The Availability of Supervision in Routine Mental Health Care

Clinical supervision is an embedded resource for practice quality in community mental health organizations. Supervision has been found to increase provider competence and decrease stress. In addition, supervision has been associated with service user outcomes including decreased depressive symptoms. However, little is known about the availability and nature of supervision in real world settings. The primary aims of this study were to identify available supervision and the extent to which contextual factors are related to that availability. The data source for this study was a multi-state and multi-site (N = 14) NIMH-funded trial survey of providers (N = 273). Supervision was measured by hours per week (quantity) and by utilization of best practice activities (content). Univariate, Chi square, independent samples t-tests, and ANOVA analyses were used to assess supervision content and quantity and to examine subgroup differences. Participants reported an average of 2.17 h of supervision per week and 28.6% of participants endorsed best practice content. Supervision quantity varied significantly across sites (p < 0.05) and program type (p < 0.05) while content did not. Individual role within the organization had a significant relationship with reported supervision content (p < 0.001). In these settings, staff in organizations are exercising discretion in how to utilize supervision within the available time. Supervision time also varied by program type, increasing with the intensity of services. Findings demonstrate that reports of availability vary according to position within the organization and the intensity of services within a given program type. Implications for workforce development, access to quality services, and implementation of evidence-based practices are discussed.