The turnover among direct care workers in the United States has steadily increased since 2013. This study's direct care workers were behavioral technicians, counselors, behavioral aides, and community care workers. The program statement addressed in this applied research study was the relationship between the initial training and direct service workers' turnover rate. The study was needed to give insight to management in facilities that provide services for people with mental health and substance use disorders. The purpose of this qualitative case study was to explore if there is a relationship between the training for direct care staff and the high turnover rate. The case study consisted of 12 interviews to determine the relationship between training and the turnover rate based on direct care staff's perspective in mental health and substance use facilities. The study's components included an introduction, literature review, data collection, data analysis, and results. The participates consisted of 12 direct care staff from a facility that provides substance use and mental health services in Missouri. Data were analyzed by a process called the cleaning data and reduction phase through the NVivo software. The data in this stay may help management understand the importance of an organized training program for all new employees and the components that make a quality program. One recommendation for future study is to repeat the study with a broader range of facilities and a larger population. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com.bibliotheek.ehb.be/en-US/products/dissertations/individuals.shtml.]