Sarah Hollins, Director of Behavioral Health Services at West Virginia University Medicine Camden Clark Medical Center

Summary

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Podcast Summary

Episode Overview

Podcast: Becker’s Healthcare Podcast
Guest: Sarah Hollins, Director of Behavioral Health Services, West Virginia University Medicine Camden Clark Medical Center
Host: Ella Reuter
Date: May 17, 2026

This episode explores the leadership philosophy and practical strategies of Sarah Hollins in behavioral health administration, delving into staff support, workplace violence prevention, staff retention, crisis care gaps, and navigating operational pressures. Hollins’ insights are firmly grounded in her hands-on approach and frontline behavioral health experience.

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Key Discussion Points & Insights

1. Leadership Shaped by Frontline Experience

• Grounded Leadership: Hollins’ leadership is influenced deeply by her own years in frontline crisis roles. She stresses building trust and being visibly involved with the day-to-day realities staff face:
  • “I attempt to stay grounded in what the work actually feels like day to day… I focus on creating an environment where people feel both safe and set up to succeed.” — Sarah Hollins [01:23]
• Proactive, Systems-Focused Safety: Rather than blaming individuals, she sees patient safety issues as process or system failures requiring standardized solutions and collaboration:
  • “…most safety issues aren't about individual failure, but they're about gaps and processes, communication or environment… I try to look for patterns, not just isolated events.” — Sarah Hollins [02:41]

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2. Workplace Violence Prevention: Shifting Culture and Practice

• Cultural Change Underway: Hollins notes that healthcare is moving away from normalizing workplace violence, especially in behavioral health:
  • “Organizations are finally starting to recognize that workplace violence in healthcare...is not just part of the job.” — Sarah Hollins [03:56]
• Data-Driven and Team-Based Approaches: There is more systemic tracking at both the system and hospital level, looking at incidents in context:
  • “Teams are really looking more closely at patterns around incidents, trigger staffing levels, patient acuity and response times instead of just...isolated occurrences.” — Sarah Hollins [04:25]
• Real Gaps Remain: Many health systems have policies but lack a true culture of safety where staff feel empowered to speak up:
  • “A lot of places have policies, but not all...have a culture where staff truly feel supported reporting concerns or, or escalating safety issues in real time.” — Sarah Hollins [05:19]
• Notable Quote:
  “Workplace violence prevention has to be integrated into staffing decisions, environmental design, onboarding, leadership visibility and daily operations, if it's really going to make a difference.” — Sarah Hollins [06:24]

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3. Staff Retention: Cumulative, Not One-off, Success

• Retention is Daily, Not a Single Initiative: Success in keeping staff depends on:
  • Realistic staffing/workloads based on acuity and volume, not just budgets;
  • Leadership visibility and responsiveness;
  • Ongoing development and certifications (e.g., suicide prevention, stigma reduction, psychiatric nursing).
    • “It’s that cumulative effect of getting really the day to day experiences right for the staff.” — Sarah Hollins [06:58]
• Empowering Frontline Staff: Staff input is sought for real improvements, boosting engagement when suggestions shape actual change.
• Transparency, Honesty, and Wellness: Normalization of utilizing EAP, honest communication about systemic constraints, and prioritizing mental health supports foster connection and retention.
  • “When staff trust leadership is advocating for them and trying to make thoughtful decisions, they're much more likely to stay, even when it's challenging.” — Sarah Hollins [09:47]

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4. Gaps in the Continuum of Care & Solutions

• Crisis as Point of Entry: Too many patients only access care in crisis—the system is reactive, with outpatient access lagging behind demand.
  • “One of the biggest gaps...is that too many patients still enter at the point of crisis instead of earlier.” — Sarah Hollins [10:50]
• Poor Transitions and Fragmented Hand-offs: Breakdown between levels (ED, inpatient, community) raises risk of relapse.
  • “Transitions between levels of care remain one of the weakest points… the risk of remission or relapse increases significantly.” — Sarah Hollins [11:54]
• Geographic Inconsistencies: Some communities have robust crisis services; others default to the ED—a mismatch between needs and resources.
• Call to Action: Integration and coordination are essential, as is expanding alternatives to hospitalization (e.g., crisis stabilization, peer support and mobile crisis units).
  • “Behavioral health camp function in silos, health systems, outpatient providers, crisis teams, community organizations and EMS, even payers, all really need to be more aligned around shared goals and those smoother handoffs.” — Sarah Hollins [12:46]

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5. Problem Solving Under Pressure

• Safety First, Then Access, Then Sustainability: Hollins uses a triage model—safety is always top priority, followed by preserving access, then ensuring financial/operational viability.
  • “Not everything can be top priority… in behavioral health, it almost always comes back to safety first, then access, then stability or sustainability.” — Sarah Hollins [14:18]
• Pragmatic, Data-Informed Action: She values timely action over waiting for perfect data, frequently pairs analytics with frontline input.
  • “I don’t like to wait for perfect data to act. There is no such perfect data.” — Sarah Hollins [14:42]
• Team Communication and Feedback Loops: Weekly cross-department meetings and rapid reassessments ensure problems are identified/solved in real-time.

