This document summarizes the efforts of MHA-NYC's Here2Help Connect crisis center to reduce counselor burnout while managing rapid growth. Surveys found external clinical employment and low compensation fairness correlated with increased burnout. Recommendations included enhanced training, supervision, and considering compensation. A follow-up survey after implementing changes found significantly lower reported burnout. Lessons highlighted engaging employees through meaningful involvement and feedback to promote well-being during organizational changes.

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Reducing Counselor Burnout While
Successfully Managing Growth
Anitha Iyer, PhD
Clinical Director, Here 2 Help Connect
Marshall Ellis
Vice President of Crisis and Behavioral Health Technologies
Associate Project Director, National Suicide Prevention Lifeline

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Overview
• About Us
•What growth?
• Why engage our employees?
• Hypotheses
• Methods
• Findings (Fall Rollout)
• Recommendations
• Implementing recommendations
• Survey methods and summary of findings (Spring Rollout)
• Lessons and plans

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AboutMHA-NYC
MHA-NYC is a leader in developinginnovative approachesto address mental
health needs
A nonprofitorganization with a three-part mission of:
◦ Services
◦ Advocacy
◦ Education
Rooted in New York City, with a growing demand for services well beyond our
borders.

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Here2HelpConnect
Here2Help Connect aims to be the nation’s model crisis center and a
recognized leader in crisis services
To accomplish this vision we aim to:
◦ Deliver clinical excellence and good customer service on every client
interaction
◦ Provide evidence-based services and contributeto the developmentof
best practices for our field
◦ Utilize state-of-the-arttechnology solutions to deliver services
◦ Collaborate with our peers in the field by sharing our experiences and
incorporating their successful innovativemodels into our services
◦ Support the professionaldevelopmentof our staff to become experts in
the field

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Our Team
Here2Help Connect has a dynamic team with a wide
variety of backgrounds, experiences, and skill sets
◦ Full-time and part-time staff
◦ Workforcedevelopmentprogram for MSW candidates
Here2Help Connect is organized into three main
functional units to support six (6) contact center teams
Working together, we’re able to successfully help
200,000 individuals annually through our many programs

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What growth?
Evolving job in an emerging mental health landscape
Volume
Lines of service
Modes of service
Productivity per counselor
Metrics and Outcomes

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Growth
0
50,000
100,000
150,000
200,000
250,000
2012 2013 2014
H2H Connect Inbound Call Volume
Total Processed
Serving more
people in more
ways

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MoreGrowth
2015
Project/ Initiative J F M A M J J A-D
AHC for Major Provider
Rerouting of Calls on Two Programs
Revamp of Flagship Program
New Call Report
Call Management Training
New Strategy for Scheduling and Reporting
Post-Call Survey
Website Redesign
Add 20 Counselors
Add / Replace New Management
New QI Form
New Telephony System
Expansion into Text of Flagship Program # 1
Expansion into Text of Flagship Program # 2
CIR Program Expansion

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Benefitsof EmployeeEngagement1
1
http://www.socialmediatoday.com/social-business/2015-04-06/shockingly-high-cost-disengaged-employees-infographic

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Why EngageOur Employees?
•Job Satisfaction-Job Performance heavily
researched relationship2
• Inconsistent results
• Many moderating variables
• Established leaders in contact center
practices and processes
•First formalized process
• Concrete recommendations
• Deliberate implementation
2 Judge, T.A., Thoresen, C. J., Bono, J. E., Patton, G. K. (2001). The
job satisfaction-jobperformance relationship: A qualitative and
quantitative review. Psychological Bulletin, 127 (3), 376-407.

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‘Helper’ Engagement
• Need to assess the impact of both the processesand changes, and the
demands of the job itself
• Theoretical framework informs both variables studied and measure
used2
• Compassion Satisfaction
• Compassion Fatigue
• Burnout
• Secondary Traumatic Stress
2 www.proqol.org

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Hypotheses
The following a priorihypotheses were generated
◦ The relationship betweensecondary traumatic stress and burnout will be
moderated by external clinical employment such that:
◦ Employees who are employed externally will report greater secondary traumatic stress and burnout
than employees who are not employed externally
◦ Employees who are employed externally in a clinical capacity will report greater secondary
traumatic stress and burnout than employees who are not employed externally in a clinical
capacity, and employees who are employed externally but not in a clinical capacity
◦ Perceivedfairness of compensation : Burnout
◦ As perception of low fairness in compensation increases, feelings of burnout will also increase

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Methods
Survey administered for the first time on Friday, September 19, 2014
◦ All H2H staff members were invited to participate in the survey
◦ Survey was open through Tuesday, September 23, 2014 at 11:59 pm
◦ ProQOL,and SRS
Survey administered for the second time on Wednesday, March 18, 2015
◦ Survey was open through Wednesday, March 25, 2015 at 11:59 pm
◦ ProQOL
Data were deidentified (associated emails removed)by MHA’s IT
representative
Analyzed using SPSS
An inter-division data workgroup was formed

