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Staffing Challenges and Strategies for Organizations Serving Individuals who have Experienced Chronic Homelessness

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Abstract

Hiring and retaining appropriate staff is essential for programs serving those who have experienced chronic homelessness. This paper describes specific staffing challenges and strategies from the Collaborative Initiative to Help End Chronic Homelessness (CICH), an 11-site, multi-agency Federal program designed to serve people experiencing chronic homelessness who also have a disabling condition such as substance use or mental health problems. This paper addresses approaches to staffing including team structures, staff supervision, and training. Challenges identified include low pay, high rates of burnout and turnover, limited time for supervision, and multiple staff training needs. This paper also explores specific staffing strategies based on the experience of the CICH sites, and concludes with implications for practice, research, and policy, including recommendations for ongoing staff training, suggestions for future mixed-methods research, and a call for an enhanced focus on strengthening the homeless services workforce.

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References

  1. National Alliance to End Homelessness. Ten Year Plan Snapshot 2007. Available at: http://www.endhomelessness.org/section/tools/tenyearplan/snapshot.

  2. National Alliance to End Homelessness (NAEH). Chronic Homelessness Brief 2007. Available at: http://www.endhomelessness.org/content/article/detail/1060/.

  3. Collaborative Initiative to Help End Chronic Homelessness Notice of Funding Availability. Federal Register. 2003;68(1):4019.

    Google Scholar 

  4. Caton CLM, Dominguez B, Schanzer B, et al. Risk factors for long-term homelessness: findings from a longitudinal review of first-time homeless single adults. American Journal of Public Health. 2005;95(10):1753–1759.

    Article  PubMed  Google Scholar 

  5. Kertesz SG, Larson MJ, Horton NJ, et al. Homeless chronicity and health-related quality of life trajectories among adults with addictions. Medical Care. 2005;43(6):574–585.

    Article  PubMed  Google Scholar 

  6. Padgett DK, Gulcur L, Tsemberis S. Housing First services for people who are homeless with co-occurring serious mental illness and substance abuse. Research on Social Work Practice. 2006;16:74–83.

    Article  Google Scholar 

  7. Yanos PT, Barrow SM, Tsemberis S. Community integration in the early phase of housing among homeless persons diagnosed with severe mental illness: successes and challenges. Community Mental Health Journal. 2004;40(2):133–150.

    Article  PubMed  Google Scholar 

  8. Burke J. Educating the staff at a homeless shelter about mental illness and anger management. Journal of Community Health Nursing. 2005;22(2):65–76.

    Article  PubMed  Google Scholar 

  9. Corporation for Supportive Housing (CSH). Toolkit for ending long-term homelessness 2007. Available at: http://www.csh.org/index.cfm?fuseaction=Page.viewPage&pageId=3422.

  10. Rickards LD, McGraw SA, Araki L et al. Collaborative initiative to help end chronic homelessness: Introduction. 2009. In press.

  11. Culhane D, Metraux S, Hadley T. Public service reductions associated with placement of homeless persons with severe mental illness in supportive housing. Housing Policy Debate. 2002;13(1):107–163 Fannie Mae Foundation.

    Google Scholar 

  12. McGraw S, Larson MJ, Foster S et al. Adopting best practices: lessons learned in the Collaborative Initiative to Help End Chronic Homelessness (CICH). 2009 In press.

  13. Kresky-Wolff M, Larson MJ, O’Brien R. Supportive Housing Approaches in the Chronic Homelessness Initiative. 2009 In press.

  14. Prosser D, Johnson S, Kuipers E, et al. Mental health, “burnout” and job satisfaction in a longitudinal review of mental health staff. Social Psychiatry and Psychiatric Epidemiology. 1999;34:295–300.

    Article  CAS  PubMed  Google Scholar 

  15. Fisk D, Rakfeldt J, Heffernan K, et al. Outreach workers’ experiences in a homeless outreach project: Issues of boundaries, ethics and staff safety. Psychiatric Quarterly. 1999;70(3):231–246.

    Article  CAS  PubMed  Google Scholar 

  16. Young AS, Grusky O, Sullivan G, et al. The effect of provider characteristics on case management activities. Administration and Policy in Mental Health. 1998;26(1):21–32.

    Article  CAS  PubMed  Google Scholar 

  17. Whitter M. Strengthening professional identity: Challenges of the addictions treatment workforce: A framework for discussion. Rockville, MD: Center on Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration; 2006.

    Google Scholar 

  18. Annapolis Coalition. An action plan for behavioral health workforce development: A framework for discussion. Rockville, MD: Substance Abuse and Mental Health Services Administration, Department of Health and Human Services; 2007.

    Google Scholar 

  19. Institute of Medicine of the National Academies. Improving the quality of health care for mental and substance use conditions. Washington, DC: The National Academies Press; 2006.

    Google Scholar 

  20. Olivet J, Mullen J, Paquette K, et al. Core Skills for the Homeless Services Workforce: Proposed Training Curricula for Service Providers and Administrators. Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration; 2007 In press.

    Google Scholar 

  21. Reid Y, Johnson S, Morant N, et al. Improving support for mental health staff: a qualitative study. Social Psychiatry and Psychiatric Epidemiology. 1999;34:309–315.

    Article  CAS  PubMed  Google Scholar 

  22. Aarons G. Measuring provider attitudes toward evidence-based practice: consideration of organizational context and individual differences. Journal of Child and Adolescent Psychiatric Clinical Nursing. 2005;14(2):255–viii.

    Article  Google Scholar 

  23. Lemak CH, Alexander JA. Factors that influence staffing of outpatient substance abuse treatment programs. Psychiatric Services. 2005;56(8):934–939.

