Workforce Retention in Florida’s Behavioral Health Sector: A Mixed-Methods Survey Investigation of Positive and Negative Contributors Impacting Intention to Leave

Abstract Florida faces a critical behavioral health workforce shortage, with provider supply falling approximately 14,000 positions short of demand. Understanding the factors that predict workforce attrition is essential for developing targeted retention strategies. This study used a mixed-methods survey design to examine workforce retention among licensed behavioral health professionals in Florida. Surveys were administered to providers across seven professions and all regions of Florida ( N = 330). Quantitative analyses included descriptive statistics, exploratory factor analysis (EFA), and ordinal regression predicting three indices of retention intention. Qualitative analyses included content analysis with investigator triangulation. Themes were derived inductively from the data itself, following the principles of emergent coding in qualitative content analysis. EFA yielded a robust two-factor structure comprising a Workload Strain and Overload and largely independent Positive Organizational Climate and Professional Satisfaction factors ( r = −.17). Both factors independently predicted retention intentions in ordinal regression models. Qualitative analysis identified seven themes promoting retention, including meaningful purpose, client progress, professional autonomy, and collegial support, alongside ten themes reflecting retention risk, most prominently inadequate compensation, administrative burden, emotional exhaustion, and organizational dysfunction. Triangulation revealed strong convergence between quantitative strain indicators and qualitative themes, while qualitative data provided additional context regarding professional devaluation, safety concerns, and the tension between mission alignment and structural barriers. Retention requires a two-factor strategy: reducing sources of strain while investing in organizational conditions that sustain meaning. Implications for policy, employer practice, and workforce development are discussed.