Journal Article

Job assessments and the anticipated retention of behavioral health clinicians working in U.S. Health Professional Shortage Areas

Lombardi, Brianna M., Pathman, Donald E., de Saxe Zerden, Lisa, Harrison, Jerry N., Konrad, Thomas R., Shafer, Amanda Beth, Fannell, Jackie

2025

Overview

Background A shortage of behavioral health clinicians impedes access to mental health services nationwide in the U.S., with shortages most acute in federally designated Mental Health Professional Shortage Areas (mHPSAs). Retaining behavioral health clinicians currently working in mHPSAs is thus critical. This study sought to identify behavioral health clinicians’ assessments of various aspects of their work and jobs that are associated with their anticipated retention within mHPSA practices. Methods Data for this cross-sectional study were drawn from an annual feedback survey of clinicians when they complete federal education loan repayment support contracts for their work within mHPSAs, from 2016 to 2023. Clinicians’ assessments of various aspects of their work and jobs were measured with validated survey items with Likert-scaled response options, with most combined into scales for analyses. Bivariate and then adjusted associations with 5-year anticipated retention were assessed for clinicians’ assessments of various aspects of their work and jobs controlling for demographic, professional, and community characteristics. Results The 2,587 respondent behavioral health clinicians (67.5% response rate) included 42% licensed clinical social workers, 39% licensed professional counselors, 12% psychologists, and 7% licensed marriage and family therapists. Two-thirds of these clinicians worked in either community mental health centers or federally qualified health centers. 42% anticipated they would remain in their practices at least another five years. Five-year anticipated retention rates were nearly three times higher for clinicians who indicated satisfaction on global work and practice assessment measures than for clinicians neutral or dissatisfied on these measures. Five-year anticipated retention rates were also higher for clinicians who reported they had an effective and supportive administration, felt well and fairly compensated, had jobs that permitted a good work-life balance, and had jobs that allowed them to practice the full range of services they desired. Conclusions How behavioral health clinicians view their jobs within U.S. mHPSAs is important to their anticipated retention. Based on study findings, to promote their retention practice administrators should provide fair and adequate compensation, foster work-life balance, permit them to deliver the services they wish to provide, and value them and their input and maintain good relationships with them.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Administrators / Adult / Analysis / Attrition / Behavioral health care / Behavioral health workforce / Clinical psychologists / Clinical social workers / Collaboration / Community centers / Community mental health services / Compensation / Cross-Sectional Studies / Drug use / Education / Employee turnover / Employers / Employment / Evaluation / Expectations / Family therapists / Feedback / Female / Health Administration / Health behavior / Health facilities / Health Informatics / Human subjects / Humans / Job retention / Job Satisfaction / Job turnover / Licenses / Male / Marriage / Measures / Medical personnel / Medically Underserved Area / Medicine / Medicine & Public Health / Mental health / Mental health professional shortage area / Mental health professionals / Mental Health Services / Middle Aged / Nursing Research / Personnel management / Personnel Turnover - statistics & numerical data / Polls & surveys / Practice administration / Primary care / Psychiatric services / Psychologists / Psychotherapy / Public Health / Questionnaires / Responses / Retention / Satisfaction / Shortages / Social workers / Socioeconomic factors / Student loans / Surveys and Questionnaires / Therapists / United States / Work / Work life balance / Work-Leisure conflict / Workforce