By Mike Maffei | Founding Partner, AlediumHR

If I were responsible for hiring psychiatrists, therapists or behavioral health leadership, I wouldn't start by asking which recruiting company has the largest database or the highest ranking on a website. I'd want to know whether the firm has recruited the people I need, understands the environment they'll be working in and can explain how it intends to reach qualified candidates.

After 30 years in recruiting, I've learned that two organizations can be hiring for essentially the same clinical title and need very different candidates. A therapist joining a national telehealth company as an independent contractor is a different assignment from a therapist becoming a full-time employee of a community mental health center. The credentials may overlap, but the expectations, recruiting process and candidate considerations can be quite different.

The best behavioral health recruiting company for your organization is the one whose experience, search process and engagement terms fit the positions you're trying to fill. That's something employers can investigate before signing an agreement.

Start with the type of recruiting you actually need

One of the first questions I'd ask a prospective recruiting partner is what kind of engagement it handles.

Behavioral health staffing companies often provide different services under similar descriptions. Some supply temporary agency-employed clinicians to cover staffing gaps. Others recruit permanent employees, identify independent contractors for client engagements or conduct executive searches for senior leadership positions.

Those distinctions affect how the search should be conducted and what the employer is purchasing.

For example, recruiting a licensed therapist who will contract directly with a telehealth organization as a 1099 professional is not the same as supplying a temporary therapist employed by a staffing agency. The recruiting company may identify and qualify the professional, while the client establishes the contractor relationship. The appropriate worker classification depends on the actual relationship and applicable law, not simply what either party prefers to call it.

For a permanent hire, the discussion may focus on compensation, benefits, career development and long-term fit. For a contractor opportunity, availability, practice arrangements, workload expectations and contract terms may be more important to the candidate.

I would also separate clinical recruiting from behavioral health executive search. Recruiting a chief behavioral health officer or vice president of clinical operations requires an understanding of leadership responsibility, organizational growth and operational performance beyond the clinical qualifications associated with individual provider roles.

Before comparing firms, decide which of these services you need. Otherwise, you may be comparing companies that solve entirely different hiring problems.

Behavioral health experience needs to match the care setting

I would expect behavioral health recruiters to understand the differences among psychiatrists, psychiatric nurse practitioners, psychologists, licensed therapists, counselors and clinical social workers. Those are not interchangeable professional categories, and their qualifications, licenses and permitted activities can differ.

The care setting adds another layer.

A hospital may need clinicians experienced in acute psychiatric care, interdisciplinary treatment and complex patient populations. An outpatient practice may place greater emphasis on continuity of care, appointment schedules and the types of therapy offered. Substance use treatment organizations may require particular experience with addiction, co-occurring disorders and the applicable clinical program.

Community mental health organizations can have different service requirements and patient populations from private practices. Telehealth organizations need to consider remote clinical experience, technology proficiency and where clinicians are authorized to serve patients.

That last point deserves particular attention. A candidate who can work remotely isn't necessarily authorized to treat patients in every state where an organization operates. Licensing requirements, applicable interstate arrangements and payer participation may affect whether someone can actually serve the intended patient population.

The Bureau of Labor Statistics projects an average of 48,300 annual openings for substance abuse, behavioral disorder and mental health counselors during 2024–2034. That's useful evidence of sustained workforce demand, but it doesn't tell an employer how many appropriately licensed clinicians are available for a particular schedule, location or practice model.

I'd ask mental health recruiters to explain which comparable positions they've worked on, how they evaluate the required credentials and what they know about the candidate market for that setting. A firm that understands the assignment should be able to have that conversation without relying on broad claims about healthcare experience.

Ask for recruiting results you can actually evaluate

When a recruiting company tells me it can produce candidates quickly, I want to know what that means.

Does it mean the first names identified, the first screened candidates presented, the first interviews scheduled or the first offers accepted? Those milestones are different, and none automatically establishes when a clinician can begin seeing patients.

Time to first qualified candidates measures how quickly the search produces people who meet the agreed screening criteria. Time to offer includes interviewing and selection. Time to start may also depend on licensing, credentialing, payer enrollment, notice periods and other requirements.

I would ask for examples of comparable completed searches, including the scope of the assignment, the number of people recruited and the timeframe being reported. Candidate qualification matters as much as volume. A list of 100 names has limited value if most are unavailable, incorrectly licensed or uninterested in the opportunity.

We have a relevant example at AlediumHR.

In 2024, we recruited 168 therapists and psychiatrists as independent contractors (1099) in four weeks for a national telehealth organization. Those recruits accounted for 87% of the organization's required hires. The client also reduced its recruiting vendor structure from ten firms to two, with AlediumHR becoming its primary recruiting partner.

That engagement involved contractor recruiting at scale, not permanent employee placement. It demonstrates our experience supporting a particular telehealth hiring model under significant volume requirements. It shouldn't be interpreted as a typical four-week result for every behavioral health search.

Our telehealth behavioral health recruitment case study provides more detail about the assignment.

Understand what you're paying for

I've questioned percentage-of-salary recruiting fees for years because I don't believe a higher salary automatically means the recruiting firm has done proportionately more work.

