Skip to main content
Key Specialties
Anesthesiology Cardiology Dermatology Diabetology Endocrinology Gastroenterology and Hepatology General Medicine Geriatrics Hematology Infectious Diseases Internal Medicine Nephrology Neurology Obstetrics and Gynecology Oncology Ophthalmology Pediatrics Psychiatry Radiology Respiratory Medicine Rheumatology Surgery Urology
Congress Coverage
ASH 2024 Annual Meeting 2024 ESMO Congress 2024 ERS Congress 2024 EASD Congress 2024 ESC Congress 2024 EAN Congress 2024 ASCO Annual Meeting 2024 ACC Congress
Clinical Collections
Women’s Health Knowledge Hub Advances in Alzheimer’s

Navigating neuroimaging in Alzheimer disease care

PET imaging is playing an increasingly critical role in managing AD, but how can you effectively integrate it into clinical practice? Our expert-led program will empower you with practical strategies and real-world case studies.

This content is intended for healthcare professionals outside of the UK.
ADVANCED SEARCH
Log in
Top
Administration and Policy in Mental Health and Mental Health Services Research

08-06-2024 | Original Article

Why do Stayers Stay? Perceptions of White and Black Long-Term Employees in a Community Mental Health Center

Authors: Emily Bass, Michelle P. Salyers, Ashton Hall, Jennifer Garabrant, Gary Morse, Eric Kyere, Nathaniel Dell, Jaime Greenfield, Sadaaki Fukui

Published in: Administration and Policy in Mental Health and Mental Health Services Research

