title: A Prospective Examination of Clinician and Supervisor Turnover Within the Context of Implementation of Evidence-Based Practices in a Publicly-Funded Mental Health System.
abstract: Staff turnover rates in publicly-funded mental health settings are high. We investigated staff and organizational predictors of turnover in a sample of individuals working in an urban public mental health system that has engaged in a system-level effort to implement evidence-based practices. Additionally, we interviewed staff to understand reasons for turnover. Greater staff burnout predicted increased turnover, more openness toward new practices predicted retention, and more professional recognition predicted increased turnover. Staff reported leaving their organizations because of personal, organizational, and financial reasons; just over half of staff that left their organization stayed in the public mental health sector. Implications include an imperative to focus on turnover, with a particular emphasis on ameliorating staff burnout.
authors.affiliation: Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3015, Philadelphia, PA, 19104, USA. rbeidas@upenn.edu.
authors.forename: Rinad S
authors.initials: RS
authors.lastname: Beidas
authors.affiliation: School of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA, USA.|Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, Philadelphia, PA, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Marcus
authors.affiliation: Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3015, Philadelphia, PA, 19104, USA.
authors.forename: Courtney Benjamin
authors.initials: CB
authors.lastname: Wolk
authors.affiliation: Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3015, Philadelphia, PA, 19104, USA.|Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 1105C McGavran-Greenberg Hall, Campus Box 7411, Chapel Hill, NC, 27599-7411, USA.
authors.forename: Byron
authors.initials: B
authors.lastname: Powell
authors.affiliation: Department of Psychiatry, University of California San Diego, San Diego, CA, USA.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Aarons
authors.affiliation: Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3015, Philadelphia, PA, 19104, USA.|Department of Behavioral Health and Intellectual Disability Services, Philadelphia, PA, USA.
authors.forename: Arthur C
authors.initials: AC
authors.lastname: Evans
authors.affiliation: Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3015, Philadelphia, PA, 19104, USA.|Department of Behavioral Health and Intellectual Disability Services, Philadelphia, PA, USA.|Community Behavioral Health, Philadelphia, PA, USA.|Community Care Behavioral Health Organization, Pittsburgh, PA, USA.
authors.forename: Matthew O
authors.initials: MO
authors.lastname: Hurford
authors.affiliation: Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3015, Philadelphia, PA, 19104, USA.
authors.forename: Trevor
authors.initials: T
authors.lastname: Hadley
authors.affiliation: Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3015, Philadelphia, PA, 19104, USA.
authors.forename: Danielle R
authors.initials: DR
authors.lastname: Adams
authors.affiliation: Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3015, Philadelphia, PA, 19104, USA.
authors.forename: Lucia M
authors.initials: LM
authors.lastname: Walsh
authors.affiliation: Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3015, Philadelphia, PA, 19104, USA.
authors.forename: Shaili
authors.initials: S
authors.lastname: Babbar
authors.affiliation: Department of Family Medicine and Community Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
authors.forename: Frances
authors.initials: F
authors.lastname: Barg
authors.affiliation: Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, 3535 Market Street, 3015, Philadelphia, PA, 19104, USA.
authors.forename: David S
authors.initials: DS
authors.lastname: Mandell
mesh_terms: D000328:Adult; D002055:Burnout, Professional / Q000453:epidemiology*; D055317:Evidence-Based Practice; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration; D008875:Middle Aged; D010414:Pennsylvania / Q000453:epidemiology; D010563:Personnel Turnover / Q000706:statistics & numerical data*; D011446:Prospective Studies; D000078329:Workforce
keywords: Implementation; Mental health services; Turnover