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Findings
SEPTEMBER 2014

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BackgroundCharacteristicsof Participants
Age of Participating H2H Employees
18-25 years old 26-33 years old
34-41 years old 42 and above
Length of MHA Employment
Less than 2 years
3-5 years
5-7 years
8-10 years
Greater than 10 years

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ExternalEmployment
0
10
20
30
40
50
60
70
External
Employment Full-Time Part-Time None
H2H Employees With Additional
External Employment
0
20
40
60
80
External
Clinical
Employment
Full-
Time Part-Time None
H2H Employees With Additional External
Clinical Employment

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Impressionsof the Workplace
0
10
20
30
40
50
60
StronglyDisagree
Disagree
NeitherAgreeNorDisagree
Agree
StronglyAgree
StronglyDisagree
Disagree
NeitherAgreeNorDisagree
Agree
StronglyAgree
StronglyDisagree
Disagree
NeitherAgreeNorDisagree
Agree
StronglyAgree
StronglyDisagree
Disagree
NeitherAgreeNorDisagree
Agree
StronglyAgree
StronglyDisagree
Disagree
NeitherAgreeNorDisagree
Agree
StronglyAgree
StronglyDisagree
Disagree
NeitherAgreeNorDisagree
Agree
StronglyAgree
“I amfairly
compensated"
“I likemy shift” “I amlearningfrom
my peers”
“I amlearningfrom
my supervisor(s)”
“I haveopportunities
for growth within the
organization”
“I haveopportunities
for professional
developmentwithin
the organization”

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MeanScoreson OutcomeVariables
0 5 10 15 20 25 30 35
Compassion Satisfaction
Burnout
Secondary Traumatic Stress
34.19
25.4
19.87
Means of Key Outcome Variables
Compassion Satisfaction: Average
Burnout: Average
Secondary Traumatic Stress: Low

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Findings
Multiple Regressing Analyses to Verify Hypotheses
Outside Clinical Employment : Burnout
◦ β = 6.749 (p < 0.05)
Perceived fairness of compensation : Burnout
◦ β = -6.545 (p < 0.05)
◦ Model (R2 < 0.452, p < 0.05) included Outside Clinical Employment
Perceivedfairness of compensation : Compassion Satisfaction
◦ β = 4,731 (p < 0.01)
◦ Model (R2 < 0.464, p < 0.05) included Outside Employment, Outside Clinical Employment, and Learning
from Supervisor

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Recommendations
ClinicalPractice
◦ Enhance training and supervision
◦ Focused training and supervision around self-awareness, self-care, and the effects of helping
professions
◦ Provide education around effects of external clinical employment during
recruitment and training
◦ Professional development
Operations
◦ Better clarity with next round to gauge team/shift effects
HR
◦ Recommendations for considering compensation practices

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ImplementingRecommendations
Teams
Added individual supervision
Call management training
Wellness Committee
Increasein staffing
New phone system
New call report
Post call survey
New QI form and feedback
Added pressure/volume
Pauseon group supervision
Departureof somewell-liked staff

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AssessingImpact
• Re-assessing employeeengagement after 6 months
• Assessing the impact of implemented recommendations
• …And then some
• Data gathering followed the same methods
• Some responding staff were new and had not participated in September
survey

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Findings
MARCH 2015

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BackgroundCharacteristicsof Participants
Age of Participating H2H Employees
18-25 years old 26-33 years old
34-41 years old 42 and above
Length of MHA Employment
Less than 2 years
3-5 years
5-7 years
8-10 years
Greater than 10 years

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ExternalEmployment
0
10
20
30
40
50
60
70
80
External
Employment Full-Time Part-Time None
H2H Employees With Additional
External Employment
0
20
40
60
80
100
External
Clinical
Employment
Full-Time Part-Time None
H2H Employees With Additional External
Clinical Employment

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MeanScoreson OutcomeVariables
0 5 10 15 20 25 30 35
Compassion Satisfaction
Burnout
Secondary Traumatic Stress
33.18
21.9*
17.85
Means of Key Outcome Variables
Compassion Satisfaction: Average
Burnout: Low; Difference is statistically significant (p<0.05)
Secondary Traumatic Stress: Low

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Lessonsand Plans
• Engaging employeesis good
• Particularly good in periods of growth
• Especially, in concrete,measurable ways
• And definitely, if you incorporatetheir feedback in observableways
• H2H plans to incorporate employee engagement surveysbi-annually
• Happy to share findings, ideas, and strategies!

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EngagementStrategies
• Business objectives Staff ideas
• Comprehensive strategies
• Encourage collaboration on key projects (call report, QI form)
• Ask for ideas and be open to implementing them
• Trust in decision making (empowering in day-to-day management)
• Wellness committee
• Quarterly recognition events
• Include in workgroups (data analysis)
• Simple strategies
• Post-it activities
• Paint colors, books for library

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Engaging Can Be Simple

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ThankYou!
William Liu
Melissa Chounet
Data Workgroup: William Liu, Lauri Benblatt, Caroline Kaye, Richard
Omega, Norbert Lewis
Jean Sandler, Lynn Kaplan, Dely Santiago, David Truzman, Gloria Jetter,
All Supervisors,All Counselors

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Questions