The Role of Staff Turnover in the Implementation of Evidence-Based Practices in Mental Health Care
Open accessAbstract
Objectives This study examined turnover rates of teams implementing psychosocial evidence-based practices in public-sector mental health settings. It also explored the relationship between turnover and implementation outcomes in an effort to understand whether practitioner perspectives on turnover are related to implementation outcomes.Methods Team turnover was measured for 42 implementing teams participating in a national demonstration project examining implementation of five evidence-based practices between 2002 and 2005. Regression techniques were used to analyze the effects of team turnover on penetration and fidelity. Qualitative data collected throughout the project were blended with the quantitative data to examine the significance of team turnover to those attempting to implement the practices.Results High team turnover was common (M+/-SD=81%+/-46%) and did not vary by practice. The 24-month turnover rate was inversely related to fidelity scores at 24 months (N=40, beta=-.005, p=.01). A negative trend was observed for penetration. Further analysis indicated that 71% of teams noted that turnover was a relevant factor in implementation.Conclusions The behavioral health workforce remains in flux. High turnover most often had a negative impact on implementation, although some teams were able to use strategies to improve implementation through turnover. Implementation models must consider turbulent behavioral health workforce conditions.
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Staff turnover in community mental health settings is very high.
“given very high staff turnover in community mental health settings (Woltmann et al., 2008)”
From Stakeholder Perceptions of the Barriers to Receiving and Delivering Exposure-Based Cognitive Behavioral Therapy for Anxiety Disorders in Adult Community Mental Health Settings (2019) · cites this paper as Woltmann et al., 2008
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- Authors
- Woltmann, E. M., Whitley, R., McHugo, G. J., Brunette, M., Torrey, W. C., Coots, L., Lynde, D., & Drake, R. E.
- Affiliations
- Dartmouth College (US)
- Venue
- Psychiatric Services
- Published
- 2008-07
- Volume
- 59
- Issue
- 7
- Pages
- 732-737
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- OpenAlex
- W2104229989
- Cited by
- 246
- References
- 32
- Citations by year
- 2026: 7 · 2025: 15 · 2024: 15 · 2023: 24 · 2022: 11 · 2021: 22 · 2020: 13 · 2019: 21 · 2018: 13 · 2017: 7 · 2016: 12 · 2015: 16 · 2014: 13 · 2013: 12 · 2012: 12
- FWCI
- 20.59
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Robert Wood Johnson Foundation
- John D. and Catherine T. MacArthur Foundation
- Substance Abuse and Mental Health Services Administration
- Agency for Healthcare Research and Quality
- Center for Mental Health Services
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
- Keywords
- employee turnover, implementation fidelity, evidence-based practice, psychosocial interventions, mental health services, behavioral health workforce, implementation teams, implementation outcomes
- MeSH terms
- Workforce, Behavioral Medicine, Community Mental Health Services, Cooperative Behavior, Diffusion of Innovation, Health Plan Implementation, Humans, Outcome and Process Assessment, Health Care, Personnel Turnover, United States, Linear Models, Logistic Models, Public Sector, Evidence-Based Medicine, Empirical Research
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