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Workforce Survey 2018

February 20, 2018
by Julie Miller, Editor in Chief
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Solutions include higher pay for employees

In January, Behavioral Healthcare Executive surveyed its audience on industry-specific workforce issues. More than 600 treatment center professionals responded, and results indicate that clinical staffing remains the top workforce challenge not just to ensure quality of care but also to allow for future program growth.

The most surprising finding was that almost half of the audience with some knowledge of the business’s growth say that their organization at some point has abandoned service expansion plans because of concerns about finding the right clinical staff. It’s an issue that speaks to both the quantity and the quality of the available workforce in local areas.

When characterizing the various types of staff in comparison to current needs, respondents clearly sense there’s an inadequate supply of clinical employees. About 60% say their clinical departments are understaffed, and only 38.1% say such staffing is adequate.

“It doesn’t surprise me,” says Jeffrey Quamme, executive director of the Connecticut Certification Board. “Clinical staff is the hardest to recruit.”








By contrast, only 29.3% of respondents say their administrative departments are understaffed. When looking at only the treatment center organizations that include marketing departments—more than half—about a third of those respondents indicate that they could use more marketing staff.








Greatest need

It’s clear that treatment professionals with clinical education and experience represent the greatest human resource need. In fact, an overwhelming majority (81.5%) of respondents say as much. 

Angela J. Beck, PhD, MPH, professor and assistant dean for the University of Michigan School of Public Health and director of its Behavioral Health Workforce Research Center, says the BHE findings are consistent with national studies that estimate the workforce shortage. For example, in a November 2016 report, the Health Resources and Services Administration estimates that by 2025, the United States will experience a shortage of 250,000 workers in the field.

“We’re not expecting a huge influx of behavioral health workers,” Beck says. “But that doesn’t mean we should give up on pipeline programs.”

What the field does have going for it in terms of recruitment is the personal investment of its many workers who have experienced mental health and addiction treatment themselves and feel a calling to give back, improve the system and share their fellowship of recovery.

“This work is tremendously missional, and it’s work in which people have a lot of passion for helping others,” says Dawne Carlson, vice president of human resources for Hazelden Betty Ford Foundation. “And because it is such deeply felt work, it can sometimes feel heavy.”

Carlson says those who care for patients and clients can get burned out easily, and that’s why the turnover rates can be rather high in comparison to other health specialties. Self-care is imperative, she says.









More than 28% of the BHE survey respondents indicate that their clinical staff turnover rates are higher than industry average.

“I don’t have statistics on clinical staff turnover in behavioral health, but anecdotally, we know it’s pretty high,” says Beck. “This is a field in which burnout is high, compensation is comparatively low, and there’s still some stigma attached to working in mental health and addictions. That three-quarters of your respondents are reporting turnover at the industry average or more than industry average would be concerning.”

Solutions for the future

About half of survey respondents say their organization offers tuition reimbursement or similar education benefits. Such perks can help retain workers while also increasing clinical competencies. Additionally, nearly 17% believe that student loan forgiveness or academic scholarships would be the best solution to help attract more workers to the behavioral health field—second only to strategies that would increase workers’ pay.

In terms of solutions, Carlson says Hazelden Betty Ford offers a graduate school program that helps create a direct link from education to active clinical work at its facilities. Talent can be replenished close to home, and new openings can be filled by the graduating students who are already familiar with the organization.


The Treatment Center Executive & Marketing Retreat provides CEOs, CFOs, COOs, directors, senior marketing/business development/admissions leaders, and other executives with the tools they need to effectively and ethically grow their services in a rapidly changing market.

April 30-May 2, 2018 | Hilton Head, SC



I am an independently licensed clinical counselor. Throughout my career, I have been turned down for many jobs simply because Medicare does not reimburse service provided by counselors. They reimburse social workers, psychologists, and chemical dependency counselors but not clinical counselors. The requirements for becoming an independently licensed counselor are the same as becoming an independently licensed social worker - graduate degree and 2 years of clinical work under supervision. Why then does Medicare not recognize counselors as valid mental health workers? I am tired of hearing about shortages in the mental health field when counselors are shut out of so many jobs simply because Medicare fails to recognize us. Counselors, we need to lobby Washington and have that changed.

That is an ideal Technology for all of us.