It’s no secret staff turnover is expensive for behavioral health providers. And finding new clinicians is no easy task.

Many providers are using innovative solutions to combat these issues, including training and licensing initiatives, flexible work hours, and promoting from within.

The stakes are high for behavioral health providers to retain good employees. The cost of turnover is not only financial, as it additionally impacts the overall workplace culture.

“There’s a cost of holding the position for someone when they are onboarding and learning, and aren’t necessarily taking new clients yet,” Kate Appleman, senior director of clinical practice and professional development at Caron Treatment Centers, said during a Behavioral Health Business webinar. “Everyone else is taking that client load.”

Wernersville, Pennsylvania-based Caron Treatment Centers is a nonprofit provider that serves patients with substance use disorders. It operates in Pennsylvania, Florida, Washington, D.C., Georgia and New York.

“There are also intangibles when you look at what it does to morale and what it does to burnout to have to cover that potential caseload for a two-month period while you’re hiring and onboarding people,” Appleman continued.

Growing within a company

Employees are more likely to stay with an organization if there are opportunities for advancement. Appleman noted that Caron is large enough to allow its employees to move into new roles and even departments, which helps with retention.

“We have a lot of staff members that are able to reinvent themselves several times over in their career,” Appleman said. “We are small enough to have middle management feel like they are really caring for our people, but large enough to have the ability to change from clinical to finance, to administration to management.”

Many providers, such as ARC Health, offer their staff education and licensure credits, too.

“This year, we’re starting clinical advisory boards, and one of these committees will be the educational committee,” Dr. Boris Royak, chief clinical officer at ARC Health, said during the webinar. “We already have several practices that provide continuing education on a large scale. We’re looking to do even more of that to centralize it and to provide educational credits to our community of clinicians within ARC Health, but also provide it to others in the community.”

Founded in 2021, Ohio-based ARC Health was formed when private equity firm The Thurston Group acquired Advance Recovery Concepts and rebranded. ARC is focused on consolidating the outpatient mental health space and expanding access to care.

Engaging providers early on in their careers is another way to help develop staff members.

Several Caron employees also teach at colleges and universities, meaning they can engage students interested in pursuing a career in behavioral health early on. These candidates might start as behavioral health technicians, then move into new roles as they pursue more education and certification.

“Our clinical staff has development plans that look at [employees’] six-month, 12-month and five-year goals, and then [we] really look at putting pieces in front of them when it comes to licensure, credentialing and education,” Appleman said. “We have strategic partnerships with a lot of local universities in Pennsylvania and Florida, so that we can get compromised rates for education for our staff members and their families.”

Caron has both inpatient and outpatient facilities. This allows the organization to bring in new clinicians at its residential facilities, where they can train and practice under its license. Then once someone obtains their licensure, clinicians can choose to work in an outpatient setting.

Growing clinicians’ skills as the company grows 

It’s also important to help clinicians grow as a business grows. While M&A can often disrupt a company’s equilibrium, it doesn’t have to cause a mass exodus, Royak said.

ARC Health prioritizes keeping on leadership when it acquires a new company. This often means that there is more continuity for clinicians and patients.

“We identify practices that are like-minded in great quality practice, great quality clinicians. Patients come to them for their brand, or for their name, for their clinicians, for how they do care, how they treat patients. We don’t want to disrupt it,” Royak said. “We want to encourage it and we want to help practices grow.”

When a practice gets acquired into a larger practice, this could also encourage clinicians to stay and advance within a larger organization.

“It provides opportunities for lateral and upward mobility because the organization is getting larger and larger, so there are more and more opportunities,” Royak said.

If new positions arise, many providers see that as a way to help advance clinicians who have already worked within the organization.

“ARC Health, as an organization, likes to promote from within. We like to seek out the talent even during the early stages of partnership within your practice,” Royak said. “We look at the practice to see what talents they have. Is there potential for staff or clinicians to contribute to ARC Health as a whole? That is not to say to take people from a practice, but only those that would like to and the practice would like to contribute.”

Flexibilities 

Upward mobility within a company isn’t the only benefit clinicians are looking for in a workplace. Many clinicians and employees are also looking for flexibility.

The COVID-19 pandemic popularized telehealth for behavioral health services. It also gave many clinicians the freedom to work from home. But as the public health emergency (PHE) ends, many patients are looking for in-person care.

As a result, providers are brainstorming ways to help keep clinicians happy and their schedules more flexible.

“When it came to clients coming back in and staff coming back in, there was some staff that was able to shift to four, 10-hour shift days so that their home three days a week,” Appleman said. “We also did a lot of pulse surveys on our patients to really look at what their need is and leveraged the clinical incentive around that. If 40% of your patients want to come back in-person and find that to be really effective, let’s look at 40% of your position really matching that.”

And sometimes, that flexibility comes down to the clinicians’ specialty and the needs of the patients.

“It’s easier to provide therapy remotely, but sometimes the psychological testing would require patients to come in,” Royak said. “Some prescribers may consider bringing patients in periodically when prescribing certain medications, say controlled substances, or evaluate how the patient presents themselves.”

While it’s important to keep clinicians satisfied, the providers said it really comes down to matching patient needs.