Going, going, gone: Provider turnover in Hawaiʻi’s youth public mental health system

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2025-05

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Provider turnover in public mental health systems disrupts therapeutic relationships and compromises treatment continuity, particularly affecting vulnerable youth populations. This qualitative study examined factors influencing provider turnover and retention in Hawai‘i's public youth mental health system through semi-structured interviews with both direct service providers (n=3) and supervisors/administrators (n=7) from Child and Adolescent Mental Health Division (CAMHD) contracted agencies. The interviews were transcribed and coded via inductive coding method. Analysis revealed nine key themes affecting turnover and retention: employee compensation (25.90% of themes), supervision and support (12.23%), autonomy and flexibility (11.51%), leadership and organizational culture (11.51%), work environment (10.79%), caseload (8.63%), provider job fit and individual factors (7.91%), training and professional development (7.19%), and administrative burdens (4.32%). The findings highlight the need for systemic changes needed to support workforce stability in Hawaii's youth mental health system. This study provides valuable insights for behavioral health organizations and policymakers to develop targeted retention strategies that maintain service quality and continuity for youth requiring mental health services.

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Psychology, behavioral health, employee retention, employee turnover, public sector, qualitative, youth mental health

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65 pages

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