What Happened to Culture and DEI?

This year’s Behavioral Health Industry Trends Report saw Culture and DEI initiatives drop to their lowest priority in the past four years, going from third in 2021 to tenth this year, back to its 2020 survey level. Looking at those numbers suggests that DEI initiatives were in large (though certainly not all) measure the result of the transformative changes brought on by a global pandemic and the demand for social justice following the murder of George Floyd. Both brought equity to the fore in many ways. In the intervening years, however, these DEI initiatives have dropped back down in priority, to fourth, sixth, and its return to tenth. So, what happened?

In an April 2024 Harvard Business Review article Lily Zheng writes about the current status of DEI initiatives across organizations. Certainly, DEI efforts have encountered considerable backlash in some quarters. And their intent is often misconstrued, often feeding backlash. With that said, many DEI initiatives have also been poorly constructed. Zheng argues for redesign rather than abandonment. I agree. When DEI is separated from broader organizational strategic priorities, it can both fail and create resentment. When it is treated as an element within a broader strategy, it can enhance the bottom line and lead to a stronger workforce.

All organizations are created to serve a set of clients. They are more successful when their workforce mirrors that target population. As Zheng notes, “Diversity efforts build workforces that reflect the communities they serve by giving everyone a fair chance to enter and rise” within the organization. Efforts to build a DEI culture, nonetheless, cannot be separated from the need to recruit talent – individuals with knowledge, skills, and abilities crucial to the success of the organization.  This means that DEI efforts must bring together the cultural competence needed to serve a specific population, the talent to deliver high-quality services, and a commitment at all levels to respect all members of the team and value the unique contribution they make and perspective they bring.

According to Zengh, few organizations can directly show results of their DEI programs– 60% lack specific goals and targets, and even fewer dedicate budget to these initiatives. The ContinuumCloud survey results parallel this observation: “Most (68%) say they’re promoting an inclusive company culture, but only 30% are measuring DEI efforts.” For many companies, DEI was reactive, with many spinning up “programs” without integrating them or providing a supporting infrastructure; they never rose to the level of an organizational imperative. They included workshops or events that were not integrated into their day-to-day operation or strategy.

Can we rescue DEI? To do so, organizations need to identify how the goals they set fit into their organizational process and day to-day work. It means creating a culture where the benefits of DEI are benefits to the whole, making clear it is not a zero-sum game; that it’s not about a particular group, it’s about everyone’s success. In its next iteration, DEI should have a direct link to organizational and workforce well-being. Zheng suggests that 2024 DEI strategies should articulate, implement, and monitor inclusive leadership competencies, focus on respectful dialogue across all media, have specific goals and targets at all levels, invest in and act on areas of marked unfairness or inequity, and ensure that learning opportunities tie directly to the day-to-day work of staff.

Behavioral health organizations have a model for effective DEI implementation. Some time back, behavioral health providers were pressured by the growing social movement demanding inclusion for those affected by mental illness and substance use disorders (not dissimilar to those leading to DEI initiatives). “Nothing about us without us,” was what we were required to embrace by those we served. Many organizations learned that using their outward-facing skills – recovery-oriented and trauma informed care – inward can have lasting benefit. These organizations focus on the well-being of staff as well as clients; they emphasize respect for lived experiences that can vary widely. They incorporate peers and those with lived experience in treatment teams, management, and governance.

The 2024 survey indicates that organizations plan to collect feedback from staff, improve on-boarding, and hold all-staff meetings or send company-wide communications to strengthen DEI and organizational culture. These will only have the desired impact if they are attached to smart goals, if data is used to identify where there may be equity challenges or exclusion that need to be addressed, and if there is measurement to assess the impact of best-practice-based initiatives and programs. A well implemented DEI strategy can build organizational well-being, improve tenure and cohesion, and create a better community. If we can prove impact on outcomes and the bottom line, its viability is far more likely.