This blog is part of Perspectives, our blog series where Institute leaders, partners, and subject matter experts share their insights on the most pressing challenges — and opportunities — in behavioral health and substance use care.
Let’s work together to ensure everyone in California’s behavioral health system is prepared, supported and valued.
I first began studying the impacts of burnout on performance as an undergraduate psychology student.
It’s a topic that has followed me throughout my career – when I worked as a behavioral health provider during and after college, when I was a PhD candidate studying the well-being of care providers – including parents and therapists – for youth with complex behavioral health conditions, and now today, as Steinberg Institute’s Director of Research, studying how to build a stronger behavioral health system (and by extension, workforce) in California.
Burnout isn’t just exhaustion. Research on burnout, especially in healthcare workers, shows it’s much more nuanced. A myriad of factors contribute to its development – long hours, low pay, high caseloads, constant exposure to suffering, and the emotional toll of providing care for the most vulnerable members of our community.
Working in direct care made that research real. I saw firsthand how burnout shows up not as lack of effort, but as exhaustion from caring deeply about people in a system that too often gives too little in return. Every experience I’ve had since has reinforced a simple truth: the health of our behavioral health workforce determines the health of our entire system.
As part of the Institute’s Vision 2030 initiative, one of our goals is to build a stronger behavioral health workforce in California. Our team conducted a behavioral health workforce pulse survey to better understand the current state of the workforce with regard to burnout, retention, and solutions to prevent people from leaving their positions or the field entirely. Over 300 providers across California took time to answer questions on their experiences working in the behavioral healthcare workforce. Consistent with national research, we found that compensation and caseload were strong predictors of burnout. But looking deeper, we discovered an even stronger predictor of burnout: providers said they were not adequately trained to meet their clients’ needs. Burnout is not simply about long hours or low pay; it is about feeling unprepared to meet the complex needs of those relying on you.
This finding reinforced what many in the field intuitively know – providers thrive when they feel supported, empowered, and equipped with the tools they need to serve the people in front of them.
People enter this field because they care deeply and want to help others. But without the right supervision, training, or system-level support, that passion can lead to burnout and turnover. When experienced professionals leave faster than new ones can be trained, a cycle emerges that strains every level of care – from crisis services to prevention and early intervention. This feeds directly into the broader workforce shortage that threatens the stability of California’s entire behavioral health system.
Our research shows that California must effectively double the number of behavioral health professionals in the coming years to meet demand. On the surface, this means recruiting more people to become providers and join the workforce. However, recruitment is only half of the equation. Retention – built on mentorship, supervision, career development, and reasonable caseloads – keeps skilled professionals in the field. To meet this moment, we must design systems that make behavioral health a lifelong career, not a temporary stop for those who burn out and move on.
Transforming behavioral health care in California, requires investing in the people who make it possible. That means listening to providers, involving them in system design, and ensuring policy decisions are informed by their lived experience on the front lines. Our workforce is not just a part of the system – it is the system’s foundation.
For the first time in decades, California is investing in real change. Historic initiatives like Proposition 1, CalAIM, and the Behavioral Health Continuum Infrastructure Program (BHCIP) are expanding early-career pipelines, building infrastructure, and modernizing care systems that address both recruitment and retention.
This is a moment to not only grow the workforce, but to make the field sustainable for those who dedicate their lives to it. When we invest in the behavioral health workforce, we are not just supporting providers – we are strengthening the care systems that help individuals, families, and communities heal.
I am so grateful to have worked as a behavioral health provider in the early stages of my career – to see firsthand the necessity of empowering and caring for providers. I’m even more grateful to continue working alongside providers through research that explores how we can expand access to care while supporting the health and well-being of those who deliver it.
As California continues to reimagine its behavioral health landscape, I am hopeful that the investments being made today will help us build not just a larger workforce, but a stronger one.
A workforce that is trained, supported, and valued.
A workforce that finds fulfillment in the work and stays in the field because the system values what they bring to it.
About Lauren Bullard
Lauren Bullard brings a long history of behavioral health research experience rooted in person-centered methodologies. Prior to joining the Steinberg Institute she worked in both academic research settings and in the private sector exploring how historically in-person behavioral health therapies may be translated to a digital format in order to broaden access without impacting quality of care. Her research has also focused on investigating barriers to accessing clinical services and health equity outcomes as well as how digital therapeutics can support mental health across diverse populations.
Lauren has a B.A. in Psychology from the University of New Mexico, an M.S. in Child Development and a Ph.D. in Human Development from the University of California, Davis.