Prior to the COVID-19 pandemic, the children’s behavioral health workforce was stretched thin due to underfunding and issues attracting and retaining clinicians. The pandemic further strained the system and contributed to higher turnover and staffing shortages. The increased stress took an emotional toll on many providers.
The second session in this year’s 14th Annual Evidence-Based Practice Conference focused on supporting the well-being of the behavioral health workforce during this difficult time. The session, “Care in the COVID-19 Context: Implications for Provider Well-Being and the Future of Behavioral Health Care,” was presented by Dr. Sharon Hoover, a licensed clinical psychologist and Professor at the University of Maryland School of Medicine, Division of Child and Adolescent Psychiatry, and Co-Director of the National Center for School Mental Health (NCSMH). Dr. Hoover shared new data on how the pandemic has strained children’s behavioral health providers and organizations. She also shared resources to support individual self-care for providers and organizational support for staff well-being.
The rates and acuity of children’s behavioral health issues rose significantly during the pandemic and hospitals, schools, and other child-serving systems struggled to absorb the increased demand. According to the CDC, mental health-related emergency department visits in 2020 for children ages 5-11 and youth ages 12-17 were up by 24% and 31%, respectively[1]. And in a recent CDC survey, 22% of parents reported that their child’s mental or emotional health is worse than before the pandemic[2].
When Dr. Hoover asked participants to share the impact of COVID-19 on their organizations, several common themes emerged: long waitlists, a huge increase in referrals, and chronic understaffing and turnover. For individual providers, the most common issues were increased stress and burnout, emotional fatigue, adjusting to telehealth, and the challenge of helping clients navigate the added stressors of the pandemic while experiencing it themselves.
Putting the individual experiences of workshop participants into context, Dr. Hoover shared that a survey of behavioral health providers conducted by the National Council for Mental Wellbeing during the first year of the pandemic reflected the same issues, with two-thirds of behavioral health providers reporting a higher demand for services and 45% of organizations reporting that their patient waitlist has grown[3]. Another survey of healthcare providers (including mental health providers) conducted by Mental Health America showed that 90% of providers reported feeling stressed out and stretched too thin, and 75% reported high levels of frustration, exhaustion, and burnout. Dr. Hoover also pointed out that many of these issues existed prior to COVID, only to be exacerbated by the pandemic’s added stressors.
Individual and organizational well-being is critical for behavioral health providers. In addition to improving their personal and professional lives, it may also lead to better services and outcomes for the children they serve. Dr. Hoover introduced ProviderWellBeing.org, a new free resource to help promote both individual and organizational provider well-being. The online resource was developed by Dr. Hoover’s team at the University of Maryland School of Medicine in partnership with the Central East Mental Health Technology Transfer Center (MHTTC) and the Georgetown University Medstar Hospital/Georgetown School of Medicine.
ProviderWellBeing.org includes an individual well-being course that includes self-assessments to help users identify areas to work on, and then helps users create a personal well-being plan. The tool also includes a free organizational well-being assessment tool. Through the site, organizations can send the assessment out to employees to gather confidential feedback on the organization’s performance in eight key areas or “domains,” including:
Each domain has a list of criteria for staff to rate. The largest is the “Diversity, Equity, Inclusion and Access” domain, which Dr. Hoover called “a critical part of people feeling well and supported at work.” The online assessment tool will aggregate employees’ responses for the organization to review and use in developing an improvement plan.
“These practices are critical,” said Dr. Hoover. “And right now, in the context of attrition of our behavioral healthcare workforce, I am convinced that the organizations that attend to organizational well-being are those that will actually survive and thrive.” She added, “We can’t place the burden of well-being on the shoulders of our employees alone. Organizations really can and should share some of the burdens of promoting provider well-being.”
Visit www.ProviderWellBeing.org to access the free online tool.
[1] Source noted in Dr. Hoover’s presentation: CDC Mental Health–Related Emergency Department Visits Among Children Aged 18 Years During the COVID-19 Pandemic — United States, January 1–October 17, 2020 | MMWR (cdc.gov)
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