A new paper in Psychiatric Services sheds light on challenges workers face in the Oregon’s public behavioral health system. Oregon, like much of the United States, faces a shortage of behavioral health providers at a time when one-third of those with mental illness report unmet needs.

The study found five factors that negatively impacted interviewees’ employment experience in public behavioral health: low wages, documentation burden, poor physical and administrative infrastructure, lack of career development opportunities, and a chronically traumatic work environment.

The study was part of larger evaluation informing Oregon House Bill 2086, which suggested pathways to livable wages for workers. The study included 24 interviews with behavioral health providers, administrators, and policy experts with knowledge of Oregon’s public behavioral health system. Most interviewees were either current or former front-line clinical staff. CHSE’s Eliza Hallett and Erika Simeon led work on the paper with affiliate faculty member Dr. Jane Zhu. 

While this study was specific to Oregon’s public behavioral health system, the findings may apply for other states trying to understand factors underlying worker turnover and dissatisfaction.

Many states are targeting wage increases for workers in the behavioral health system. However, the study underscored that those efforts may be insufficient to address all the systemic issues at play. The study suggests that states also address issues like clinical and regulatory burden, chronic stress, and lack of professional development opportunities if they want to improve worker retention and satisfaction.

Study interviews were conducted before increases in behavioral health reimbursement approved by the Oregon Legislature had been distributed. While the authors anticipate the rate increases will alter some of the study’s findings, rate increases alone will likely be insufficient to combat all of the identified systemic challenges.