Burn-Out
Research has identified stressors specific to mental health professionals. Included are the stigma associated with mental health and the profession, negative characteristics of clients and their relatives, demanding relationships with clients, personal threats from unstable clients, challenging interactions with other professionals, and legalistic frameworks.
Mental health professionals feel increased levels of stress and burnout as a result of heavy workloads, administrative burdens, lack of positive feedback, low pay, a lack of resources, general working conditions that are inadequate and a poor work environment. Other lessor stressors are time management, inappropriate referrals, safety issues, role conflict and ambiguity, and a lack of supervision.
Factors contributing to job satisfaction include working at a healthy workplace, variety of tasks, being valued by and receiving support from others, and being informed by and about their organization.
Patient suicide is another major stressor for many mental health clinicians, with the majority reporting posttraumatic stress symptoms after one takes place in their work place. Particularly following a client suicide, social support from one’s own family members or colleagues is an important resource for helping the clinician cope with their feelings of guilt.
While the number of empirical studies is extremely limited, the literature contains a host of practical strategies that have been recommended for decreasing burnout, though without support from research. Strategies include: (1) competitive salaries, (2) financial and non-financial incentives to enhance staff motivation and morale, (3) opportunities for promotion and career advancement, (4) funding for increased staffing levels, (5) training staff on self-care strategies, (6) additional clinical supervision and mentoring, (7) clear job descriptions/expectations, (8) routine assessment of burnout, (9) flexible work schedules, (10) social events and informal support, (11) in service trainings, and (12) open-door policies with management.
Burnout is defined as an occupational phenomenon in ICD-11: “Burnout is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed. It is characterized by three dimensions: (1) feelings of energy depletion or exhaustion; (2) increased mental distance from one's job, or feelings of negativism or cynicism related to one's job; and (3) reduced professional efficacy. Burnout refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life” (10). Maslach et al. describe burnout as that point at which important, meaningful, and challenging work becomes unpleasant, unfulfilling, and meaningless. Energy turns into exhaustion, involvement (also referred to as engagement) becomes cynicism and efficacy is replaced by ineffectiveness (11).
Equity work at its core is about humanity and relationships. Relationships take emotional investment and at times, emotional and intellectual labor. And while caring for others can be incredibly fulfilling, the labor and commitment required can result in burnout. Therefore it is important to recognize the importance and benefits of self-care.
Burnout is “a prolonged response to chronic emotional and interpersonal stressors on the job - defined by the three dimensions of exhaustion, cynicism, and inefficacy.*” There’s a common misconception in equity work that “to accomplish more, you need to sacrifice more.” This view is shortsighted and can lead to burnout. When we prioritize our health - mental, physical, and emotional - we are better equipped to manage life’s demands.
While the term burnout commonly refers to the fatigue experienced by the demands within a professional setting, similar fatigue and anxiety can develop from our daily social and personal interactions. We can help ourselves achieve a more emotionally stable footing by making self-care a routine part of our lives.
A contemporary review of studies reported that burnout among mental health professionals ranged from 21% to 67% (Morse, Salyers, Rollins, Monroe-DeVita, & Pfahler, 2012). Described as “the terminal phase of therapist distress” (Baker, 2003, p. 21), burnout has been shown to lead to decreased engagement with clients, disruptions in continuity of care, and high turnover rates (Chiller & Crisp, 2012; Schaufeli, Bakker, & Van Rhenen, 2009). Since the 1990s, scholars have pointed out that insufficient self-care is one of the distal causes of the deterioration of professional functioning, which may lead to burnout (e.g., Brady, Norcross, & Guy, 1995; O’Halloran & Linton, 2000). More specifically, insufficient selfcare was found to contribute to emotional depletion and exhaustion, which subsequently impaired one’s functioning at work and significantly impacted the quality of service provision (Collins, 2005).
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