Barriers and Facilitators to Staff Recruitment and Retention for ACT Teams: Perspectives of Staff and Participants

• Published in: The Journal of Behavioral Health Services & Research Vol. 51; no. 4; pp. 499 - 515
• Main Authors: Tepper, Miriam C., Le Beau, Mariah, Clark, Gary, Thorning, Helle, Pope, Leah G.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.10.2024; Springer Nature B.V
• Subjects: Adult; Assertive community treatment; Attitude of Health Personnel; Community and Environmental Psychology; Community Mental Health Services - organization & administration; Compensation; Female; Flexibility; Focus Groups; Health behavior; Health Informatics; Health Personnel - psychology; Health Promotion and Disease Prevention; Health Psychology; Humans; Interviews; Interviews as Topic; Male; Medicine; Medicine & Public Health; Mental disorders; Mental Disorders - therapy; Mental health; Middle Aged; Patient Care Team; Personnel Selection; Personnel Turnover; Psychiatry; Public Health; Qualitative Research; Quality management; Recruitment; Retention; Shortages; Staffing; Teams; Workforce
• ISSN: 1094-3412; 1556-3308; 2168-6793; 1556-3308
• DOI: 10.1007/s11414-024-09898-z

The behavioral health workforce has been experiencing deepening problems with recruitment and retention, particularly in publicly funded settings serving individuals with serious mental illnesses. This quality improvement project gathered Assertive Community Treatment (ACT) participant (service user) and provider perspectives on workforce challenges. The authors conducted 8 interviews with ACT participants and 9 focus groups with ACT current staff, team leaders, and former staff. Interviewees discussed barriers to recruitment and retention, including inadequate compensation, work becoming more task-oriented during periods of short staffing, a lack of understanding of what ACT work entails, and elements of the team-based model of care; and facilitators of recruitment and retention, including other aspects of the team-based model of care, connections with colleagues and ACT participants, and flexibility. ACT participants had variable experiences regarding availability of their teams. Recommendations from focus groups and interviews include increasing flexibility, improving awareness of ACT work, optimizing team functioning, addressing staff wellness, and attending to risk. Findings include key insights that may help address the critical workforce shortages in public behavioral health settings.