The irony of many behavioral health workplaces is that even as the providers on staff help their clients thrive, they themselves are often shouldering more stress than they can handle. Turnover in many of these organizations isn’t just high; it’s basically a revolving door—and the pressures for remaining staff mount faster than a therapist can say, “Tell me more about that.”
The playbook some leaders seem to be using for this high-stakes game is clearly missing a page on team support. And yet, when their best clinicians leave for greener pastures, they feel shocked.
The real kicker? Becoming one of those greener pastures isn’t as difficult as you might think. It all starts with creating a culture of support.
Here some of the most common ways behavioral health organizations undermine their own retention rates:
1. Undervaluing Staff with Poor Wages
It’s a simple equation: better pay equals happier employees. But for many behavioral health professionals, their pay barely does justice to their meaningful work.
Let’s dive into the data for a reality check. According to the Bureau of Labor Statistics, the 2022 mean annual salaries looked like this:
- Marriage and Family Therapists: $63,300
- Mental Health and Substance Abuse Social Workers: $60,130
- Substance Abuse, Behavioral Disorder, and Mental Health Counselors: $56,230
- Counselors, All Other: $49,770
If you want to retain staff, these rates should be your baseline. When you value staff above and beyond the average, you do more than just attract better applicants on the front end—you also show your commitment to those who commit their lives to helping others. Plus, when your team isn’t consumed by financial worries, they can really bring their A-game to work every day—fully engaged and ready to make a difference.
Matthew Spencer, Chief Clinical Officer of Oklahoma-based GRAND Mental Health—a Newsweek Most Loved Workplace®—puts it bluntly: “We have to put our money where our mouth is and pay the individuals who are working so hard in this field…They deserve it.”
And for GRAND, it’s not just talk; they walk the walk with a minimum wage of at least $18 an hour for all staff levels, not just clinicians. (For comparison, the state-wide minimum wage in Oklahoma is $7.25.)
Doubt wage increases will boost retention? Here’s some food for thought:
- One in three mental health professionals leave their job each year.
- A Harvard University study found that a mere $1/hour wage increase led to an 18.7% decrease in turnover.
- Conversely, a $1/hour wage decrease resulted in a whopping 28% increase in turnover.
- Conservative estimates put the cost of turnover for one employee at roughly one-fifth of that employee’s salary. (So, if a clinician has an annual salary of $60,000, the cost of losing that employee—including the loss of their productivity, the drain on remaining team members’ productivity, and any expenses associated with recruiting and training their replacement—is about $12,000.)
Paying higher wages might seem expensive, but when you consider the cost of eventually losing staff to organizations that actually are providing ample compensation, it’s easier to justify the extra spend. But more than that, reduced turnover also leads to greater care continuity, which means better client outcomes.
Want a full breakdown of benefits and compensation offered by top behavioral health employers? Grab your copy of our free ebook: Rising Above the Workforce Shortage: Building a “Best Place to Work” in Behavioral Health.
2. Ignoring Burnout and Staff Well-being
There’s no faster way to dim the spark in your brightest stars than ignoring signs of burnout. If your once-vibrant staff seem constantly disengaged from the important work they’re doing, that’s certainly a sign that something’s amiss.
Here are a few essential elements to preventing burnout (notice they don’t include pizza parties or thank-you notes).
Ample Time Off
More than just having vacation days on paper, organizations must actively encourage and facilitate staff use of PTO. That means creating a culture where taking time for self-care isn’t seen as a sign of weakness, but an essential aspect of professional practice. In fact, extended time away from work might be a highly effective way to address burnout. Remember, a therapist who’s on the brink of burnout can’t offer their clients—or themselves—the care they deserve.
But even smaller, more consistent chunks of time off can give stressed-out providers the breathing room they need.
“With my current employer, we have four hours of self-care every week,” said New Mexico-based therapist Elena M. Petre, LCSW. “There are no limitations on how it’s used, when, or for what. We don’t have to be in the office for those hours. So our weeks are actually 36 hours for a full-time salary. It’s hugely appreciated.”
Comprehensive Benefits
Beyond the paycheck, what keeps a team grounded and feeling valued are benefits that support their life outside of work. Health insurance, mental health resources, retirement plans, and even help with childcare can play a massive role in alleviating everyday stress. These benefits say, “We’ve got your back,” allowing providers to focus on what they do best—helping others.
Innovative Technology
Administrative work is a major drain on provider time and day-to- day job satisfaction. The National Council for Mental Wellbeing reports that one-third of the workforce spends the majority of their time on administrative tasks—with 68% of providers saying administrative work detracts from time spent on client care.
Streamlining providers’ administrative work can have a huge impact on their efficiency and job satisfaction—not to mention empower them to focus more on delivering exceptional client care.
For example, Eleos Health’s specialized behavioral health AI platform reduces documentation time by more than 50%—while also empowering providers to better engage with their clients and serving up clinical insights to further improve care.
A Culture of Feedback
One of the most important tools for preventing burnout is listening—really listening—to what your employees have to say. Regular, structured feedback sessions where staff can voice their concerns, suggest improvements, and feel heard are invaluable. And don’t view it as just a vent session—if suggestions aren’t acted upon, you’ll make employees feel unsupported and patronized.
