mental health technician

mental health therapist

therapist

psychiatric nurse

registered mental health nurse

Sandstone Care

I worked at Sandstone Care for over three years and witnessed significant changes during that time. In my experience, the organization has shifted away from its original clinical focus toward more operational and performance-driven priorities.

There have been ongoing challenges with staffing levels. Despite increasing census and demand, additional clinical staff were not consistently added, which resulted in larger group sizes and limited programming capacity. At times, three residential houses were open, but only two were able to run full group programming. Management refuses to see reality.

Therapists are expected to manage a high workload, including multiple multi-hour groups per week, individual caseloads, and documentation requirements. Balancing these responsibilities can be difficult, particularly when expectations continue to expand without additional support or resources.

At times, staffing patterns and operational decisions felt misaligned with the needs of the milieu, which created situations that, in my perspective, felt unsafe for both staff and clients. These concerns were raised by staff but did not always appear to result in meaningful changes.

There were also moments where decisions from leadership reflected, in my opinion, a lack of clinical understanding of residential care, which contributed to frustration among frontline staff. This sometimes came across as operational or clinical incompetence, particularly when policies or expectations did not align with best practices for adolescent treatment.

Leadership structure and direction changed frequently, which created instability and made it difficult to maintain consistency in programming and expectations.

Additional concerns include:

A strong focus on documentation and performance metrics, sometimes at the expense of clinical flexibility
Limited recognition or support for staff despite high workload demands
Expectations that shift quickly, requiring ongoing adaptation with minimal onboarding or training

While there are many dedicated and hardworking staff who care deeply about the clients they serve, the overall system can make it difficult to consistently provide the level of care that clinicians aim for.

Overall, this role may be best suited for individuals who are comfortable working in a fast-paced, high-demand environment with evolving expectations. This company is no longer the same.

Pros:
+ Full benefits
+ Wonderfully kind, experienced therapists 
+ Large, sunny office space
+ Therapy dogs on site (occasionally)
+ Ample, off-street parking
+ Strong dual diagnosis treatment center*
*Sandstone Care is truly one of the best treatment programs that I've come across. They sincerely know what good programming looks like and their therapists are top notch. I loved my job and the position I held within the company.

Cons:
- High employee turnover
- No HR department
- Inexperienced supervisors
- Cliquey environment
- Employees prone to gossip

Advice to management:
Invest in creating an HR department. During my first week of employment a woman resigned and posted a note to the entire organization to the effect of, "No matter how hard you work, it won't matter if you aren't 'in' with the right crowd." Her sentiment rang true. During my time at Sandstone Care, my character was attacked in ways that were not quantifiable nor justified. I was regularly subjected to verbal abuse from a male superior, notably, that I needed to smile more, make more eye contact, and stop sighing. My employment was threatened more than once solely on the basis of how I was "perceived in the office" - instead of productive feedback, I was told that if I couldn't figure out what that meant or how to change on my own then I must not be self-aware. I had never in my 10 years of steady employment received this type of criticism. The work environment is toxic and hostile, reminiscent of a small-town high school.

When I sought help from senior management I was told, verbatim, "We disagree with the statements and your assertion about the work environment being hostile." They were not interested in a dialogue of any kind. Consistent with the zeitgeist, a woman's opinion matters far less than of those in positions of power. 

**Instill the empathy and values in your employees, particularly management, that are taught in your treatment program.**

If you are single and willing to work around the clock, this is the place for you. This is prime place for young clinicians to get their hours towards licensure then move on to bigger/better things, which is great but also unfortunate given they won't hire LGPC/LGSW's. While there are incredibly kind people who work there, there's a toxic culture being promoted which is speak up at your own risk. If you don't like what is happening company wise, you "self-select" to leave... which is sort of understandable but at some point I feel like management should listen to the concerns of their staff. It's really disappointing that their core values and mission is geared towards inspiring and empowering change but the only change being inspired or empowered is geared towards making money. Cutting corners and asking employees to work well outside of their roles has caused a cycle of burn out of great clinicians and administrators. Just be mindful, the management team is based out of Colorado and while they made attempts, there is a limited understanding of the DMV culture or what stressors are associated with this area. There were a few too many times we were left to handle things on our own while our executive leadership reminded us they were "just a phone call away". That doesn't really help when you're in the middle of a clinical cluster and need some sort of leadership to guide. If you do take a job with Sandstone just be prepared for a love affair with Microsoft Teams and willingness to dedicate your life to being a part of their company culture. It's just really hard to justify "drinking the kool-aid" and "re-framing" your perception when you are put in positions that just shouldn't be asked of their employees. It's not about patient care, it's about how few people can get the job done at the right price.... exactly the reputation they worked to avoid. 

