Developing and Engaging Milieu Staff on Child and Adolescent Inpatient Psychiatric Units: Impact and Management of Staffing Factors

Given patient acuity, safety issues, shift work, and demands for patient care within a milieu-based practice, mental health staff on inpatient psychiatric units experience several work-related factors that can impact their sustainability, stress, and burnout. Leadership is often faced with a revolving door of staff in this setting, which was exacerbated during the COVID-19 pandemic. Programs vary in their approach to hiring, onboarding, and retaining a healthy and robust workforce. This chapter will review these topics, as well as considerations to mitigate staff turnover and burnout.