Login to get access

Abstract

Previous research has focused on factors influencing turnover of employees in the mental health workforce, yet little research has explored reasons why employees stay. To facilitate retaining a diverse mental health workforce, the current study aimed to elucidate factors that contributed to employees’ tenure at a community mental health center (CHMC) as well as compare these perceptions between Black and White employees. Long-term employees (7 years or more) from one urban CMHC (n = 22) completed semi-structured stayer interviews. Using emergent thematic analysis, stayer interviews revealed four major themes for why they have stayed at the organization for 7 years or more: (1) work as a calling, (2) supportive relationships, (3) opportunities for growth or meaningful contribution, and (4) organization mission’s alignment with personal attributes or values. Comparison between Black and White stayer narratives revealed differences in their perceptions with work as a calling and opportunities for growth and meaningful contribution. Guided by themes derived from stayer interviews, the current study discusses theoretical (e.g., job embeddedness theory, theory of racialized organizations, self-determination theory) and practical implications (e.g., supporting job autonomy, Black voices in leadership) in an effort to improve employee retention and address structural racism within a mental health organization.
Literature
Bashshur, M. R., & Oc, B. (2015). When voice matters: A multilevel review of the impact of voice in organizations. Journal of Management, 41(5), 1530–1554.CrossRef
Beidas, R. S., Marcus, S., Wolk, C. B., Powell, B., Aarons, G. A., Evans, A. C., Hurford, M. O., Hadley, T., Adams, D. R., Walsh, L. M., Babbar, S., Barg, F., & Mandell, D. (2016). A prospective examination of clinician and supervisor turnover within the context of implementation of evidence-based practice in a publicly-funded mental health system. Admin Policy Ment Health, 43, 640–649.CrossRef
Bond, G. R., Pensec, M., Dietzen, L., McCafferty, D., Giemza, R., & Sipple, H. W. (1991). Intensive case management for frequent users of psychiatric hospitals in a large city: A comparison of team and individual caseloads. Psychosocial Rehabilitation Journal, 15(1), 90–98.CrossRef
Brabson, L. A., Harris, J. L., Lindihiem, O., & Herschell, A. D. (2020). Workforce turnover in community behavioral health agencies in the USA: A systematic review with recommendations. Clinical Child and Family Psychology Review, 23, 297–315.PubMedCrossRef
Brown, W. A., & Yoshioka, C. F. (2003). Mission attachment and satisfaction as factors in employee retention. Nonprofit Management and Leadership, 14(1), 5–18.CrossRef
Bukach, A. M., Ejaz, F. K., Dawson, N., & Gitter, R. J. (2017). Turnover among community mental health workers in Ohio. Administration and Policy in Mental Health, 44, 115–122.PubMedCrossRef
Burns, K., Christie, A., & O’Sullivan, S. (2020). Findings from a longitudinal qualitative study of child protection social workers’ retention: Job embeddedness, professional confidence and staying narratives. British Journal of Social Work, 50, 1363–1381.CrossRef
Butler, S. S., Brennan-Ing, M., Wardamasky, S., & Ashley, A. (2014). Determinants of longer job tenure among home care aides: What makes some stay on the job while others leave? Journal of Applied Gerontology, 33(2), 164–188.PubMedCrossRef
Crabtree, B. F., & Miller, W. L. (1999). Doing qualitative research. Sage.
Dean, L. T., & ThorpeJr, R. J. (2022). What structural racism is (or is not) and how to measure it: Clarity for public health and medical researchers. American Journal of Epidemiology, 191(9), 1521–1526.PubMedPubMedCentralCrossRef
Duffy, R. D., & Dik, B. J. (2013). Research on calling: What have we learned and where are we going? Journal of Vocational Behavior, 83(3), 428–436.CrossRef
Duffy, R. D., Dik, B. J., Douglass, R. P., England, J. W., & Velez, B. L. (2018). Work as a calling: A theoretical model. Journal of Counseling Psychology, 65(4), 423–439.PubMedCrossRef
Fukui, S., Wu, W., & Salyers, M. P. (2019). Mediational paths from supervisor support to turnover intention and actual turnover among community mental health providers. Psychiatric Rehabilitation Journal, 42(4), 350–357.PubMedCrossRef
Fukui, S., Rollins, A. L., & Salyers, M. P. (2020). Characteristics and job stressors associated with turnover and turnover intention among community mental health providers. Psychiatric Services, 71(3), 289–292.PubMedCrossRef
George, C. (2015). Retaining professional workers: What makes them stay? Employee Relations, 31(1), 102–121.CrossRef
