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Staffing patterns in rural community support programs

E J Hollingsworth1, M K Pitts, D McKee

  • 1Mental Health Research Center, University of Wisconsin, Madison 53706.

Hospital & Community Psychiatry
|November 1, 1993
PubMed
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Rural mental health programs may not face the severe staffing shortages often claimed. A survey of Wisconsin programs found experienced staff and manageable caregiver-to-client ratios, suggesting a closer examination of these rural mental health staffing issues is needed.

Area of Science:

  • Mental Health Services Research
  • Rural Health Workforce Studies
  • Community Support Programs

Background:

  • Rural mental health programs are often perceived to struggle with staff recruitment, retention, and high caseloads.
  • Existing assumptions about acute staffing problems in these settings warrant closer investigation.

Purpose of the Study:

  • To assess staff size, characteristics, and staff-to-client ratios in rural Wisconsin community support programs.
  • To determine the extent of paraprofessional versus professional staff utilization in these programs.

Main Methods:

  • Survey of 12 community support programs in small cities and rural Wisconsin.
  • Data collection on full-time-equivalent caregiving staff, caregiver-to-client ratios, staff demographics, salaries, and turnover.

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  • Exclusion of psychiatrists from staff analysis.

    • Main Results:

    • Average of 5.6 full-time-equivalent caregiving staff per program with a 1:13 caregiver-to-client ratio.
    • Caregiving staff were predominantly female, with an average of 8.8 years of experience and a mean salary of $20,732.
    • Approximately 38% of caregivers were paraprofessionals, a proportion higher in rural settings, correlating with lower salaries and experience levels.

    Conclusions:

    • Rural community support programs in the study employed experienced staff and met recommended caregiver-to-client ratios.
    • The findings challenge the notion of widespread acute staffing problems in rural mental health programs.
    • Further research should explore the link between staff characteristics and client outcomes in these settings.