Employee Retention in Behavioral Healthcare

Part Two in a Series 

Employee retention is a tremendous problem in the American behavioral healthcare system. In a 2018 survey of more than 600 treatment professionals, 60% claimed that their clinical departments are understaffed, and most pointed the finger at turnover as the main reason why. Not only is turnover expensive for organizations (1/2 to 2 times the employee’s annual salary), but in behavioral healthcare it can have real implications for patients.

While a 2016 study by Frontiers in Psychology noted that raw staff turnover does not affect quality of care, both staff density (number of staff members per patient) and staff consistency (length of time with no staff turnover) do have a strong impact on patient outcomes. Therapeutic relationships take time to build, and a patient who is starting to open up to a provider with whom trust has been established may stop talking when faced with an unfamiliar clinician.

Fortunately, there are things you can do to boost employee retention. In fact, an estimated 3 out of every 4 workers who leave their jobs could have been retained. Here’s what you need to know.

Symptoms of an Unhealthy Work Environment

If your facility is humming along with no real issues, odds are good that you are unlikely to see a sudden employee revolt. Most of the time, there will be signs of dissent long before you start losing significant numbers of team members. These include, but are not limited to:

  • Excessive sick days or tardiness
  • Low overall energy
  • Little enthusiasm
  • Cliques
  • Rumors and gossip
  • Arguments between staff members
  • Snarky or snappish responses
  • Patient complaints about staff attitudes


Everyone has a bad day now and then. But if the above are starting to become the norm with multiple members of your team, take it as a warning sign that you need to intervene before things get worse.

Employee Retention Techniques

Even if your organization is currently running well, it’s best to take a proactive approach to employee retention. Preventing problems is always easier than solving them. Still, if your team is starting to disintegrate, it’s never too late to start turning things around. People, in general, want to know that they matter and that their employer cares about them. Little efforts will have a significant impact.  For instance, saying good morning by name to each individual; as opposed to a generic “good morning everyone”. Another simple example is knowing the names and inquiring about the person’s children sends the message that you sincerely care about them.

People don’t leave businesses, they leave bad bosses

A strong, supportive management team with excellent people skills is essential to retaining employees. Take a hard look at those who are in leadership roles in your organization, including yourself. Solicit feedback from team members by asking them to rate their direct supervisor’s management skills, and to contribute ideas on how management could be more effective. Be cautious when promoting strong employees to leadership roles—make sure they also have the soft skills needed to be effective managers. Consider investing in training programs to help both current and future leaders develop their people skills.

Employee development should be ongoing

Employee development starts on Day One. Create a formal onboarding program that not only addresses paperwork and other must-dos, but also focuses on helping new hires feel like part of the team. Simple things like ordering a nameplate for their desk, showing them where the restrooms are, and including them on the lunch order can go a long way toward making new hires feel valued.

Employee development should never stop. People tend to leave positions where they feel stuck. If you don’t already have them, write job descriptions for each position, along with a corporate structure model. Look at potential pathways for career development from each entry level position. Create a formal development program that includes mentoring opportunities, regular performance reports, and individualized learning plans. Consider paying for degree or certification programs that can help employees move up the ladder. Make cross training and job shadowing available and easy to access.

Authenticity matters

Employees want to know what to expect, and they need a healthy work culture. If you haven’t already done so, take the time to write a mission statement and vision statement. List your core company values. Share that information with everyone on the team, and then look for ways to live those values every day. Institute a policy of relentless respect and proactive trust building. Implement team building activities along with an open door policy.

Also consider the physical office environment. Solicit employee feedback on everything from functional design to ambience. Look into hiring a topnotch office cleaning service, especially if the space is constantly dirty. A bright, clean office space can go a long way toward boosting employee morale.

Engage and empower your team

Find ways to both tell and show employees that they are valued. A great way to do this is through employee-centered programs. These may include, but are not limited to:

  • Paid time off
  • Health insurance
  • Wellness programs
  • Birthday and holiday celebrations
  • Free meals and/or beverages during the workday
  • Onsite child care
  • Formal employee empowerment program

Employee turnover can be expensive for your organization and devastating for your patients. Fortunately, the majority of employees who leave could be retained with some relatively simple techniques. You may not be able to implement everything at once, but making small positive steps at regular intervals shows your team that you’re trying and can help boost your retention rates.

Want to learn more? Read Part One of this series, “How to Attract and Hire Top Notch Talent”

Mary Ellen Harris has a PhD in Leadership and a Master’s degree in Instructional Design / Organizational Design. She has 30 years of professional experience in Human Resources and Business Leadership and is regarded as an expert in talent acquisition, employee relations, talent development, talent retention, change management, and company culture enhancement.

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