The Good: 

I began working as a Mental Health Tech for Sandstone Care with gratitude to have found such an accepting and transparent work culture with generous full-time benefits. I knew that I had been blessed to be paired with compatible coworkers that were upbeat and productive. The facility's management team also seemed peculiarly enthusiastic to be supportive, and went out of their way to answer any questions that emerged while I learned the MHT role. Most of all, I admired the level of respect and loyalty which clients received from staff on a consistent basis.

The Bad: 

I was unsure of how long I'd stay with Sandstone Care when I onboarded, as the starting pay compares to that of the unskilled labor force, expected future pay raises were less than mediocre, and the position (advertised as entry level) required a higher than average degree of professional skill sets and task management. 

The Ugly:

Sandstone Care has a long way to go before obtaining a healthy balance between fair compensation and work expectation.  The company also has an undeniably high turnover rate and is in a chronic state of being understaffed (which is not limited to MHT's). As a result, lower level staff feel consistently strained and unable to complete basic job expectations under a burdened system.

Final Thoughts: 

If you are a recent college graduate or someone with minimal experience in the mental health field, the MHT position with Sandstone Care could be a potential bridge to helping you get the experience you need to obtain a higher paying position with an external company. The job may also offer rewarding moments if you have an empathetic personalty. Though Sandstone Care has high future growth potential, it needs to create an effective strategy for readdressing overall employee satisfaction. 

A typical day at sandstone, requires you to stretch yourself between loyalty to the manager and company who makes bad decisions and doing what’s best for the client. This can be taxing because if you care about client care you will have to ignore managements instructions. 
There is little to no training for the actual job. The two weeks of virtual training were a waste of my time, when I got to the site I was dropped into the middle of an ocean with zero support. The curriculum they gave me was a list of random therapy topics. I had to spend hours researching on curriculum development. As a new clinician this was very overwhelming and I specifically asked ant my  interview about the curriculum and what I was told was not what it was. 
Management could not care less about me and my experience. They have lied to me multiple times straight to my face and twisted things to protect themselves while others are being hurt. They 9/10 times don’t show up to our scheduled supervision meetings claiming they have another meeting then. If they do show up they sit and scroll on their phone ignoring what I or others have to say.  In short management is not supportive. 
Workplace culture has been nothing short of exhaustingly toxic. People talk about me behind my back, and team meetings were spent discussing what a bad therapist I am when I approached management about this they said I’m doing nothing wrong. But they did not appropriately reprimanded the bullying. It continues. 
The hardest part of the job is having to figure things out out on your own and clean up managements bad choices over and over and over again and do it with out involving management because they will make rash unhelpful decisions or reprimand you for doing what’s right because it makes them look bad. 
The most enjoyable part of the job is the down time when there aren’t clients. I have had a lot of that because this place is so poorly run clients don’t want to come here. 

After some time away from this job, I finally feel confident enough to share my experience. I started in admissions, and as many reviews have pointed out, there is a lot of pressure from upper management to enroll as many people as possible, regardless of their financial situation. There’s a clear disconnect between those in leadership, who are financially comfortable, and the families who are often struggling to afford care. The pressure can feel intense and, at times, ethically questionable.

One key individual in admissions is currently on maternity leave, but if they return, I expect the high turnover rate will continue. Their management style, combined with the stressful nature of the role, contributed to my own personal challenges, including substance use struggles. Unfortunately, the company’s benefits for getting help in this area are lacking.

I transferred to the talent department, hoping for a better experience, but I encountered many of the same issues. Leadership seemed overwhelmed, and many employees were either unqualified or focused on getting certifications to leave the company. Team bonding was discouraged without leadership involvement, reflecting a culture of mistrust. Leadership even contacts employees who’ve left bad reviews to ask them to remove them.

The metrics in the talent department focus more on busywork than actual productivity, with leadership believing that increased talk time can make up for the low pay and tough work environment. I truly hope those still in this situation are able to find a way out, and if this job has negatively impacted your well-being, my heart goes out to you.

