1WWW.MHAOFNYC.ORG

Reducing Counselor Burnout While Successfully Managing Growth

Anitha Iyer, PhDClinical Director, Here 2 Help Connect

Marshall EllisVice President of Crisis and Behavioral Health TechnologiesAssociate Project Director, National Suicide Prevention Lifeline

2WWW.MHAOFNYC.ORG

Overview• About Us

•What growth?

• Why engage our employees?

• Hypotheses

• Methods

• Findings (Fall Rollout)

• Recommendations

• Implementing recommendations

• Survey methods and summary of findings (Spring Rollout)

• Lessons and plans

3WWW.MHAOFNYC.ORG

About MHA-NYC

MHA-NYC is a leader in developing innovative approaches to address mental health needs

A nonprofit organization with a three-part mission of: ◦ Services

◦ Advocacy

◦ Education

Rooted in New York City, with a growing demand for services well beyond our borders.

4WWW.MHAOFNYC.ORG

Here2Help Connect

Here2Help Connect aims to be the nation’s model crisis center and a recognized leader in crisis services

To accomplish this vision we aim to:◦ Deliver clinical excellence and good customer service on every client

interaction

◦ Provide evidence-based services and contribute to the development of best practices for our field

◦ Utilize state-of-the-art technology solutions to deliver services

◦ Collaborate with our peers in the field by sharing our experiences and incorporating their successful innovative models into our services

◦ Support the professional development of our staff to become experts in the field

5WWW.MHAOFNYC.ORG

Our TeamHere2Help Connect has a dynamic team with a wide variety of backgrounds, experiences, and skill sets

◦ Full-time and part-time staff

◦ Workforce development program for MSW candidates

Here2Help Connect is organized into three main functional units to support six (6) contact center teams

Working together, we’re able to successfully help 200,000 individuals annually through our many programs

6WWW.MHAOFNYC.ORG

What growth?Evolving job in an emerging mental health landscape

Volume

Lines of service

Modes of service

Productivity per counselor

Metrics and Outcomes

7WWW.MHAOFNYC.ORG

Growth

0

50,000

100,000

150,000

200,000

250,000

2012 2013 2014

H2H Connect Inbound Call Volume

Total Processed

Serving more

people in more

ways

8WWW.MHAOFNYC.ORG

More Growth2015

Project/ Initiative J F M A M J J A-D

AHC for Major ProviderRerouting of Calls on Two ProgramsRevamp of Flagship ProgramNew Call ReportCall Management TrainingNew Strategy for Scheduling and ReportingPost-Call SurveyWebsite RedesignAdd 20 CounselorsAdd / Replace New ManagementNew QI FormNew Telephony SystemExpansion into Text of Flagship Program # 1Expansion into Text of Flagship Program # 2CIR Program Expansion

9WWW.MHAOFNYC.ORG

Benefits of Employee Engagement1

1 http://www.socialmediatoday.com/social-business/2015-04-06/shockingly-high-cost-disengaged-employees-infographic

10WWW.MHAOFNYC.ORG

Why Engage Our Employees?•Job Satisfaction-Job Performance heavily researched relationship2• Inconsistent results

• Many moderating variables

• Established leaders in contact center practices and processes

•First formalized process• Concrete recommendations

• Deliberate implementation

2 Judge, T.A., Thoresen, C. J., Bono, J. E., Patton, G. K. (2001). The job satisfaction-job performance relationship: A qualitative and quantitative review. Psychological Bulletin, 127 (3), 376-407.

11WWW.MHAOFNYC.ORG

‘Helper’ Engagement• Need to assess the impact of both the processes and changes, and the demands of the job itself

• Theoretical framework informs both variables studied and measure used2

• Compassion Satisfaction

• Compassion Fatigue• Burnout

• Secondary Traumatic Stress

2 www.proqol.org

12WWW.MHAOFNYC.ORG

Hypotheses

The following a priori hypotheses were generated

◦ The relationship between secondary traumatic stress and burnout will be moderated by external clinical employment such that:◦ Employees who are employed externally will report greater secondary traumatic stress and burnout

than employees who are not employed externally

◦ Employees who are employed externally in a clinical capacity will report greater secondary traumatic stress and burnout than employees who are not employed externally in a clinical capacity, and employees who are employed externally but not in a clinical capacity

◦ Perceived fairness of compensation : Burnout◦ As perception of low fairness in compensation increases, feelings of burnout will also increase

13WWW.MHAOFNYC.ORG

Methods

Survey administered for the first time on Friday, September 19, 2014◦ All H2H staff members were invited to participate in the survey

◦ Survey was open through Tuesday, September 23, 2014 at 11:59 pm

◦ ProQOL, and SRS

Survey administered for the second time on Wednesday, March 18, 2015◦ Survey was open through Wednesday, March 25, 2015 at 11:59 pm

