Planning and Implementing an Organizational Health Assessment in a Community Mental Health Setting

Background/Purpose: The community mental health (CMH) workforce is the driving force behind mental health service provision and the most valuable asset to any CMH organization. In order to build and retain a stable and healthy workforce, systematic recruitment and retention strategies are needed. An organizational health assessment (OHA) is one valuable tool in developing targeted organizational interventions aimed at creating a positive work environment and retaining an engaged workforce (Glisson, 2007; Hemmelgarn, et al., 2006; Potter et al., 2016). Starting in 2017, a large CMH agency implemented an OHA to drive actionable steps to improve employee experience and decrease turnover.

Methods: This is a case study of a large CMH agency developing and implementing a low-cost OHA to improve staff experience and turnover. This case study describes the five phases of the study: Development of the assessment tool, data collection, analysis, metrics and data visualization, and dissemination of findings. Based on current theory and literature in the human services sector, a survey was designed to assess the following factors: (a) job satisfaction, (b) affective engagement, (c) team commitment, (d) connection to mission, (e) relationship to supervisor, (f) communication satisfaction, (g) diversity climate, (h) role ambiguity, (i) pressure to produce, (j) job (k) burnout, and (l) intention to leave. We identified validated scales to assess the above-mentioned factors. The survey was distributed to 503 clinical and non-clinical staff with a response rate of 77% in its first year of implementation.

Results: A path model was used to test the interrelationships between organizational health factors and turnover intentions. We modeled each factor’s relationships to intention to leave mediated by engagement, burnout, and job satisfaction. This allowed us to understand the relative impact each health factor had on turnover intentions, how they are related to each other, and how addressing one may potentially impact the other. Then, based on the results of the analysis, we developed two-page profiles that included the key metrics and cut-off scores for each factor. These cut-off scores were the point that differentiates those who were likely to be intent on leaving the agency in the next few years or not. The profiles were standardized and data could be easily subset to compare findings by subgroups, such as work unit, locations, and positions.

Conclusion/Implications: To successfully implement an OHA, an organization needs to focus on the utilization of the assessment results. This allows the staff to see that their voices are being heard and changes are being made based on their feedback. The organization’s leadership needs to support the OHA process, clearly communicate the value of the assessment, be committed to the anonymity of the individual responses, and be committed to utilizing the assessment results for improvement. Also, managers must be given a safe place to reflect on the OHA results. Self-reflection should be encouraged and praised without being punitive. Lastly, it is recommended that the OHA be completed for multiple years to look at trends over time and minimize the seasonal effect that can impact the results.