Example Provided:

• Collaboration Between ED and Behavioral Health Units: Clinical assessment coordinators facilitate patient admission flow; leadership weekly reviews barriers and communication breakdowns.
  • “…we have staff, what we call our clinical assessment coordinators that go down and they evaluate patients for potential admission… leadership actually meets weekly to try to look at some of those problem solving issues.” — Sarah Hollins [17:05]

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Notable Quotes

• “Retention and engagement come from people feeling heard and supported. Not just managed.” — Sarah Hollins [02:11]
• “Organizations doing this well are the ones that are really treating workplace violence prevention as part of the operational strategy and culture change, not just that regulatory requirement.” — Sarah Hollins [06:05]
• “The goal should really be building a continuum that's easier to access, easier, easier to navigate, and more responsive in real time so patients can receive the right care at the right time instead of cycling through the system during repeat crises.” — Sarah Hollins [13:33]

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Timestamps for Key Segments

• 00:27 – Introduction to Sarah's role and Camden Clark Medical Center
• 01:23 – How frontline crisis work shapes leadership
• 03:56 – Current changes and gaps in workplace violence prevention
• 06:58 – Strategies for retaining and supporting staff, with concrete examples
• 10:50 – Major gaps in the behavioral health continuum & needed changes
• 14:18 – Problem-solving in high-stakes environments: priorities and process
• 17:05 – Example: Weekly operational collaboration between ED and behavioral health units

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Memorable Moments

• The emphasis on actionable, ongoing training and the importance of staff “voice” in shaping workplace improvements.
• Honest recognition of persistent industry challenges and Hollins' pragmatic optimism in meeting them through teamwork and transparency.
• The real-world process example of behavioral health and ED teams collaborating proactively rather than reacting after issues arise.

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Transcript

[A]

Hello and welcome back to Becker's Behavioral Health Podcast. I'm Ella Reuter and today I'm really excited to be joined by Sarah Hollins, director of Behavioral Health Services at West Virginia University Medicine, Camden Clark Medical center in Parksburg. Sarah, thank you so much for being here today.

[B]

Thank you so much for the opportunity, of course.

[A]

And to kick us off, can you share a little bit more about your role and your organization?

[B]

Sure. So, as you said, I'm the director of behavioral health services here and this is my second go around at Camden Clark. So I was here when the unit first opened back in 2007, left for a while, and then moved my family here in 2017 and have been here ever since. It's just a wonderful community, it's a wonderful hospital and we're really just very patient centered and family focused. So it's a joy to be able to bring behavioral health services to our community.

[A]

Wonderful. Well, thank you so much for that brief overview. I'd love to start off. You've really built your career from frontline crisis services to leading behavioral health programs. How has that shaped the way you approach leadership today, especially around staff support and patient safety?

[B]

Well, coming up through frontline crisis work has really shaped everything about how I lead. I've been in situations where staffing has been tight, acuity has been high, and decisions have to be made quickly so I don't lead from a distance. I attempt to stay grounded in what the work actually feels like day to day. And when it comes to support staff or supporting staff, I should say I focus on creating an environment where people feel both safe and set up to succeed. That means to me having realistic staffing plans, clear expectations, and being visible and available to my team. If something isn't working, I want to hear about it early and I want to be able to fix it quickly. I also try to prioritize practical support by giving them ongoing training and making sure staff have a voice and process changes. Retention and engagement come from people feeling heard and supported. Not just managed, but on the patient safety side. My approach is very proactive and systems focused. Frontline experience has taught me that most safety issues aren't about individual failure, but they're about gaps and processes, communication or environment. So I try to look for patterns, not just isolated events, and push for standardization where it'll reduce risk while also still allowing that clinical judgment from where it matters with the frontline staff. It's also made me very focused on culture and behavioral health. Safety is directly tied to how supported and prepared staff feel. You'll oftentimes see me directly helping with the patients and supporting my staff. And that can be helping during codes and restraints as well. I found when teams trust their leadership in each other, they communicate better, they respond earlier and prevent that patient. So for me, leadership is really about building that kind of environment where staff are supported and patient safety is embedded in everything that we do, not just something that we react to when there's a problem 100%.

