How a “mental health crisis” led these nonprofits to retool office culture

In First Step House’s Central City admissions office, Paulette Anderson, with short, curly hair, round glasses, and a warm, steady demeanor, is often the first person visitors see.

“Everyone who comes in is family,” she said. “I’m here when you’ve hit rock bottom and just need someone to talk to. If all you have to do is cry, you can do that.”

First Step House is a nonprofit organization that provides drug use disorder recovery and supportive housing services to some of Salt Lake City’s most vulnerable residents, a safety net for people who might not otherwise have one.

The services offered at the facility are vital in a city where the number of homeless people has increased by 14% from 2020 to 2021 and demand for mental health treatments has increased across the country.

But while the need for mental health, drug use treatment, and supportive housing services may grow, organizations across the US that serve these populations are struggling to recruit enough people to fill positions. An analysis found that in Utah and Wyoming, “the largest proportion of their populations live in areas with a lack of mental health.”

The country is in the midst of a “mental health crisis,” said Shawn McMillen, executive director of First Step House.

(Leah Hogsten | The Salt Lake Tribune) Shawn M. McMillen, Executive Director of First Step House, and Jazz Hamilton, Human Resources Director, October 4, 2022. First Step House provides comprehensive care and treatment for people diagnosed with a substance use disorder became. mental illness, veterans, those involved in the criminal justice system, those on low or no income, and those living in unstable or no homes.Ê

Last August, Odyssey House, another nonprofit behavioral health services organization, had a 20% vacancy rate. That’s now down to about 10%.

“We’re making progress,” said Emily Tillett, Odyssey House’s chief people and infrastructure officer, “but it’s still not the same as it was five years ago when we folks were lining up on the street to come and work for us.”

First Step House also hired more staff and now has a vacancy rate of just under 3%, according to Jazz Hamilton, First Step House’s human resources director.

First Step House and Odyssey House have been recognized as Top Workplaces for several years, including 2022, and have had some success in retaining and attracting new employees at a time when many behavioral health services are struggling. The Salt Lake Tribune asked workers and managers at the two nonprofits what they do differently.

Shorter working hours, higher pay

Raye Silvers, Admissions Manager, has worked at First Step House for 16 years.

During the pandemic, she had to work longer hours. “The need has always been great,” Silvers said, but during the pandemic she began seeing people with “higher vision.”

Assessing the mental and physical strain on staff, First Step House switched to a four-day work week and Silvers reduced their hours slightly. This change allowed her to join a gym, take yoga classes, and take long walks with her dog while still getting about the same amount of work done.

(Leah Hogsten | The Salt Lake Tribune) Raye Silvers, Admissions Manager for First Step House, October 4, 2022. First Step House provides comprehensive care and treatment for people diagnosed with a substance use disorder, mental illness, veterans and those who died on criminal justice system, people with little or no income and people who have unstable or no housing.

The move to a four-day workweek is just one of the recent changes aimed at improving employee morale, retention rates and burnout, Hamilton explained.

“We’re trying to reorder the ‘to-do’ lists,” Hamilton said. “What are the most impactful things you can do? What can be thrown around by tomorrow or next week?”

Hamilton noted that while bosses cut the workweek, they also increased wages. He said their lowest-paid employee is now making nearly $19 an hour.

Odyssey House has also increased salaries in recent years, Tillet said. This was due in part to an increase in Medicaid reimbursement rate changes enforced through state legislation.

“In the last two years, wages have increased by at least 25% in most of our positions,” she said. “That was a big thing for us. Medicaid has been static since the beginning of time. Now we have finally made a breakthrough, and this is having an impact on our employees and customers.”

Education and training opportunities

The non-profit organizations also retain employees through training and further education opportunities.

At Odyssey House, Tillett said, those who stay with the nonprofit for a year are eligible for a $9,000-a-year tuition reimbursement program if they are pursuing degrees in behavioral health-related subjects.

Certain employees are also eligible for loan forgiveness from the National Health Service Corps.

Evelyn Anderson, a licensed clinical social worker at Odyssey House, uses this program. She began her internship at Odyssey House after completing her master’s degree online at a university in Texas. During her internship, HR sent out emails about the program, and she made a note to apply once she was eligible.

She has now had most of her student loans waived and is about halfway through the program.

“I would have definitely been in that field,” said Evelyn Anderson. “I’d be here whether it was or not, but it’s really helpful.”

She loves her job in part because “it’s really, really rewarding to watch people’s lives actually get back on track and then work through all of their mental health issues that led to their drug use.”

She said working for a nonprofit and with people who are sometimes in court-ordered treatment makes her job more difficult and less lucrative than others in her field.

But seeing people go through treatment on their “own terms” is worth it. “It can be more rewarding in the end,” she said, “even if it’s harder in the beginning.”

Supportive and authentic

Both nonprofits offer employee assistance programs for employees who need mental health support.

(Leah Hogsten | The Salt Lake Tribune) First Step House provides comprehensive care and treatment for people diagnosed with addictions, mental illnesses, veterans, those involved in the criminal justice system, those on low to no income and all of these who have unstable or no accommodation. The facility serves over 1,200 people a year who arrive with very little resources, a lack of support and numerous obstacles to overcome.

They also try to create supportive environments not only for customers but also for employees. “It’s a very supportive and authentic environment for workers,” said Hamilton of First Step House.

Even small things like the clothes people wear to work can be a recruitment tactic. At Odyssey House, “we want you to come to work as a whole person, so we advertise that we have a casual-dress vibe,” Tillett said.

“Everyone is open to ideas about how we can do things better,” said Evelyn Anderson, “both for employees and customers.”

First Step House’s Raye Silvers and Paulette Anderson say they have informal check-ins with each other following disruptive events – as if someone walks in screaming, yelling and drunk. Team members take time to acknowledge and discuss the sense of viewer trauma associated with these experiences.

For Anderson, who started working at First Step House about a year ago, those efforts have worked.

“This,” she said, “is the most fulfilling job I’ve ever had.” How a “mental health crisis” led these nonprofits to retool office culture

Justin Scacco

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