    Article  PubMed  Google Scholar 

  24. Graham HL. Implementing integrated treatment for co-existing substance use and severe mental health problems in assertive outreach teams: training issues. Drug and Alcohol Review. 2004;23:463–470.

    Article  PubMed  Google Scholar 

  25. Felton JS. Burnout as a clinical entity—its importance in health care workers. Occupational Medicine. 1998;48:237–250.

    Article  CAS  PubMed  Google Scholar 

  26. Gomez JS, Michaelis RC. An assessment of burnout in human service providers. Journal of Rehabilitation. 1995;61(1):23–26.

    Google Scholar 

  27. Leiter MP, Meechan KA. Role of structured burnout in the field of human services. Journal of Applied Behavioral Science. 1986;22(1):47–52.

    Article  CAS  PubMed  Google Scholar 

  28. Maslach C, Jackson SE. The measurement of experienced burnout. Journal of Occupational Behaviour. 1981;2:99–113.

    Article  Google Scholar 

  29. Schulz R, Greenley JR, Brown R. Organization, management, and client effects on staff burnout. Journal of Health and Social Behavior. 1995;36(4):333–345.

    Article  CAS  PubMed  Google Scholar 

  30. Sorgaard KW, Ryan P, Hill R, et al. Sources of stress and burnout in acute psychiatric care: Inpatient vs. community staff. Social Psychiatry and Psychiatric Epidemiology. 2007;42:794–802.

    Article  PubMed  Google Scholar 

  31. Corrigan PW, Garman AN, Lam C, et al. What mental health teams want in their leaders. Administration and Policy in Mental Health. 1998;26(2):111–123.

    Article  CAS  PubMed  Google Scholar 

  32. Knudsen HK, Johnson JA, Roman PM. Retaining counseling staff at substance abuse treatment centers: Effects of management practices. Journal of Substance Abuse Treatment. 2003;24:129–135.

    Article  PubMed  Google Scholar 

  33. Aarons G. Transformational and transactional leadership: association with attitudes toward evidence-based practice. Psychiatric Services. 2006;57:1162–1169.

    Article  PubMed  Google Scholar 

  34. Stetler C, Ritchie J, Rycroft-Malone J, et al. Improving quality of care through routine, successful implementation of evidence-based practice at the bedside: an organizational case study protocol using the Pettigrew and Whipp model of strategic change. Implementation Science. 2007;2(3):1–13.

    Google Scholar 

  35. Boyer SL, Bond GR. Does assertive community treatment reduce burnout? A comparison with traditional case management. Mental Health Services Research. 1999;1(1):31–45.

    Article  Google Scholar 

  36. Leda C, Rosenheck R, Fontana A. Impact of staffing levels on transitional residential treatment programs for homeless veterans. Psychosocial Rehabilitation Journal. 1991;15(1):55–67.

    Google Scholar 

  37. Scientific Software Development GmbH, Atlas.ti (version 5.2), http://www.atlasti.de; 2007.

  38. Bradley EH, Curry LA, Devers KJ. Qualitative data analysis for health services research: developing taxonomy, themes, and theory. Health Service Research. 2007;42(4):1758–1772.

    Article  Google Scholar 

  39. Miles MB, Huberman AM. Qualitative data analysis: an expanded sourcebook. 2nd edn. Thousand Oaks, CA: Sage; 1994.

    Google Scholar 

  40. Strauss A, Corbin J. Basics of qualitative research: grounded theory procedures and techniques. Newbury Park: Sage; 1990.

  41. Larson MJ, McGraw S, Kresky-Wolff, M, et al. Applying the Concepts of “Housing First” and “Low Demand” in Programs for Individuals Experiencing Chronic Homelessness. In press.

  42. Gundlapalli A, Hanks M, Stevens SM, et al. It takes a village: a multidisciplinary model for the acute illness aftercare of individuals experiencing homelessness. Journal of Health Care for the Poor and Underserved. 2005;16(2):257–272.

    Article  PubMed  Google Scholar 

  43. Prescott L, Harris L. Moving Forward, Together: Integrating Consumers as Colleagues in Homeless Service Design, Delivery and Evaluation 2007; pending publication.

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Acknowledgements

Recognition and appreciation to the members of the Policy Group that developed the Collaborative Initiative to Help End Chronic Homelessness: ICH: Philip F. Mangano and Mary Silveira; HHS: Walter Leginski, Jane Taylor, Michael J. English, Frances L. Randolph, Jean Hochron, and Lyman Van Nostrand; HUD: John Garrity, Mark Johnston, and Laura Hogshead; and VA: Pete Dougherty, Robert Rosenheck, and Al Taylor. Recognition and appreciation also to Megan Renfrew, Elizabeth Mason, and Emily Elstad of New England Research Institutes (NERI).

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Authors and Affiliations

  1. National Center on Family Homelessness, 181 Wells Avenue, Newton, MA, 02459, USA

    Jeffrey Olivet MA, Megan Grandin & Ellen Bassuk MD

  2. Center for Qualitative Research, New England Research Institutes, 9 Galen Street, Watertown, MA, 02742, USA

    Sarah McGraw PhD

Authors
  1. Jeffrey Olivet MA
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  2. Sarah McGraw PhD
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  3. Megan Grandin
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  4. Ellen Bassuk MD
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Correspondence to Jeffrey Olivet MA.

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Olivet, J., McGraw, S., Grandin, M. et al. Staffing Challenges and Strategies for Organizations Serving Individuals who have Experienced Chronic Homelessness. J Behav Health Serv Res 37, 226–238 (2010). https://doi.org/10.1007/s11414-009-9201-3

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  • DOI: https://doi.org/10.1007/s11414-009-9201-3

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