2022 California Council of Community Behavioral Health Agencies (CBHA) Conference

Lessons of COVID-19: Staff Dedication and Skill Key to Success

The Institute for Community Living (ICL) compass shines brightly on our North Star: “People get better with us.” This simple yet profound message has given us meaning and purpose during unprecedented social upheaval. We know, empirically, that what matters most and keeps people in their job is meaning and purpose. In its ranking of employment qualities, for example, the Society of Human Resource Management put “respectful treatment of employees” first, with opportunities “to use their skills and abilities to make a difference” third. Interestingly, compensation came in fifth.

Our Culture is the Wind Beneath Our Wings

At ICL, there were countless examples of staff at every level going beyond expectations to be there for clients and for each other. Here are reflections from two senior staff from our housing divisions.

“Our staff showed up, day after day, during the height of the pandemic – providing support and reassurance, sharing updates as government guidance changed daily. Whatever people needed, staff provided – food for clients afraid to shop or medications they weren’t able to get. Our frontline staff supported each other as well – covering shifts when other staff were out sick or quarantined. We really did get through it all together.”
Sharon Sorrentino, VP, Child, Family and Young Adult Services

“Our staff teamed up and delivered food, PPEs, and monthly checks to clients. Garbed in PPEs they checked in on high-risk clients with medical challenges, secured wrap-around services as needed. Staff checked in on each other; reached out through regular phone calls to make sure they were okay, asked what they needed and how their families were doing. We did everything we could to stay connected and provide support when other staff needed it.”
Soniar Clarke, VP, Supportive Housing

In more common disasters, there is an overwhelming all-hands-on-deck and “rush to cure” response. What has been unbelievably unique about the pandemic is its’ length and persistence, demanding protracted efforts and calling into action sustained resiliency and resources. While most organizations can respond in the short term, it has been the strength of the ICL culture that has maintained a heightened response over the long haul.

Because of the steps ICL has taken over the years to emphasize the meaning and purpose of our work, these winning attributes have become embedded in our organizational fabric. One important dimension of our “people get better with us” culture, is that all of us – regardless of our roles—prioritized safety while keeping all of our programs open during the pandemic.

We know it will take years for our country – and the world – to adequately heal and adapt to life post-pandemic. It was clear from the earliest days of COVID-19 that physical health challenges would extend far into the future. What was unexpected to most of the world—though not to the behavioral health provider community – was the extent of the toll on emotional and psychological health, and the subsequent pressure this places on an already overwhelmed care system. So, what can we do to address this dilemma?

ICL Full Page Fall 2021

What helped ICL respond effectively to the onslaught of challenges in the worst days of the pandemic is at the heart of our success. Staff began every day filled with purpose knowing they were essential, that their efforts, compassion, and self-sacrifice contributed to literally saving lives and sustaining wellness and recovery. They buoyed each other with inspiring stories and unconditional support.

Backed by an organizational culture that encourages staff to look beyond programmatic boundaries and gives them the skills to do so, their understanding of the multi-level impact on clients, families and communities helped strategize where care would be most needed. And then, how to deliver that care in the face of the pandemic’s myriad of obstacles.

Home visits are a lifeline for our clients, and staff knew they were more important than ever. Always with full PPE, staff made frequent home visits to make sure the most fragile and isolated clients had nutritious food, medications, and a feeling that they mattered, that we cared about them, and that they were not alone.

We recognized that working in the pandemic is a second “full time job” requiring all of us to re-prioritize what matters most to staff and clients. The well-being of our staff is always important and was heightened from the outset. The depth of our staff’s commitment is so ingrained that, in the beginning, we had to actually discourage staff from visiting clients for everyone’s safety.

Organizational culture endures with consistent, transparent messaging. We used every means of communication as often as possible, offering coping tips and strategies as well as guidance on new ways to serve clients. We designed our leadership weekly huddles to be our central hub of information and highly responsive to staff. We established frequent virtual and in person staff check-ins, facilitated numerous virtual town halls for all shifts including our overnight staff, consistently shared stress management and work/life balance tips, and increased supervision. We translated and synthesized governmental guidance into easy to follow action steps. And our safety action steps included distributing over 1 million pieces of PPE, frequent hyper-vigilant cleaning of facilities and offices, and social distancing reinforced with posters—some designed by clients. Since the vaccine became available, we have embarked on informational campaigns, partnered with Community HealthCare Network for onsite vaccine drives, and fully support people to get tested.

Our staff know that they make a difference, not just because we say so, but because we measure and share clients’ outcomes and clients’ views about their own care. Staff know that they are part of something larger than themselves. Routinely, we celebrate client success stories at small and large gatherings so everyone knows that people are getting better. We keep our promise by asking staff and clients “how are we doing?” One employee recently said, “ICL has made it possible for a guy like me to do this type of work and make a difference.” Another remarked, “Our team has more power to help people than is normally given to staff.”

For many years, everything we have done has been in service of an integrated whole health, whole person approach. It’s about getting people better, not in some ways, but in all ways. And everyone is part of – and recognize their role in – bringing to life our promise that “People Get Better with Us.” Or as one staff member put it, “It’s like a Make a Wish Foundation for our clients!”

A Shared Culture at the Heart of What We Do

Throughout these difficult months, we’ve used the ever deepening strength of our organizational culture and mission to offset the pandemic’s serious burden on clients and staff. “People Get Better with Us” is an all-encompassing promise – to staff, clients, and volunteers. More than a tagline, these words inspire and fulfill our work every day. And ALL of our staff – whether in payroll, maintenance or a supportive housing program – are an integral part of caring for people. We believe that the values of our organization guide not only how we relate to and work with clients, but create a place where staff feel that sense of shared purpose; we work hard to build community and human connection. “I’m integrated into all of the programs at ICL, so we are pulling together”, one employee told us recently. “And together we have more relationships and resources to help our clients.”

We’re especially proud that this shared culture has grown organically. In the end, what most bonds people together at ICL is knowing we are all part of “getting people better.”

Responding to the Next Wave of Mental Health Needs

We applaud the nation’s overdue recognition of the driving force of emotional well-being and mental illness. But this hopeful development is clouded by the current state of the behavioral health services system, particularly its workforce, which has always deserved adequate compensation, respect, and appreciation for essential life-saving work.

According to a report issued earlier this year by SAMHSA (federal Substance Abuse and Mental Health Services Administration), national behavioral health needs require a workforce of at least 4.5 million; yet there are only some 700,000 individuals working in behavioral health, including substance use disorder services. This leaves a 4-million-person shortage for behavioral health services.

The SAMHSA report offers a number of recommendations for filling this gap, including a national public education campaign about the need for behavioral health providers; encouraging students to pursue this career; and increasing loan forgiveness programs in behavioral health specialties to encourage entry to the field and increase the peer professional workforce.

On a more local level, there are many ways providers are addressing the workforce crisis. At ICL, we’ve focused significant resources over the past decade to reward staff for the critical work they are doing – in tangible ways like raising salaries or giving bonuses when we are able; offering a matching pension plan; and absorbing skyrocketing insurance premiums (in the millions of dollars each year) so our staff does not have to. Our strategic plan includes increasing investment in leadership, administrative and clinical competencies, elevating our employee wellness, actively support work-life balance, advancing overall whole person health, and preventing burn-out.

While the workforce shortage is unnerving and we are all waiting for the federal and state initiatives to take hold, where are those 700,000 people going to choose to work?

David Woodlock is CEO and Pamela Mattel, LMSW, is COO at the Institute for Community Living (ICL).

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