mental health technician

registered nurse

clinical therapist

licensed vocational nurse

recreation therapist

SAN-Marcos-Treatment-Center

As a mental health assocatiate (MHA) you are tasked with caring for youth, ages 7-17, who struggle with mental health related disorders. Anger management (the most prevalent issue observed ), depression, and suicidal thoughts are primary amongst youth who come to live here. Your daily routine as an MHA will vary depending on the shift you are scheduled, 6:00am-2:00pm, 2:00pm-10:00pm, 10:00pm-6:00am. During each shift you are responsible for helping your assigned group of children adhere to a master schedule as provided to you by the facility. Because most of the individuals who do reside here are in the adolescent age rage, adhering to a schedule is not something they are always willing to do. often times the children do get angry and feel limited by the schedules, which makes things difficult.  Another issue you will face are physical altercations amongst peers and foul language directed at both staff and peers. In the training portion of the job, if you are selected to participate, current resident directors try to prepare you for said incidents. However it becomes a lot harder when you are confronted with these issues daily.This was one of the most difficult parts of working within this facility. Other things that were difficult to deal with were understaffing due to a high turnover rate, and the pay. As an MHA you will know the residents better than another supporting staff, you will be addressing issues head on, and more than likely take a lot of verbal abuse from the residents when they cannot have their way. In my eyes the pay should reflect that, but unfortunately it does not. Even with a degree the pay for this position was little over $10per hour. unfortunately,  I feel a lot of this has to do with the  high turnover rate. However, if the pay rate is not something you are concerned with, this job will provide you with some great insight on how to work with children with similar mental health related issues.

If you’re thinking about working here, you need to be aware of some things they don’t tell you in training.

You will NOT get a lunch break (designated 30) if you work morning or evening shifts. (I don’t know about overnight) There isn’t enough staff to cover for your absence, and the patients’ schedule doesn’t really allow it. You’re expected to eat with patients in the cafeteria. 

Your managers (yes multiple ones) will text you aggressively every week to pick up more shifts or work doubles (16+hours) and reframe it as “helping out.” It doesn’t matter if you’re full time or part time. There are part time employees who get pressured into working over full time hours and full time employees who work as much as 70.

The progressive and nurturing approach they teach you in training is mocked by the seasoned staff once you start working. Many staff members ,including nurses, don’t seem to understand mental illness, characterize patients as “just wanting attention,” and aren’t properly trained to handle a dangerous situation like a patient actively trying to commit suicide. Many also say unprofessional and inappropriate things to the patients. I’ve seen some staff, again including nurses, openly antagonize patients or outright avoid them, leaving one staff member to handle screaming and aggressive patients alone. These are kids with behavioral issues due to trauma. 

The culture overall is toxic and not conducive to the patients’ treatment.

That being said, working with the patients is the only good thing about this place. 

Be very wary choosing this place. The other reviewers who said they got panic attacks or worried something bad would happen that would jeopardize their career weren’t exaggerating.

I loved my job itself, my kids and coworkers. I will never regret my experience and needed the work experience which will forever be valuable and helpful for resumes and work opportunities. This does not take away the fact that the work culture is horrible. Set your boundaries and prioritize your mental health. The turnover is immense, there is favoritism, scheduling and ratio is disproportionate and staff is constantly out of ratio. Managers have favoritism, the pay is not fitting of the work tasks, and the line of communication from supervisors/managers is terrible and employees are blamed for what is not their duty but the manager's. The facility should monitor more closely who works there and their benefits. So many valuable employees are lost and so many hired who don't truly care about the kids. There are definitely shady things with managers and employees that are shady and covered up. 

There are so many staff and FAO's who are amazing and make you feel the shift is amazing and supported. Sadly, this is not a common occurrence.

The first red flag was the orientation but I figured I would learn more once I started working. You are almost given impossible duties. You will be out of ratio often so it's an unrealistic expectation to have 2 MHA'S wake up 13-14 patients and help them meet "morning expectations" while separating fights at times very early in the morning. it is such a high risk to be out of ratio while walking them down the school yard. There's no professionalism. Co-workers are not even educated in mental disorders and I've worked with older ones that believe they're just being bad. They don"t read their charts and just mock everything.Some are just lazy and avoid doing paperwork. You don't work with the same people all the time,since we are soooo under staff. I've dealt with the anxiety of who's coming in because sometimes that itself determines your shift. If you don't have a good co-worker then you will eventually do everything and struggle keeping everything in control.it's a mess and the worse part is the inconsistency with everything. Management is the worse and i want to do another more put together review because there's so much more.

