Prof. Alvarez-Hernandez & Colleagues Research the Mass Exodus of Mental Health Professionals from Puerto Rico
The need for mental health professionals in Puerto Rico has risen in response to natural disasters and growing inequality. However, Latino providers are migrating from Puerto Rico at higher rates than ever. Retaining mental health providers on the island is an urgent concern, since the widening service gap worsens citizens’ health and economic disparities and eventually, the overall development of the island. Prof. Luis R. Alvarez-Hernandez from BU School of Social Work and his colleagues, under the leadership of Harvard and Massachusetts General Hospital affiliated post-doctoral research fellow Dr. Natalia Giraldo-Santiago, published the first study examining the push and pull factors for the migration of mental health professionals, focusing on Latino providers immigrating from Puerto Rico to the United States.
Why Are Latino Mental Health Professionals Thinking of Leaving Puerto Rico?
The study found that professionals reported experiencing a combination of push factors, including:
- Income dissatisfaction: More than half of the providers received a significantly low salary compensation than the average mainland U.S. salary.
- Emotional exhaustion in the workplace: The COVID pandemic contributed to higher rates of burnout. In addition, the workload on mental health professionals who choose to stay may have increased as others leave. Thus, incentivizing more and more people to immigrate to the U.S.
- Lack of organizational support and resources: Puerto Ricans face high rates of marginalization and disinvestment from US government and organizations due to a history of colonization. The study shows that, while professionals are satisfied with their jobs, they are left unsupported by the systems they work within. This further contribute to their emotional exhaustion and dissatisfaction.
- Age: Lastly, young providers were more likely to report migration thoughts than their older counterparts. As younger people immigrate and older people retire, the hiring crisis continues to grow.
Policy Recommendations to Reduce Migration Rates Due to Poor Work Environments
“The migration of healthcare workers is a major aspect of globalization and a phenomenon creating circumstances in which some countries gain, and others lose opportunities for social and economic development,” the authors say. However, the migration of mental health professionals is being overlooked worldwide. Therefore, it’s important for organizations and governments to reduce unnecessary migration patterns by improving policies and systems that are currently pushing these professionals to migrate, and supporting those who have already done so.
Each of the push factors identified in the study can be at least partially addressed by policy changes. For instance, increasing salaries can incentivize mental health practices in Puerto Rico and reduce burnout. Capping the number of cases per provider and offering hybrid or telework options can also combat exhaustion and improve mental health professionals’ perception of organizational support.
Future Research
The authors recommend more longitudinal studies and qualitative interviews to provide a better understanding of the issues providers face. By gaining a more holistic understanding, organizations can reduce these push factors more effectively.
Read the research summary in Spanish and English.
Learn More About Prof. Alvarez-Hernandez’s Research
“Factors Associated with Thoughts of Migration Among Latinx Mental Health Professionals from Puerto Rico to Mainland United States,” was co-authored by Natalia Giraldo‐Santiago, PhD and Jenny Zhen‐Duan, PhD from Massachusetts General Hospital; and Prof Yolanda Machado‐Escudero from the University of North Florida.