Hallett, E., Simeon, E., Amba, V., Howington, D., McConnell, K. J., & Zhu, J. M. (2023). Factors influencing turnover and attrition in the public behavioral health system workforce: Qualitative study. Psychiatric Services, 1–9.
Hardré, P. L., & Reeve, J. (2009). Training corporate managers to adopt a more autonomy-supportive motivating style toward employees: An intervention study. International Journal of Training and Development, 13(3), 165–184.CrossRef
Hennink, M. M., Kaiser, B. N., & Marconi, V. C. (2017). Code saturation versus meaning saturation: How many interviews are enough? Qualitative Health Research, 27(4), 591–608.PubMedCrossRef
Hom, P. W., Lee, T. W., Shaw, J. D., & Hausknecht, J. P. (2017). One hundred years of employee turnover theory and research. Journal of Applied Psychology, 102(3), 530.PubMedCrossRef
Hsieh, H-F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15(9), 1277–1288.PubMedCrossRef
Knight, D. K., Becan, J. E., & Flynn, P. M. (2012). Organizational consequences of staff turnover in outpatient substance abuse treatment programs. Journal of Substance Abuse Treatment, 42(2), 143–150.PubMedCrossRef
Kyere, E., & Fukui, S. (2022). Structural racism, workforce diversity, and mental health disparities: A critical review. Journal of Racial and Ethnic Health Disparities, 1–12.
Lai, L. (2011). Employees’ perceptions of the opportunities to utilize their competences: Exploring the role of perceived competence mobilization. International Journal of Training and Development, 15(2), 140–157.CrossRef
Lee, T. W., Burch, T. C., & Mitchell, T. R. (2014). The story of why we stay: A review of job embeddedness. Annu Rev Organ Psychol Organ Behav, 1, 199–216.CrossRef
Li, J., Han, X., Qi, J., & He, X. (2021). Managing one’s career: The joint effects of job autonomy, supervisor support, and calling. Journal of Career Development, 48(6), 973–986.CrossRef
Liao, P. Y. (2022). Proactive personality, job crafting, and person-environment fit: Does job autonomy matter? Current Psychology, 1–12.
Loan-Clarke, J., Arnold, J., Coombs, C., Hartley, R., & Bosley, S. (2010). Retention, turnover and return–a longitudinal study of allied health professionals in Britain. Human Resource Management Journal, 20(4), 391–406.CrossRef
Macdonald, A., Adamis, D., Craig, T., & Murray, R. (2019). Continuity of care and clinical outcomes in the community for people with severe mental illness. The British Journal of Psychiatry, 214(5), 273–278.PubMedCrossRef
Marasi, S., Cox, S. S., & Bennett, R. J. (2016). Job embeddedness: Is it always a good thing? Journal of Managerial Psychology, 31(1), 141–153.CrossRef
Mitchell, T. R., Holtom, B. C., Lee, T. W., Sablynski, C. J., & Erez, M. (2001). Why people stay: Using job embeddedness to predict voluntary turnover. Academy of Management Journal, 44(6), 1102–1121.CrossRef
Mor Barak, M. E., Nissly, J. A., & Levin, A. (2001). Antecedents to retention and turnover among child welfare, social work, and other human service employees: What can we learn from past research? A review and metanalysis. Social Service Review, 75(4), 625–661.CrossRef
Morse, G., Salyers, M. P., Rollins, A. L., Monroe-DeVita, M., & Pfahler, C. (2012). Burnout in mental health services: A review of the problem and its remediation. Administration and Policy in Mental Health and Mental Health Services Research, 39, 341–352.PubMedCrossRef
Norris, D. M., & Primm, A. (2023). Burnout and moral injury among black psychiatrists and other black mental health professionals. Psychiatric Services, appips20220522.
Pullen, E., Fischer, M. W., Morse, G., Garabrant, J., Salyers, M. P., & Rollins, A. L. (2023). Racial disparities in the workplace: The impact of isolation on perceived organizational support and job satisfaction. Psychiatric Rehabilitation Journal, 46(1), 45–52.PubMedCrossRef
Ray, V. (2019). A theory of racialized organizations. American Sociological Review, 84(1), 26–53.CrossRef
Ray, S. L., Wong, C., White, D., & Heaslip, K. (2013). Compassion satisfaction, compassion fatigue, work life conditions, and burnout among frontline mental health care professionals. Traumatology, 19(4), 255–267.CrossRef
Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. American Psychologist, 55(1), 68–78.PubMedCrossRef
Salyers, M. P., Hudson, C., Morse, G., Rollins, A. L., Monroe-DeVita, M., Wilson, C., & Freeland, L. (2011). BREATHE: A pilot study of a one-day retreat to reduce burnout among mental health professionals. Psychiatric Services, 62(2), 214–217.PubMedCrossRef
Salyers, M. P., Firmin, L., Gearhart, R., Avery, T., E., & Frankel, R. M. (2015). What we are like when we are at our best: Appreciative stories of staff in a community mental health center. American Journal of Psychiatric Rehabilitation, 18(3), 280–301.PubMedPubMedCentralCrossRef
