hospitals developed the Psychiatric Physician Assistant Fellowship in partnership with the NYS Office of Mental Behavioral health leaders have historically been hesitant to hire new PAs because they lack the specialized skills needed to step into these roles. This fellowship was intentionally designed to bridge that gap: it provides early-career PAs with the hands-on experience, clinical competencies, and supervised practice necessary to be successful in behavioral health settings. By creating a structured pathway into the field, the program not only expands the pool of PAs who are ready to work in our system today but also builds a future bench of experienced PAs who can go on to precept, mentor, and shape the next generation of psychiatric PA clinicians.
- Pairing Service Commitments & Financial Incentives to foster sustainability: Consistent with a 2020 AAMC survey indicating that loan repayment significantly affects employment decisions,2 an essential cornerstone of our strategy has been the use of financial incentives to stabilize and grow the behavioral health workforce. At the heart of these efforts is the BH4NYC Loan Repayment Program, which has awarded over $5M in student loan repayment to 200 clinicians in exchange for a three-year service commitment, boosting recruitment and retention of staff who collectively provide 110K+ inpatient and outpatient patient visits annually.
Retention and Wellbeing as a Driver of Stability
Retention efforts—ranging from fellowship opportunities to violence-prevention initiatives—are fostering a stronger culture of engagement, stability, and commitment across our system. These non-financial supports play a vital role in sustaining our workforce by strengthening job satisfaction, reinforcing supervisory infrastructure, and ensuring continuity of care. Together, they form the backbone of a supportive environment that encourages staff to thrive within NYC Health + Hospitals and provide a foundation on which to expand career pathways, deepen clinical expertise, and promote safety and trust across behavioral health settings:
- Career Ladders: The system launched the first cohort of our Social Work Clinical Licensure Program, offering up to 82 Licensed Master Social Workers free test prep and exam fee coverage in exchange for a two-year service At the same time, the Behavioral Health Nursing Career Ladder has created new pathways for up to 24 entry-level nursing support staff to become registered nurses, including tuition support, academic preparation, and a three-year post-graduation service commitment; since program launch 6 months ago, 50% have already completed prerequisites and applied to nursing school.
- Strengthening Psychiatric Mental Health Nurse Practitioner Training: Launching in January 2026, we will introduce a new program to strengthen the behavioral health practice of PMHNPs hired within the past three years. For the past several years, NYC Health + Hospitals has partnered with Community Healthcare Network (CHN) to place and develop PMHNPs within their advanced training Building on that experience, we are now establishing our own internal program. While the rapid expansion of PMHNP programs has helped increase system capacity nationwide, there remains opportunities to deepen clinical training and standardize practice expectations for new graduates.3 To support this workforce, a new program uses an 18-week cohort model integrating lectures, interactive workshops, and real-time coaching. By equipping our newest PMHNPs with enhanced skills and structured guidance, we are strengthening their practice and advancing a broader culture shift that affirms and elevates the role of PMHNPs across NYC Health + Hospitals.
- Workplace Safety & Violence Prevention: Violence-prevention initiatives continue to support both staff safety and overall morale by enhancing psychological safety, strengthening team cohesion, and increasing the visibility of organizational 4 Through our Violence Prevention Academy, approximately 1,500 staff have received advanced-level training—including specialized crisis communication, de-escalation skills, and train-the-trainer preparation that enables them to return to their units and support broader learning. Preliminary pre-post data show statistically significant increases in confidence related to de-escalation skills.
These workforce investments have sparked a renewed sense of pride and motivation among behavioral health staff. Clinicians report feeling seen, valued, and better supported.
Changing the Narrative: From Shortage to Strength
The gains that NYC Health + Hospitals has made in behavioral health workforce development offer a model for strengthening public service careers more broadly, and our progress is measurable:
- The behavioral health turnover rate has dropped significantly, now at 47% compared to nearly 18% in 2022, reflecting improved job satisfaction and organizational stability
- Vacancies across disciplines have declined sharply, most notably in social work, where the vacancy rate has fallen to 4.3%, from 12% in 2024, ensuring continuity of care and reducing gaps
- Our 2024 social worker recruitment campaign, Social Workers Needed Here, has won a Silver Award for Purpose-Led Campaign of the Year from Modern Healthcare and Ad Age
NYC Health + Hospitals is demonstrating what is possible within civil service systems by centering investment in people, aligning workforce strategy with operational needs, and advancing inclusive hiring and retention practice. Workforce development is no longer a background function: it is a central driver of health system performance, equity, and reputation.
Sophie Pauze, MPA, is Senior Director of Strategic and Impact, and Omar Fattal, MD, MPH, is System Chief of Behavioral Health Services at NYC Health + Hospitals. For more information, contact Sophie Pauze at pauzes@nychhc.org or (347) 675-8928, or visit the NYC Health + Hospitals website at www.nychealthandhospitals.org.
Footnotes
- PSYCH DOCS4NYC – NYC Health + Hospitals Campaign Website and Video
- Youngclaus, J., & Fresne, J. A. (2020). Physician education debt and the cost to attend medical school: 2020 update. Association of American Medical Colleges. https://store.aamc.org/downloadable/download/sample/sample_id/368
- Thomas, J. (2022, September 15). The miseducation of America’s nurse practitioners. Journal of Medicine. National Association for Medical Doctors. www.namd.org/journal-of-medicine/3268-the-miseducation-of-america%E2%80%99s-nurse-practitioners.html
- The Joint Commission. (2022). Workforce safety and well-being: Workplace violence prevention. The Joint Commission. https://www.jointcommission.org/en-us/knowledge-library/workforce-safety-and-well-being-resource-center/workplace-violence-prevention