[A]

And it's really cool to hear about that hands on approach that you really take in your leadership role. Thank you. You've spent years really focused on de escalation and workplace violence prevention. What do you see changing right now? And where do you think organizations and health systems are still underprepared?

[B]

So what I found changing right now is that organizations are finally starting to recognize that workplace violence in healthcare, especially in behavioral health, is not just part of the job. There's a much bigger focus on proactive prevention, staff training, environmental safety, and building systems that support early intervention before situations escalate. I'm also seeing a shift towards more data driven approaches. Here at WVU Medicine, we have a workplace violence team, both at the system and the hospital level. And teams are really looking more closely at patterns around incidents, trigger staffing levels, patient acuity and response times instead of just treating the those violent events like isolated occurrences. And that's important because prevention really starts with understanding the system, not just reacting after an event happens. Where I still think many organizations are underprepared is implementing all of that consistently. Right. A lot of places have policies, but not all of them have a culture where staff truly feel supported reporting concerns or, or escalating safety issues in real time. There's also still a gap between training and practice. So that annual de escalation, you know, those modules alone are not enough for high acuity behavioral health environments, let alone organizations to do just annually. Staff really need ongoing hands on training, interdisciplinary coordination, and leaders who actively are involved in safety efforts, not just reviewing those reports afterwards. And I also think organizations sometimes underestimate the impact of that repeated exposure to violence that how that has on staff retention, morale and burnout. If employees don't feel physically and psychologically safe where they work or the units that they work, it really affects everything to engagement, patient experience, turnover, and just the overall quality of care. So organizations doing this well are the ones that are really treating workplace violence prevention as part of the operational strategy and culture change, not just that regulatory requirement. And it really has to be integrated into staffing decisions, environmental Design, onboarding, leadership, visibility and daily operations, if it's really going to make a difference 100%.

[A]

Especially when we're seeing those huge gaps in the workforce, still seeing those shortages and having those big challenges in behavioral health. And as you mentioned, you've seen or had a big focus on retaining as well. So what strategies have really worked for you in retaining and supporting staff on the ground? Even if you want to name a

[B]

few examples, Great question. So I found that retention really isn't driven by one big initiative. It's that cumulative effect of getting really the day to day experiences right for the staff. So first, staffing and workload have to be realistic. You can't retain people if they feel set up to fail each and every shift, right? I and you know, our system really try to focus on aligning staff modules that actually look at acuity and volume, not just budget targets, and building in that flexibility. So teams are really constantly operating in a crisis mode. Many members on my team are actually cross trained to help alleviate with any shortages that may arise. So that's been really helpful. And then secondly, frontline support from leadership really matters. I try to make it a priority to be visible, accessible and really responsive to my staff. When there are concerns or they raise concerns to me, whether it's safety, workflow or morale, I try to address them quickly and really close that loop. So that's been helpful as well. I also try to invest heavily in ongoing development and behavior health, especially confidence really comes from that preparation. We have several trainings every year on suicide prevention. We've recently partnered with our local community based mental health agency to provide stigma reduction not only to my unit, but to the entire organization. And also many of the nurses on my unit have their certification in psychiatric nursing which ties into that clinical ladder that we have here within our system. And another big help is really giving staff a voice and how the work gets done. You know, having them give me the best ideas for improving flow, safety, patient experience. That almost always comes from the frontline staff and their important work, those great ideas. So when they see their input really turn into real change, that engagement goes up. And from a well being standpoint, I try to focus on practical supports rather than just messaging things like using pto, their holiday time, creating debriefs after high acuity events for units within our organization, also normalizing the use of resources through our EAP without stigma, and also engaging in our well being programs like Thrive and our shorts rounds to help just that caregiver response. And finally, I try to be Transparent about constraints. You know, behavioral health is a really tough environment and I think people understand that, especially the people that work there. But they want honesty about what's being done to improve things. And when staff trust leadership, is advocating for them and trying to make thoughtful decisions, they're much more likely to stay, even when it's challenging, at times 100%

[A]

really building those relationships there. It sounds like that's been really key in the whole journey.

[B]

Yes.

[A]

And from your experience building and leading crisis services as you have, where are the biggest gaps today in the continuum of care and what do you think needs to change in order to better connect patients to the right level of support?