◦ ProQOL

Data were deidentified (associated emails removed) by MHA’s IT representative

Analyzed using SPSS

An inter-division data workgroup was formed

14WWW.MHAOFNYC.ORG

FindingsSEPTEMBER 2014

15WWW.MHAOFNYC.ORG

Background Characteristics of Participants

Age of Participating H2H Employees

18-25 years old 26-33 years old

34-41 years old 42 and above

Length of MHA Employment

Less than 2 years

3-5 years

5-7 years

8-10 years

Greater than 10 years

16WWW.MHAOFNYC.ORG

External Employment

0

10

20

30

40

50

60

70

ExternalEmployment Full-Time Part-Time None

H2H Employees With Additional External Employment

0

20

40

60

80

ExternalClinical

Employment

Full-Time Part-Time None

H2H Employees With Additional External Clinical Employment

17WWW.MHAOFNYC.ORG

Impressions of the Workplace

0

10

20

30

40

50

60

Str

ong

ly D

isag

ree

Dis

agre

e

Nei

ther

Agr

ee N

or D

isag

ree

Agr

ee

Str

ong

ly A

gree

Str

ong

ly D

isag

ree

Dis

agre

e

Nei

ther

Agr

ee N

or D

isag

ree

Agr

ee

Str

ong

ly A

gree

Str

ong

ly D

isag

ree

Dis

agre

e

Nei

ther

Agr

ee N

or D

isag

ree

Agr

ee

Str

ong

ly A

gree

Str

ong

ly D

isag

ree

Dis

agre

e

Nei

ther

Agr

ee N

or D

isag

ree

Agr

ee

Str

ong

ly A

gree

Str

ong

ly D

isag

ree

Dis

agre

e

Nei

ther

Agr

ee N

or D

isag

ree

Agr

ee

Str

ong

ly A

gree

Str

ong

ly D

isag

ree

Dis

agre

e

Nei

ther

Agr

ee N

or D

isag

ree

Agr

ee

Str

ong

ly A

gree

“I am fairly compensated"

“I l ike my shift” “I am learning from my peers”

“I am learning from my supervisor(s)”

“I have opportunities for growth within the

organization”

“I have opportunities for professional

development within the organization”

18WWW.MHAOFNYC.ORG

Mean Scores on Outcome Variables

0 5 10 15 20 25 30 35

Compassion Satisfaction

Burnout

Secondary Traumatic Stress

34.19

25.4

19.87

Means of Key Outcome Variables

Compassion Satisfaction: Average

Burnout: Average

Secondary Traumatic Stress: Low

19WWW.MHAOFNYC.ORG

FindingsMultiple Regressing Analyses to Verify Hypotheses

Outside Clinical Employment : Burnout ◦ β = 6.749 (p < 0.05)

Perceived fairness of compensation : Burnout ◦ β = -6.545 (p < 0.05)

◦ Model (R2 < 0.452, p < 0.05) included Outside Clinical Employment

Perceived fairness of compensation : Compassion Satisfaction ◦ β = 4,731 (p < 0.01)

◦ Model (R2 < 0.464, p < 0.05) included Outside Employment, Outside Clinical Employment, and Learning from Supervisor

20WWW.MHAOFNYC.ORG

Recommendations

Clinical Practice◦ Enhance training and supervision

◦ Focused training and supervision around self-awareness, self-care, and the effects of helping professions

◦ Provide education around effects of external clinical employment during recruitment and training

◦ Professional development

Operations◦ Better clarity with next round to gauge team/shift effects

HR◦ Recommendations for considering compensation practices

21WWW.MHAOFNYC.ORG

Implementing RecommendationsTeams

Added individual supervision

Call management training

Wellness Committee

Increase in staffing

New phone system

New call report

Post call survey

New QI form and feedback

Added pressure/volume

Pause on group supervision

Departure of some well-liked staff

22WWW.MHAOFNYC.ORG

Assessing Impact• Re-assessing employee engagement after 6 months

• Assessing the impact of implemented recommendations

• …And then some

• Data gathering followed the same methods• Some responding staff were new and had not participated in September

survey

23WWW.MHAOFNYC.ORG

FindingsMARCH 2015

24WWW.MHAOFNYC.ORG

Background Characteristics of Participants

Age of Participating H2H Employees

18-25 years old 26-33 years old

34-41 years old 42 and above

Length of MHA Employment

Less than 2 years

3-5 years

5-7 years

8-10 years

Greater than 10 years

25WWW.MHAOFNYC.ORG

External Employment

0

10

20

30

40

50

60

70

80

ExternalEmployment Full-Time Part-Time None

H2H Employees With Additional External Employment

0

20

40

60

80

100

ExternalClinical

EmploymentFull-Time Part-Time None

H2H Employees With Additional External Clinical Employment

26WWW.MHAOFNYC.ORG

Mean Scores on Outcome Variables

0 5 10 15 20 25 30 35

Compassion Satisfaction

Burnout

Secondary Traumatic Stress

33.18

21.9*

17.85

Means of Key Outcome Variables

Compassion Satisfaction: Average

Burnout: Low; Difference is statistically significant (p<0.05)

Secondary Traumatic Stress: Low

27WWW.MHAOFNYC.ORG

Lessons and Plans• Engaging employees is good

• Particularly good in periods of growth

• Especially, in concrete, measurable ways

• And definitely, if you incorporate their feedback in observable ways

• H2H plans to incorporate employee engagement surveys bi-annually

• Happy to share findings, ideas, and strategies!

28WWW.MHAOFNYC.ORG

Engagement Strategies• Business objectives Staff ideas

• Comprehensive strategies• Encourage collaboration on key projects (call report, QI form)

• Ask for ideas and be open to implementing them

• Trust in decision making (empowering in day-to-day management)

• Wellness committee

• Quarterly recognition events

• Include in workgroups (data analysis)

• Simple strategies• Post-it activities

• Paint colors, books for library

29WWW.MHAOFNYC.ORG

Engaging Can Be Simple

30WWW.MHAOFNYC.ORG

Thank You!William Liu

Melissa Chounet

Data Workgroup: William Liu, Lauri Benblatt, Caroline Kaye, Richard Omega, Norbert Lewis

Jean Sandler, Lynn Kaplan, Dely Santiago, David Truzman, Gloria Jetter, All Supervisors, All Counselors

31WWW.MHAOFNYC.ORG

Questions