Do What You Love? A Qualitative Study of Unionized Public Mental Health Clinicians’ Labor Organizing Challenges

Unionized public mental health clinicians have increasingly engaged in labor organizing to improve their demanding labor conditions and to stem the tide of ongoing public mental health workforce shortages. However, these workers face challenges in their organizing efforts. In spring 2023, we interviewed 30 unionized public mental health clinicians working in New York City and Chicago to understand their labor organizing challenges. We analyzed semistructured interviews using thematic analysis. Clinicians face labor organizing challenges specific to the profession. For example, managers and workers themselves often use clinicians’ dedication to their underresourced patients to justify exploitation and blunt collective action—what we call “the ideology of the helping profession.” Clinicians also encounter challenges that are universal to labor organizing (e.g., collective action costs, diverse bargaining units, management opposition) but are nevertheless textured by their experiences as helping professionals in the United States’ fragmented and underfunded public mental health system. Although research has examined policy barriers to improving public mental health clinicians’ labor conditions, our study is the first to explore barriers experienced by grassroots, worker-led efforts on the shop floor.