County mental health agency faces staffing crisis in caring for vulnerable residents

Apr. 21—Tarrant County's mental health authority, which provides care for children and adults with mental illnesses and intellectual and developmental disabilities, has about 500 unfilled positions, a workforce crisis that is affecting some of the county's most vulnerable residents.

My Health My Resources of Tarrant County's budget accounted for about 2,311 full time employees in February. Instead, the agency employed 1,809 people that month, according to an MHMR financial report prepared for its board of trustees.

MHMR, the county's mental health provider, is one of 37 similar agencies throughout the state that make up the backbone of Texas' public mental health system. MHMR provides a range of services, like treatment for adults with serious mental illnesses to spaces where adults with intellectual disabilities can spend time safely and enroll in programs like job training. Agencies like MHMR are grappling with the same workforce shortages that other industries are experiencing, except with higher stakes and more complicated funding.

Susan Garnett, MHMR's CEO, said the staffing levels were challenging behavioral health providers throughout the state. Behavioral health has always been difficult to recruit qualified workers for, Garnett said, because of the demands of the work and pay available.

"We thought of ourselves as being in troubled waters" before the pandemic, Garnett said.

Now, it's a crisis.

Last summer, the crisis was exemplified by an unusually dramatic exodus of multiple direct service workers. At one of the group homes the agency operates, a residential employee left the position, which paid about $11 an hour at the time, for a job at Amazon with higher wages, Garnett said

"The entire rest of the staff went and applied for jobs and moved to Amazon," Garnett said.

The group home, one one of 11 MHMR owns and operates, was able to stay open after other workers were relocated and asked to work additional hours in the interim. But Garnett said she's used the example to illustrate the crisis MHMR and other agencies are facing when it comes to providing direct care to some of the county's most vulnerable residents.

Shortly after the entire group home staff left to work for Amazon, MHMR's board agreed to increase the starting salary for these positions to $15 an hour, Garnett said. The increase hasn't completely fixed the crisis, but it has helped retain some workers and recruit some additional employees. The agency has also added new benefits for employees, like access to the Talkspace online therapy company, as well as providing one-time stipends to employees last year. Garnett said she and other leaders are considering additional programs and benefits to help recruit and retain employees.

"In the old days an annual reward to a staff person was all that was needed to be done," Garnett said at a board meeting last month. "That's not the world that we live in anymore."

Statewide, there's no immediate answer to filling the thousands of empty positions in roles like day care workers, direct service providers and nursing assistants, and other demanding and typically underpaid roles that fill essential roles within society. In Texas, the median hourly wage for a direct care worker was $10.38 in 2019, according to research from PHI, a nonprofit working for better care for people with disabilities. Direct care workers help people with disabilities or limited ability with a range of day-to-day tasks, from eating and taking medication, getting bathed and dressed, and other help they might need.

"We've asked folks in these jobs to serve our most vulnerable people ," Garnett said. "We've become so accustomed to relying on them without paying any attention to them. They're saying, 'I need to be paid attention to.'"

Is the workforce staffing crisis affecting you or a loved one? Do you work as a direct service provider? Tell us your experience or send us your questions by calling or texting reporter Ciara McCarthy at 817-203-4391 or email cmccarthy@star-telegram.com.

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