Keeping mental health workers on the job


In an attempt to retain staff who work on the front lines with the mentally ill, county health providers have teamed with Anne Arundel Community College to offer some employees tuition-free courses in counseling and psychology.

Organizers hope the effort will address a projected nationwide shortage of mental health workers in a field where salaries are low and turnover is high.

The goal is to encourage more people to pursue advanced degrees and long careers in the field.

"It could open up a career path which up until now has not existed," said Frank Sullivan, executive director of the county's mental health agency, which oversees providers in Anne Arundel.

"Most people who come in with a high school degree have no hopes of moving up through the ranks at a certain point, and we'd like to change that," said Sullivan, who approached the college about the partnership.

The employees typically work directly with patients in psychiatric rehabilitation programs, teaching them daily living skills and supervising group homes.

It's demanding and frequently stressful work.

"They're among the lowest-paid people in the mental health system," said Herbert S. Cromwell, executive director of the Community Behavioral Health Association, which represents community mental health programs in Maryland.

According to statewide surveys conducted by the association, annual salaries are generally in the low $20,000 range, and last year's average turnover rate was 35 percent.

But pay isn't the only factor in the workers' high turnover rate.

"A lot of it has to do with the way that employers make an individual feel valued, and that their work is meaningful and that they have the skills to do it," Sullivan said.

First class under way

Employees in six private, nonprofit psychiatric rehabilitation programs in the county began their classes last month with a minicourse to prepare them for college-level work and to refresh their study skills.

Now the class of 31 students, many of whom have not gone beyond high school, is immersed in the three-credit course: "Beginning Counseling and Assessment Techniques."

"Their work involves direct services with clients. The problem is they've never had formal training," said Elizabeth Appel, course instructor and chairwoman of the college's human services department.

"These are basic skills to give them some foundation," she said.

The students' tuition is covered by their employers and Sullivan's agency. The college waived application and registration fees.

"Most of the students are so enthusiastic and have said they want to continue and get an associate's degree," Appel said.

The catalyst for creating the program was a 1999 federal study of mental health services that projected a growing shortage of mental health workers during the next few years.

The report was a topic of discussion at a conference Sullivan attended in Annapolis last year.

"I thought I'd better try to get a jump on this as a local director and make sure our providers have some opportunities to entice people to stay in the field," he said.

Drug company's role

Pharmaceutical giant Eli Lilly and Company came to have a role in the project after Sullivan and a company representative, who also attended the conference, talked about the difficulty of retaining mental health workers.

The drug manufacturer developed the antidepressant Prozac.

Sullivan mentioned the possibility of offering classes to employees, and the representative told him about an Eli Lilly education manual called "Team Solutions."

The manual is written for patients with schizophrenia and other severe mental illnesses, and addresses the role of mental health care providers in a patient's life. The students work with an accompanying version designed for health care providers.

Chapters include: "Understanding Your Illness," "You and Your Treatment Team," "Helping Yourself to Prevent Relapse."

Appel said she's using the manual as a supplement to the college's courses.

"It's tailored specifically to what these people do," she said. "We're not changing the course content."

The manual, which has Eli Lilly's name on the cover, addresses the use of medications in treating mental illness, but doesn't refer to any specific drug company.

Sullivan said the Eli Lilly affiliation does not concern him.

He said the county's mental health agency works with most pharmaceutical companies to provide medications to the indigent population.

"I think they have a product that's selling itself," Sullivan said. "These medications work."

"They've helped us get people out of the hospital, and we're excited about that," he said.

Sullivan said that it's important to take steps to retain valuable employees, as Maryland's mental health system is facing a budget deficit caused by a lack of funding and increased demand for services. Many clinics are struggling to stay open, he said.

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