I was really excited to get hired as an MHA and gain experience for grad school. The only rewarding part of the job is when your patients and you can develop a bond. The company is for- profit and it shows, the facility is run down, you'l never have the supplies you need to effectively do your job, management is awful at communication, the level of care the patients get from their therapists and psychiatrists is minimal at best, the pay is NOT enough for how stressful and high risk the job actually is, the job description they post is definitely gilded over so they can sucker you in. It is rare to find a coworker that has been there for longer than a year because the retention rate is so low because of the awful work conditions. Again, the kids you work with is the only saving grace of working at SMTC. If you can get experience or an internship any other place, DO THAT INSTEAD. 

And last but not least, there is literally never an opportunity for a break during you shift. No fifteens and you lunch/bfast/ or dinner is spent eating with the patients. Its exhausting.

The psychiatric healthcare industry needs to be significantly improved as nearly nothing has changed in years, and these kids deserve much much better. It's frustrating to want to support and help the patients grow/get better only to see them not receive proper treatment due to management. Communication is poor and be prepared to work longer hours than you intend, especially if you happen to be stuck with coworkers consistently late. They won't be punished for it.

As a MHA, you'll take on the bulk of the treatment and will be seeing the patients the most. That doesn't sound right. Patients may be seperated by insurance, which you'll be able to see quickly depending on the unit you get placed on. It's sad.

I feel bad for leaving sometimes because I care about the kiddos. Hope things change in the psychiatric industry so I don't see places like this that are basically troubled teen camps.


I worked as an MHA. There seems to be some seniority within units. They raised the pay to 17 an hour since August but trust it's not worth it. Management seems to always be understaffed and that is taken out on the staffs schedules. Management also expects staff to be extremely flexible with schedules due to understaffing but a lot of MHA's are students which isn't anyone's issue except managements. They chose to hire a bunch of students so they have to work around us. The kids are the best part of the job but, management and staffing are the worst. When I needed my supervisor it was hard to find him for 3 days so I text him, he says we can talk in person, but yet I had already been looking to speak to him. After that text it took 2 additional days to find him then he didn't get back to me about what I needed. I was supposed to have guaranteed days off, yeah no that didn't happen. Work environment is highly stressful from staff and patients.

rules they make you enforce to the kids imo is not the most effective way of treatment. You work a lot and have a mentally taxing job so the pay is not worth the work you end up doing. The hours are not flexible as well as certain managers can be kind of catty. I think in order to do this job you need some sort of training in psychology because at the end of the day you’re effecting real kids with what you’re doing. If you don’t like your unit you will not be able to change it and they don’t take into account your preference of age group. Also, depending on the unit and who your managers are it can be a very thankless job. The kids are awesome but they come from various backgrounds and need a lot of help, you will be the one that spends the most time with them, it can be very hard to work with certain age groups as they can tend to be stressed out very easily (rightfully so) but they will take that anger out on you without proper training so just beware. There were lots of good days but the bad days were very bad. 

Being a Mental Health Associate at the San Marcos Treatment Center is challenging. There is a lack of support, it is dangerous, and orientation is not representative of what it is actually like on the units. You are putting yourself in situations, as a professional, where you may have to physically restrain kids, and it comes down to he-said/she-said over whether or not it was necessary. This can have far-reaching impacts on your future. Management does not hesitate to throw you under the bus. It is a for-profit company and it shows. It seems they are so desensitized to their environment that they forget they are working with literal children, staff and management become easily agitated, they try to guilt-trip you into picking-up extra work hours on your days off, and it is honestly a tense environment waiting to go-off at any moment. Consider your options very carefully before taking a job here.

This was probably the single most educational job I had. It built the foundation for every job I had. There was not a behavioral health issue I did not see or had to address. As a workplace environment your teams would evenly divide work, we knew when someone was having a hard day and would keep that in mind when scheduling the shifts responsibilities. We celebrated events and I think it was the most intimate environment in terms of knowing who worked with. The hardest part was working with a youth that had to be physically held and maintaining an emotional cushion to not be affected at the time of the hold or other special treatment intervention. I still think of those youth, their experiences and trauma that brought them to the facility.

Top Job Titles	Average Salary
Mental health technician 6 salaries reported	$17.33 per hour
Registered nurse 23 salaries reported	$34.91 per hour
Clinical therapist 5 salaries reported	$57,500 per year
Licensed vocational nurse 16 salaries reported	$26.50 per hour
Recreation therapist 7 salaries reported	$37,500 per year

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