Cited by 246Health Policy Implementation SciencePsychiatric care and mental health servicesHealth Sciences Research and Education

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The Role of Staff Turnover in the Implementation of Evidence-Based Practices in Mental Health Care

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Woltmann, Emily M., Whitley, Rob, McHugo, Gregory J., Brunette, Mary, Torrey, William C., Coots, Laura, Lynde, David, Drake, Robert E.·2008·Psychiatric Services

DOI 10.1176/ps.2008.59.7.732

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Abstract

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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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)
ORCID: Whitley, Rob
McHugo, Gregory J.
Brunette, Mary
Torrey, William C.
Venue: Psychiatric Services
Publisher: American Psychiatric Association Publishing
Published: 2008-07
Volume: 59
Issue: 7
Pages: 732-737
ISSN: 0022-1597 (ISSN-L)
1075-2730
1557-9700
DOI: 10.1176/ps.2008.59.7.732
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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The Role of Staff Turnover in the Implementation of Evidence-Based Practices in Mental Health Care

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