Why do Stayers Stay? Perceptions of White and Black Long-Term Employees in a Community Mental Health Center.

Previous research has focused on factors influencing turnover of employees in the mental health workforce, yet little research has explored reasons why employees stay. To facilitate retaining a diverse mental health workforce, the current study aimed to elucidate factors that contributed to employees' tenure at a community mental health center (CHMC) as well as compare these perceptions between Black and White employees. Long-term employees (7 years or more) from one urban CMHC (n = 22) completed semi-structured stayer interviews. Using emergent thematic analysis, stayer interviews revealed four major themes for why they have stayed at the organization for 7 years or more: (1) work as a calling, (2) supportive relationships, (3) opportunities for growth or meaningful contribution, and (4) organization mission's alignment with personal attributes or values. Comparison between Black and White stayer narratives revealed differences in their perceptions with work as a calling and opportunities for growth and meaningful contribution. Guided by themes derived from stayer interviews, the current study discusses theoretical (e.g., job embeddedness theory, theory of racialized organizations, self-determination theory) and practical implications (e.g., supporting job autonomy, Black voices in leadership) in an effort to improve employee retention and address structural racism within a mental health organization.

Machine Learning with Human Resources Data: Predicting Turnover among Community Mental Health Center Employees.

BACKGROUND: Human resources (HR) departments collect extensive employee data that can be useful for predicting turnover. Yet, these data are not often used to address turnover due to the complex nature of recorded data forms. AIMS OF THE STUDY: The goal of the current study was to predict community mental health center employees' turnover by applying machine learning (ML) methods to HR data and to evaluate the feasibility of the ML approaches. METHODS: Historical HR data were obtained from two community mental health centers, and ML approaches with random forest and lasso regression as training models were applied. RESULTS: The results suggested a good level of predictive accuracy for turnover, particularly with the random forest model (e.g., Area Under the Curve was above .8) compared to the lasso regression model overall. The study also found that the ML methods could identify several important predictors (e.g., past work years, wage, work hours, age, job position, training hours, and marital status) for turnover using historical HR data. The HR data extraction processes for ML applications were also evaluated as feasible. DISCUSSION: The current study confirmed the feasibility of ML approaches for predicting individual employees' turnover probabilities by using HR data the organizations had already collected in their routine organizational management practice. The developed approaches can be used to identify employees who are at high risk for turnover. Because our primary purpose was to apply ML methods to estimate an individual employee's turnover probability given their available HR data (rather than determining generalizable predictors at the wider population level), our findings are limited or restricted to the specific organizations under the study. As ML applications are accumulated across organizations, it may be expected that some findings might be more generalizable across different organizations while others may be more organization-specific (idiographic). IMPLICATIONS FOR HEALTH CARE PROVISION AND USE: The organization-specific findings can be useful for the organization's HR and leadership to evaluate and address turnover in their specific organizational contexts. Preventing extensive turnover has been a significant priority for many mental health organizations to maintain the quality of services for clients. IMPLICATIONS FOR HEALTH POLICIES: The generalizable findings may contribute to broader policy and workforce development efforts. IMPLICATIONS FOR FURTHER RESEARCH: As our continuing research effort, it is important to study how the ML methods and outputs can be meaningfully utilized in routine management and leadership practice settings in mental health (including how to develop organization-tailored intervention strategies to support and retain employees) beyond identifying high turnover risk individuals. Such organization-based intervention strategies with ML applications can be accumulated and shared by organizations, which will facilitate the evidence-based learning communities to address turnover. This, in turn, may enhance the quality of care we can offer to clients. The continuing efforts will provide new insights and avenues to address data-driven, evidence-based turnover prediction and prevention strategies using HR data that are often under-utilized.

Structural Racism, Workforce Diversity, and Mental Health Disparities: A Critical Review.

OBJECTIVE: Racial workforce diversity has been suggested as a critical pathway to address persistent racial mental health disparities. However, structural racism has been noted to diminish such workforce diversity efforts. The purpose of this critical review is to identify the mechanisms through which structural racism operates in organizations, including mental health organizations, to undermine workforce diversity efforts and reinforce inequities. METHODS: Using the theories of racialized organizations, the current review critically draws on literature underscoring the racial character of organizations as mezzo-level racialized structures that may systematically activate and uphold white privilege in the mental health workplace. RESULTS: Findings suggest that in the context of institutionalized white dominance, workers of color within mental health organizations may experience race-based cultural exclusion, identity threat, and racialized workplace emotional expression, and be burdened by racialized tasks. The workers of color may also become the means for organizations to attract communities of color due to their diverse characteristics, yet workers' effects to address disparities in mental health are minimized due to potential racialized organizational forces, including the whiteness of organizational leadership and color-blindness. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Structural racism may create resistance to the efforts and effects of a racially diverse workforce within mental health organizations. This review calls for a race-conscious framework that drastically shifts the traditional organizational structure to an inverted hierarchy (i.e., client-centered management) to maximize diversity efforts in the mental health organizational workforce to address racial disparities in mental health.

Differential impact, differential adjustments: diverse experiences of the COVID-19 pandemic by college students in an Upper-Midwestern University, USA.

The impact of the COVID-19 pandemic though widespread is not monolithic. Therefore, a differentiated understanding of the pandemic's impact on people is critical. Further, it is important to recognize that even within the same group people's experiences may differ. The current study explored how the onset of COVID-19 and its mitigation measures impacted university students across the broad spectrum of their lives. The study utilized a qualitative approach based on individual and focus group interviews through Zoom. Participants were recruited using convenience and purposive sampling strategies. Twenty-one students (mean age = 33.8, over 76% whites, 15 females) participated in the study. Guided by systems and ecological systems theories and grounded in a contextualist paradigm, the data were analyzed thematically. Pseudonyms were adopted to preserve the anonymity of the participants. The findings revealed that COVID-19 has impacted students in varied ways ranging from the seemingly simple to the multi-layered and complex. An overarching theme, "same storm, different boats", which conveys the notion of differential impact, and differential adjustments was identified. Nested under the overarching theme are two main themes (1) Impact of COVID-19: disruptions, stressors, and silver linings and (2) Coping with COVID-19. Participants reported positive as well as negative impacts. Factors that helped students cope included institutional support, empathy from instructors, and family support. The findings suggest that to effectively respond to the impact of COVID-19 on students, it will be important to identify and attend to the distinct and diverse stressors within this population, and systems and ecological systems theories are important guiding frameworks.