This season of the STAR² Center Talks Workforce Success explores a variety of approaches health centers can take to support mental health professions pathways. Tune in to hear from Susan Boyles, Director of Behavioral Health at Adelante Healthcare, as she shares ideas on how to effectively engage health center staff and the broader community to identify innovative ways to support the recruitment and integration of the mental health workforce into community health centers.

Transcript by Rev.com

Sydney Axelrod:

Welcome to The STAR² Center Talks Workforce Success. I’m your host for this episode, Sydney Axelrod, Associate Director of Workforce Development at The STAR² Center at the Association of Clinicians for the Underserved, or ACU. This season we’re focusing on mental health professions’ pathways and integration into community health centers. Today, I’m talking to Susan Boyles, director of Behavioral Health at Atalanta Health Care. Thank you so much for being here, Susan.

Susan Boyles:

Well, thank you so much for having me.

Sydney Axelrod:

Absolutely. It’s our pleasure. Susan, to get started, can you tell me a little bit about yourself and your background? How is it that you came to get started in a career that supports community health centers?

Susan Boyles:

Sure, I would love to. I grew up in a rural area of western Pennsylvania. I got my bachelor’s degree in psychology and then later on, after I worked for a number of years, went back for my master’s in social work and then became licensed. Even at that time, my first job, really out of college, with my bachelor’s degree was a case manager for the county that I lived in. So that’s really always been rooted in what I wanted to do, because I believe so strongly in helping the communities that we live and work in, that it’s really imperative to be connected to that community. Regardless of whether I continued to live in Western Pennsylvania or whatever county, or city that I lived in, I wanted to be part of that.

Sydney Axelrod:

Wow. That’s wonderful. Thank you so much for sharing that. I think it’s such a powerful story to have sort of started in this space and continue to be committed to supporting communities in this way. In your opinion, why do you think that mental health is such an important component of the services that are provided by community health centers?

Susan Boyles:

That is a great question. I really believe in whole-person care, and I know that that’s a term that has kind of been out there for a little while, but really when you think about it, physical health is just part of our health, overall. It is not our complete health. I think ignoring the mental health part really is a disservice to our patients. So combining the physical health with mental health, really make sure that you’re treating every need that that patient has, because our mental health can impact our physical health and our physical health can also impact our mental health.

Sydney Axelrod:

Yeah, absolutely. I couldn’t agree with you more. I know that health centers sort of continue to face these challenges around recruiting and retaining a robust mental health workforce, so can you share maybe a little bit about some pathway programs that either you’ve developed or are aware of, that really support that expansion and the recruitment and the retention of that mental health workforce?

Susan Boyles:

Absolutely. So something that we have done is that we connected with a lot of the local universities in the Phoenix area and developed partnerships with them where we are able to offer internship and practicum opportunities for both bachelor’s level to provide a pathway for that BHT level, or that entry level, as well as the master’s level for their practicums for those students that need those hours. Then we are very open to taking on new graduates as well. I think sometimes facilities might shy away from new graduates, but we have found that they have been wonderful because they are really primed and ready for that experience. When you’re able to give them a good practicum experience and they feel that connection to the mission and the vision of your organization, they want to come back and they really want to continue to do that work. We also provide clinical supervision for them so that they have the clinical oversight as a master’s prepared, and then we are also preparing them for both associate level licensure as well as independent level licensure. That helps with the retainment.

Sydney Axelrod:

Thank you. Yeah. That sounds like a really compelling model to really invest in your own community, at a very early stage in their career development. It sounds like there’s been some real good payoffs with making that initial investment that folks continue to stay invested as they get started into their career.

Susan Boyles:

Absolutely. Another piece that we did for retainment was adding stay interview questions to both the mid-year reviews as well as the annual reviews. Those stay interview questions, I think, have made a big difference because in a one-to-one you’re talking, but often time is limited, you might be focused on specific clinical things, but really getting to the questions of what keeps them here, what makes them happy, what maybe do they need that we need to make sure that we’re rising to the occasion to make sure that we’re meeting those needs. I think that’s made a big difference as well.

Sydney Axelrod:

Yeah. Thank you for sharing that. I think that’s a really smart approach. I think oftentimes folks either rely on those one-on-one conversations, which as you mentioned, are usually focused on the work itself and don’t leave a lot of space to check in, in that way, or they end up relying on what they’re learning from exit interviews when people are leaving, which can be valuable, but doesn’t give you the same opportunity to really make those improvements. I think that’s a really smart model to really focus on those stay interviews and stay connected to your staff. It sounds like these programs are really effective in that initial recruitment of folks early in their career, but can you think of any strategies that health centers can use to really support that mental health workforce to ensure that they feel integrated into the overall organization?

Susan Boyles:

Yes. I think I would like to answer this in a two-part question.