If two placements carry a 25% fee, a $120,000 position generates a $30,000 recruiting fee, while a $180,000 position generates $45,000. The salary calculation explains the difference in price. It doesn't explain whether the second search required $15,000 more in recruiting effort or delivered proportionately greater value.

A difficult psychiatrist search may justify a substantial fee. So might a confidential leadership assignment requiring extensive research and assessment. My point is that the fee should have a defensible relationship to the service and assignment, rather than being accepted simply because percentage-based pricing has been customary.

Employers also need to understand the difference between how a fee is calculated and when it becomes payable.

A fixed fee establishes an agreed recruiting price. A contingency arrangement generally makes payment dependent on a successful placement. A retained search typically involves payments during the engagement and may still be priced as a percentage of compensation. For organizations with ongoing therapist recruiting or multiple locations, a recurring recruiting arrangement may provide more predictable capacity and monthly costs.

These models are not mutually exclusive in every respect. A firm could, for example, charge a fixed fee payable upon successful placement.

AlediumHR offers flexible recruiting arrangements, including contingency and retained search for behavioral health assignments and Recruiting-as-a-Service (RaaS™) for recurring hiring needs. Our broader healthcare recruiting services also include fixed-fee options. The actual pricing, payment obligations and scope should be confirmed for the specific engagement.

I'd compare recruiting fees separately from compensation, onboarding expenses, vacancy-related costs and temporary staffing charges. Combining all those numbers into one supposed recruiting cost makes it difficult to compare proposals fairly.

Ask what the sourcing platform contributes

Technology has made it possible for recruiters to identify and research candidates more efficiently. That can be valuable in behavioral health, where many qualified clinicians are employed, have established patient caseloads or aren't actively applying for jobs.

At AlediumHR, we use the proprietary Talentlytical® platform to expand candidate discovery, including professionals who may not be visible through conventional job postings. Our experienced recruiters remain responsible for candidate engagement, qualification and evaluation.

I'd ask any recruiting company using AI-assisted sourcing what the employer actually receives from that investment. Is the firm reaching a broader candidate population? Are recruiters spending more time speaking with qualified clinicians? Can the company explain how candidates are screened before presentation?

A sourcing platform doesn't establish whether a psychiatrist is interested in a particular practice arrangement, whether a therapist has the necessary license or whether compensation expectations align with the employer's budget. Those questions still require professional judgment and direct conversations.

Technology can improve the search process. Its value should be demonstrated through the work delivered, not assumed from the fact that a firm uses AI.

Read the guarantee before comparing its duration

Placement guarantees are another area where the details matter.

AlediumHR's behavioral health recruiting page advertises a 12-month placement guarantee. Our healthcare executive search practice separately advertises a 24-month executive placement guarantee, with terms established by the engagement agreement.

Employers should ask what the guarantee covers, when it begins, what happens if someone leaves, whether a replacement search is provided and what exclusions or obligations apply.

I'd pay particular attention to how the agreement treats permanent employees compared with independently contracted clinicians. An employer shouldn't assume the same replacement provisions apply to every engagement model without seeing that in writing.

A longer guarantee may provide greater protection, but duration alone doesn't tell you how useful the remedy will be.

Be skeptical of unsupported best-of lists

Searching for the best behavioral health recruiting company or top behavioral health staffing companies may produce comparison articles alongside individual firms' service pages.

Some lists are published by recruiting firms themselves. Others come from commercial publishers. They can be useful for discovering potential providers, but I'd check who wrote the list, how the companies were selected, whether commercial relationships are disclosed and what evidence supports the recommendations.

I wouldn't assume every list is paid placement. I also wouldn't treat an unexplained ranking as independent proof that one firm is better suited to your organization.

A company specializing in temporary clinical coverage may be excellent at that service and still be the wrong choice for a permanent behavioral health director or a large independent-contractor recruitment program.

Questions I'd settle before signing

By the time an employer is ready to select a partner, I would want clear answers to a few practical questions:

  • Have you recruited these clinical disciplines for organizations operating in our care setting?
  • Are you recruiting employees, independent contractors, temporary agency staff or executives?
  • Who conducts the search, and how are qualifications and candidate interest verified?
  • What recruiting milestones will you report, and how often will we receive updates?
  • What exactly will we pay, when is payment due and what does the guarantee cover?

Those answers should make the choice considerably clearer than a marketing presentation.

At AlediumHR, our behavioral health recruiting practice supports organizations across the United States and Canada, including hospitals, outpatient providers, community mental health organizations, substance use treatment programs and telehealth companies. We recruit clinical professionals and behavioral health leadership, supported by experienced recruiters and the Talentlytical® platform.

We've also demonstrated our ability to handle substantial behavioral health recruiting assignments, including the national telehealth engagement described above. That is evidence employers can examine alongside our proposed approach, fees and contractual commitments.

I believe a recruiting partner should be able to explain how it intends to handle your particular hiring need before asking you to sign. If your organization is evaluating behavioral health recruiters, we're available to discuss the positions and recruiting model you need.

Sources & Further Reading