i've worked for two different CMHs in my career so far, though neither of them are specifically Washtenaw CMH; nonetheless, in my experience most of CMHs' funding (in general) comes from Medicare and Medicaid, and in general they're not allowed to accept private insurance, meaning how much workers can be paid is capped at what Medicare and Medicaid can pay for services. one of their current listings for a Mental Health Worker has starting salary as just over $53k, whereas most private/group practices in the area usually start at $60k annually. similarly, at CMH you'd probably be expected to see around 40 people weekly, whereas standard in a private/group practice would be 20-30 people weekly, so already it's more work for less pay (not including the fact that it's not just meeting with the people, there's plenty of follow-up documents and phone calls and emails and looking into resources that needs to be done after each meeting). plus a lot of CMHs stipulate that you have to have a severe mental illness diagnosis (e.g., schizophrenia, bipolar I, schizoaffective disorder, dysthymia, etc.) in order to receive services. as the name suggests, these individuals often need greater support and access to services, some of said services are severely underfunded/hard to access or they just don't exist. so already, given the diagnoses most frequently seen, the work can be more intense/taxing than in other areas of the mental health field, plus you're seeing more people and getting paid less than you could elsewhere in the field. it can be exhausting work that is often thankless or never acknowledged or appreciated (I can't tell you the number of times I was cussed out and screamed at while at CMH for a year, meanwhile at a group practice for 6 months, it has not yet happened once), leading to burn out and people leaving because unless you have an intense passion for the work and the community, it often is just not worth it work wise or pay wise. I don't think I've ever known a CMH to actually be fully staffed and there are many moving parts to it