One, to make sure that there’s a career path for all of those folks that are coming in to the mental health departments, that’s something that we created here at Adelante where we have career pathways from our front office, to our back office, to our clinicians, and we’re supporting them in that career growth. We’ve had a number of successes where I had a MA that went back to school, became an intake specialist or a case manager first and is now an intake specialist. We’ve also had two intake specialists go back to school because they want to be therapists. We’re happy to support them in that. I think that also helps them feel really connected to the organization when you are saying, “We want to help you. If you have these goals, how can we help support you in that?”

The other piece in getting really integrated into the organization is making sure that you do, I think, early socialization with the rest of the organization. When we first opened up with behavioral health, there were a lot of folks that were really scared because they didn’t know what that meant, they didn’t know what the patients were going to be like, and they of course had worst-case scenario in their mind. So easing them a little bit and making sure that we provided education was really key because a lot of them were concerned about the typical myths that exist for mental health and patients with behavioral health issues. So that socialization and that education was really key. Then for our therapists and our psych providers, of course, they are considered providers, so we do give them provider-level benefits, just like the medical providers. I think that is also very helpful for retainment and recruitment of those staff.

Sydney Axelrod:

Yeah. That’s excellent. Thank you for sharing that. I’m hearing all kinds of really successful strategies in there. Investing in all of your staff and considering all of your staff as opposed to putting your mental health staff into a silo and only thinking about their needs discreetly, but rather instead looking at your whole staff and investing in everybody’s career development, I think, is a really compelling approach there. Then also, I heard you saying really investing in that initial onboarding and making sure that we’re building that community connection from the beginning, but again across the board and really holding your mental health workforce in the same regard as your physical health providers, I think, is a really interesting approach, and it sounds like it’s been really successful for you all.

Susan Boyles:

Yes, it has.

Sydney Axelrod:

That’s great. Do you have any recommendations for health centers that are really kind of struggling to get this right, to recruit, to retain, to train this next generation of mental health providers and staff?

Susan Boyles:

Sure. I think that I would strongly recommend if they’re struggling, with recruitment, to make those connections with local universities. I can tell you that our universities were very happy to have another place for students to go because they found that placement for these internships, externships, and practicums were actually very difficult for them to make sure that every student had that in the right timeline so that they could graduate on time. They were very open to have that additional partnership. I would definitely recommend reaching out to those resources as well as having educational job fairs where folks in the community can understand what services you offer, what positions that you have. That was one thing too that we discovered early on was that there was a lot of unknown, oh, I didn’t realize you would have a MA in a behavioral health office. we then started to receive a lot of interest from internal MAs as well as external MAs. I think that education about all of the positions that you have in your department and what those requirements are for those different positions, that was really important.

I think the other piece would be just to make sure that there’s good education within the organization. I was actually pretty surprised when we first started, how many other folks that were in the organization working on the medical side that had a bachelor’s in psychology maybe, but ended up getting an MA certificate and was working in that department, or was in our quality department and were very interested in coming over. So making sure that everyone in the organization also knows what positions you’ll have, and again, that education is really key.

Sydney Axelrod:

Yeah. I love that. I love the holistic approach to education that you’re not just educating potential students at a university, but you’re also educating the broader community, you’re also educating your current staff. I think that’s such a wonderful resource to tap into, which you sort of shared a little bit with your sort of career development opportunities as well, but really folks aren’t going to take opportunities to stretch in that way if they don’t know that that’s available to them.

Susan Boyles:

Absolutely.

Sydney Axelrod:

Any sort of additional tools, resources, or final thoughts that you might like to share with our audience about some of the effective ways that they can train and then really integrate that mental health workforce into their community health centers?

Susan Boyles:

Absolutely. I think really dispelling some of the myths and working on the stigma around mental health is very important for the organization, so providing those trainings to everyone. We also provided a training on de-escalation because really you could have a patient on the medical side that is upset about a diagnosis or upset because their prescription didn’t get called in in time and they are escalating at the front desk, so we really felt like this wasn’t isolated to behavioral health, it was something that really the whole organization would benefit from. In doing that, that allowed us to really speak to the stigma around mental health and how we can kind of combat that at every level. That was really something that made a big difference. When I tell you that we did this deescalation for everyone in the organization, it was everyone in the organization; from our frontline staff, all the way up to our executive team.

Sydney Axelrod:

Wow. What a powerful approach to really provide that educational opportunity to everybody and do a little awareness building into what goes into this critically important behavioral and mental health work that folks are doing. That’s great.

Well, Susan, thank you so much for joining us today. Listeners, thank you for tuning in. We hope that today’s conversation provided you with some ideas, suggestions, and insights into ways that you can approach mental health professions, pathways, and integration into your community health centers. Be sure to check out all of our free workforce tools and resources found at chcworkforce.org and check out all that Adelante Health Care is doing at adelantehealthcare.com. Thank you again so much and have a wonderful rest of your day.