[B]

So I think from my experience, one of the biggest gaps in the behavioral health continuum is that too many patients still enter at the point of crisis instead of earlier. In the process, we've improved awareness and demand for services has really increased. But access to timely outpatient care, therapy, substance abuse treatment, and community support still hasn't caught up. And I really feel like that sometimes creates those bottlenecks everywhere else in the system. I also think transitions between levels of care remain one of the weakest points in that continuum. So patients may stabilize in the ed, inpatient care, or even that crisis setting like a crisis stabilization unit. But if the follow up services aren't like available quickly or communication between those providers are fragmented, that risk of remission or relapse increases significantly. And I feel too often patients and families are really left trying to navigate a still very complicated system on their own. I think another major gap is that lack of consistency and maybe crisis response models across communities. Some areas have strong mobile crisis programs. They have crisis stabilization services and partnerships with law enforcement and ems. Thankfully we do here in our community. But other communities still rely heavily on those emergency departments and inpatient admissions as a default solution. That's not always the right level of care for the patient, and it puts an additional strain on an already overwhelmed hospital or hospital system. I think what needs to change is better integration and coordination across that continuum. Behavioral health, camp function in silos, health systems, outpatient providers, crisis teams, community organizations and ems, even payers, all really need to be more aligned around shared goals and those smoother handoffs. And I also think we need to continue to expand alternatives to hospitalization. Things like our crisis stabilization units, empath units, peer support services, mobile crisis response. Not every behavioral health crisis requires inpatient admission, but patients do need rapid access to the right level of support before things really escalate further. So I think ultimately the goal should really Be building a continuum that's easier to access, easier, easier to navigate, and more responsive in real time so patients can receive the right care at the right time instead of cycling through the system during repeat crises.

[A]

Yes, yes. I feel like that's a story we hear often is maybe patients being handed a laundry list of options and they need help navigating through the system. And so thank you so much for pointing that out. I really appreciate that. And behavioral health leaders, as you know, are constantly navigating competing priorities from access, safety, and especially financial pressures. How do you approach problem solving in high stakes environments?

[B]

So I typically approach those high stake problem solving issues, but I just try to get really clear on what actually matters in that moment. Not everything can be top priority, as you know, at the same time. And behavioral health, it almost always comes back to safety first, then access, then stability or sustainability. Forgive me, if safety is at risk, that drives the decision. From there I look at how we preserve access without creating a downstream risk. And then we have to make it financially viable. Right then. I also try to be very data informed. I don't like to wait for perfect data to act. There is no such perfect data. Right. So I use what we have. I'm looking at throughput metrics, incident trends, staffing patterns, and I try to pair that with real time frontline input. The people, again, like I've said throughout, the people closest to the work usually know where the friction points are. So I try to make a point to engage my nurses, my mental health specialists and the providers early in the process. Our behavioral health unit and our ed, our leadership actually meets weekly to try to look at some of those problem solving issues. So I also try to simplify the problem. You know, in high pressure situations, complexity can slow us down. So I have to look at again what's urgent versus what's important, what's controllable versus not. And then try to make that high impact change quickly and align my team and other teams around that to make an actual plan. I really think communication is also a big part of it. I try to be transparent about any trade offs that need to be made, especially when decisions affect access or workloads. So the staff understand that why and also the patients understand that why, and that helps with that trust and execution. And then finally I try to build rapid feedback loops. So in behavioral health, things shift quickly. I try to reassess often and adjust as needed. That way we can keep that communication flowing between departments, between staff and with our patients.

[A]

That's incredible. And I'm curious too. Do you have a specific example or problem that you wanted to share, maybe to help our audience really grasp this process?

[B]

Well, I think I had mentioned so with our ED and our behavioral health unit, we have to work hand in hand, very closely. So we have staff, what we call our clinical assessment coordinators that go down and they evaluate patients for potential admission. So we're constantly, like I said weekly looking at a leadership position of how is that going? We're trying to identify opportunities, we're trying to identify barriers. If there's any communication breakdowns within our teams, that way we can constantly be operating at an efficient level. And that also goes down to our providers as well. You know, are they working together as a team and you know, what opportunities or barriers can we identify? So we're constantly working together.

[A]

Well, wonderful. This has been a really insightful conversation. I really appreciate you taking the time to hop on here and discuss workplace safety and well being. Thank you again for joining us on Becker's Behavioral health podcast. And thank you to our listeners for tuning in. We'll be back soon with more conversations on the future of behavioral health.

[B]

Thank you.