Salyers, M. P., Garabrant, J. M., Luther, L., Henry, N., Fukui, S., Shimp, D., Wu, W., Gearhart, T., Morse, G., York, M. M., & Rollins, A. L. (2019). A comparative effectiveness trial to reduce burnout and improve quality of care. Administration and Policy in Mental Health and Mental Health Services Research, 46(2), 238–254. https://​doi.​org/​10.​1007/​s10488-018-0908-4.CrossRefPubMed
Sekiguchi, T., Li, J., & Hosomi, M. (2017). Predicting job crafting from the socially embedded perspective: The interactive effect of job autonomy, social skill, and employee status. The Journal of Applied Behavioral Science, 53(4), 470–497.CrossRef
Selden, D. R. (2010). The effects of staff turnover on psychiatric rehabilitation programs. Psychiatric Rehabilitation Journal, 34(1), 71.PubMedCrossRef
Singh, R. (2019). Developing organisational embeddedness: Employee personality and social networking. The International Journal of Human Resource Management, 30(16), 2445–2464.CrossRef
Spradley, J. P. (2016). The ethnographic interview. Waveland.
Steel, R. P., Griffeth, R. W., & Hom, P. W. (2002). Practical retention policy for the practical manager. Academy of Management Perspectives, 16(2), 149–162.CrossRef
Stewart, R. E., Adams, D. R., Mandell, D. S., Hadley, T. R., Evans, A. C., Rubin, R., & Beidas, R. S. (2016). The perfect storm: Collision of the business of mental health and the implementation of evidence-based practices. Psychiatric Services, 67(2), 159–161.PubMedCrossRef
Stewart, R. E., Mandell, D. S., & Beidas, R. S. (2021). Lessons from Maslow: Prioritizing funding to improve the quality of community mental health and substance use services. Psychiatric Services, 72(10), 1219–1221.PubMedCrossRef
Suchman, A. L., Williamson, P. R., Litzelman, D. K., Frankel, R. M., Mossbarger, D. L., & Inui, T. S. (2004). Toward an informal curriculum that teaches professionalism. Transforming the social environment of a medical school. Journal of General Internal Medicine, 19(5 Pt 2), 501–504.PubMedPubMedCentralCrossRef
Sullivan Commission on Diversity in the Health Workforce (2004). Missing persons: Minorities in the health professions. Washington, DC.
Van den Heuvel, M., Demerouti, E., & Peeters, M. C. (2015). The job crafting intervention: Effects on job resources, self-efficacy, and affective well‐being. Journal of Occupational and Organizational Psychology, 88(3), 511–532.CrossRef
Van Wingerden, J., Bakker, A. B., & Derks, D. (2017). Fostering employee well-being via a job crafting intervention. Journal of Vocational Behavior, 100, 164–174.CrossRef
Wine, B., Osborne, M. R., & Newcomb, E. T. (2020). On turnover in human services. Behavior Analysis in Practice, 13(2), 492–501.
Woltmann, E. M., Whitley, R., McHugo, G. J., Brunette, M., Torrey, W. C., Coots, L., Lynde, D., & Drake, R. E. (2008). The role of staff turnover in the implementation of evidence-based practices in mental health care. Psychiatric Services, 59(7), 732–737.PubMedCrossRef
Wrzesniewski, A., & Dutton, J. E. (2001). Crafting a job: Revisioning employees as active crafters of their work. Academy of Management Review, 26(2), 179–201.CrossRef
Wu, C., Parker, S. K., Wu, L., & Lee, C. (2018). Where and why people engage in different forms of proactive behavior: Interactive effects of self-construals and work characteristics. Academy of Management, 61(1), 293–323.CrossRef
Wynen, J., Van Dooren, W., Mattijs, J., & Deschamps, C. (2019). Linking turnover to organizational performance: The role of process conformance. Public Management Review, 21(5), 669–685.CrossRef
Zhang, N., & He, X. (2022). Role stress, job autonomy, and burnout: The mediating effect of job satisfaction among social workers in China. Journal of Social Service Research, 1–11.
Zhang, F., & Parker, S. K. (2019). Reorienting job crafting research: A hierarchical structure of job crafting concepts and integrative review. Journal of Organizational Behavior, 40(2), 126–146.CrossRef
Zimmerman, R. D. (2008). Understanding the impact of personality traits on individuals’ turnover decisions: A meta-analytic path model. Personnel Psychology, 61(2), 309–348.CrossRef
Metadata
Title
Why do Stayers Stay? Perceptions of White and Black Long-Term Employees in a Community Mental Health Center
Authors
Emily Bass
Michelle P. Salyers
Ashton Hall
Jennifer Garabrant
Gary Morse
Eric Kyere
Nathaniel Dell
Jaime Greenfield
Sadaaki Fukui
Publication date
08-06-2024
Publisher
Springer US
Published in
Administration and Policy in Mental Health and Mental Health Services Research
Print ISSN: 0894-587X
Electronic ISSN: 1573-3289
DOI
https://doi.org/10.1007/s10488-024-01387-x