“My supervisor genuinely listens to understand and isn’t just placating our ideas or concerns,” said Florida-based therapist Nicole Pizza, LMFT. “The difference comes with action, and I really appreciate that. It makes me want to do more for whatever company I’m with.”
3. Avoiding Transparency and Open Communication
A “move fast and break things” business philosophy might work well in Silicon Valley, but in the behavioral health sector, the “things” you risk breaking are not intangible assets, but the spirits and trust of your most valuable resource: your employees. When business decisions that affect clinical practices are made behind closed doors and handed down without context, it doesn’t just create confusion; it breeds mistrust.
Active communication, on the other hand, helps build trust. One Gallup study found that employee engagement improved when managers had daily, direct communication with their direct reports.
The communication has to be sincere, though. If your attempts to communicate are performative or fake, your staff will be able to tell. Communication should be a two-way street. Leadership should be honest and open with employees, and employees should feel comfortable and supported in being honest and open, too. Make sure they know how to voice their ideas and concerns, and offer different avenues of communication for different preferences (not every staff member is going to stand up in an all-staff meeting and provide a brutally honest perspective).
And as mentioned above, make sure you act on the feedback you receive. Otherwise, you not only discourage staff from continuing to provide it, but you also send the message that what they have to say isn’t important enough to drive change. Even if you can’t put every idea into practice, at least acknowledge it—and when possible, communicate why it isn’t being prioritized right now and how you plan to address it in the future.
4. Overemphasizing Care Quantity
Caught in the productivity paradox, many behavioral health organizations mistakenly chase session counts over meaningful therapeutic encounters. This misstep not only creates a toxic workplace and leads to provider burnout; it also dilutes the quality of care, leaving both providers and clients hungry for more substantial support.
Here are some ways to reframe productivity for a healthier workplace.
Prioritize Client Outcomes Over Care Volume
Shift the focus from how many clients are seen to the impact therapy has on them. True productivity is about creating lasting change in clients’ lives—not just booking as many sessions as possible.
Include Clinician Well-being in Productivity Metrics
Recognize that the health of the organization is directly linked to the well-being of its providers. A truly productive team is not just busy; it’s balanced, supported, engaged, and satisfied.
Take a Balanced Approach to Caseload Management
Ensure therapists have caseloads that match their capacity and areas of expertise, allowing for deep, impactful work rather than surface-level encounters. This approach respects the complexity of mental health care and the clinician’s role within it—and it also allows therapists working with “harder” clients to have fewer cases overall.
Elisabeth Morray, PhD, Vice President of Clinical Operations at Alma, also encourages leaders to be flexible on caseloads based on fluctuating provider needs.
“If you go through a phase where you feel like, I’m not resourced enough to be treating a lot of trauma at this point, then you shouldn’t, right?” Morray said. “But maybe when you’re ready—and if you’re ready—you can pick it back up and build it to a point that feels sustainable.”
Set Team-Based Goals
Cultivate a culture where achievements are measured by collective outcomes, such as improved community mental health or reduced hospital admissions. This promotes a sense of unity and shared purpose, countering the isolating effects of an individual numbers-driven mindset.
Encourage Continuous Professional Development
Integrate growth and learning into the definition of productivity. Clinicians who are evolving their skills and knowledge are better equipped to provide high-quality care, enhancing the overall productivity of the organization.
In order to achieve true success in behavioral health, organizations need to reassess what it means to be productive. Creating a thriving workplace means moving away from a focus on quantity and instead emphasizing deep connections and transformative care.
5. Allowing Team Conflict to Fester
Just because a team is made up of behavioral health professionals doesn’t mean they’re immune to workplace disagreements (or don’t need deliberate team-building). Every workplace needs to create time and space for fostering team unity. And even the healthiest teams can have conflict, giving way to burnout-causing workplace tension without the proper channels for addressing that friction.
Here are a few ways to make sure your workplace culture isn’t undermined by team conflict.
Implement Proactive Conflict Resolution
Setting up clear, structured processes for handling disagreements acknowledges that conflict is a normal part of any workplace, even one filled with mental health professionals.
Engage in Intentional Team-Building
Create opportunities for team members to connect on a personal level, beyond the confines of their professional roles.
Champion Open Communication
Encourage feedback. Open forums, regular team meetings, and a culture that values transparency can help prevent misunderstandings and build a foundation of trust. (And to the point above on transparency and communication, remember that feedback that isn’t acted on quickly dries up—so address concerns and ideas proactively to make sure the team knows that they’re valued.)
Celebrate Collective Successes
Recognizing the achievements of the team as a whole, rather than just individual accomplishments, helps boost morale.
Offer Training in Interpersonal Skills
Even therapists can benefit from developing their communication and conflict-resolution skills. The right educational initiatives can improve how staff interact with each other and help them navigate the inevitable challenges of working closely together.
The journey from a high-turnover, pressure-cooker environment to a thriving haven of support and professional satisfaction is paved with intentional, strategic changes.
If you’re ready to start designing a better behavioral health workplace, check out our new ebook: Rising Above the Workforce Shortage: Building a “Best Place to Work” in Behavioral Health.
You’ll discover tried-and-true tactics for transforming your organization into an employer of choice—including specific guidance on how to avoid the pitfalls summarized above.