A typical workday at Sandstone care as an Admissions Coordinator was going into their queue and taking calls from leads and if they take you out the queue for live calls they put you on a long list.  You are expected to make 100 calls per day and or 4 hours of talk time each day.  I believed I learned what the issues are when it comes to drug addictions, alcoholism and mental health.   After training and nesting most of our training class which we started with 14 people in the training class and by the time we hit the floor 7 people were left.  The training is informative but the trainer is disrespectful and he lacks patience.  The management with a couple of managers was not the greatest experience.  They are cliquish and show favoritism.  It is a very untrustworthy environment and I see why they have a high turnover.    In the training class we was told about the required metrics which most people meet and I have met but after a week they  put us on a call list to call people all day.  After a week on the floor they took our training class out of the live queue where we were destined to fail.  They implemented a new metric we had no training on and had no clue about after 4 weeks.  The environment is not pleasant there.  I wanted to help people get into treatment but it seems to me this company only cares about numbers and how many people they can get to wait on their waiting list to get in their programs.  I do not recommend applying to this company or ever working for them.

I will say that Sandstone Care is the worst place I have ever worked. Despite the façade you will see in your first few hours, this is NOT a place for someone who actually cares about mental health and substance use treatment for those in need. 

Workers are pushed to meet unrealistic expectations, and are thrown into selling rather than caring. In addition they encourage unhealthy competition among employees and show obvious favoritism. In the short time I was there I witnessed ~1/3 of the staff turnover, they are truly churning through employees. 

I found management in particular to be very difficult to tolerate as they showed too much excitement for belittling and embarassing their subordinates. And tend to respond with a knee-jerk reaction of "well that's not MY fault and in fact it's YOURS". While the training is informative, the trainer has a short fuse and is abrasive to say the least. The entire middle management team is as untrusting as they are unworthy, and will threaten even the top performing employee with PIPs if they should be so bold as to disagree with any word from a managers mouth. 

The communication is HORRIBLE. Constant changes to very important things are rarely communicated to the entire team, only the favorites are told everything they need to know to actually do their jobs.

I am absolutely disappointed in my experiences here, and regret the role I played in admitting people that were struggling into care here since it is so blatantly obvious that each patient is simply a number. I encourage you to keep looking, and to not let this place take any second of your time. 

Ironically, this is a company that claims to focus on mental health services, yet it ultimately harms the mental well-being of its own employees. In 2023, the company rapidly expanded, opening several new locations with high expectations of increased revenue. However, this growth did not bring the anticipated profits, resulting in significant financial losses and placing undue stress on clinicians due to poor financial decisions.

In the summer of 2024, the company conducted layoffs, eliminating several positions and terminating staff with little regard for compassion or care. Turnover rates are alarmingly high, with many employees unable to last even a year. The constant cycle of staff departures has led to frequent changes, often feeling as though leadership is making new adjustments every week—without consulting the clinicians who are directly affected.

Programs are frequently merged, so if you apply for a specific role, be prepared to take on additional responsibilities. Although the company regularly asks for feedback, it seems to be a mere formality, as nothing meaningful ever comes of it. Admissions staff are under pressure to accept clients, even those who aren't a good fit for the programs. If you voice concerns, you're often blamed for lacking the "necessary skills" to manage the situation, as keeping clients enrolled is critical for the company’s bottom line.

The only positive aspect was the people who worked there. I left this company with my anxiety at an all-time high and my mental health severely deteriorated.

I was so excited to be hired and work for this company. I was so impressed with their mission goals and felt it was the perfect place for me. Since firstly employed, they had changed the procedures attached to my position, several times. With unrealistic expectations, and the training was a conflicting since there were so many constant changes . The way that I had been treated and talked to had really diluted my self-confidence and ability to do my job correctly and efficiently. I was initially told that it would take a few months to really get my position down. After learning a new procedure of my position and the way it’s done, in that short period of time, they completely changed the process again. And they say this crazy expectation of a high success ratio, and that is not fair. What’s even worse is that you cannot go to management or HR and speak of frustrations and issues, they are held against you, and then you are placed into a probationary time frame, constantly being threatened to be fired, instead of reaching out and asking, “how can I help you? What can I do to help you get on the same page as your coworkers.”  Unfortunately, this has been the hardest and most frustrating position I have ever had. My team lead was arrogant and demeaning. I have read so many negative reviews that seem to match my exact experience. I wish I would’ve read all these prior. I never would’ve set foot in the building. 

Top Job Titles	Average Salary
Mental health technician 55 salaries reported	$19.72 per hour
Mental health therapist 72 salaries reported	$76,389 per year
Therapist 10 salaries reported	$79,050 per year
Psychiatric nurse 1 salary reported	$55.57 per hour
Registered mental health nurse 40 salaries reported	$39.59 per hour

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