Caring for the Caregivers: Burnout in Public Mental Health Care Professionals

Clinicians, Professionals

Professionals working in mental health have been in a state of burnout since COVID. When the pandemic hit, the need for essential critical healthcare providers dramatically ramped up. The resulting emotional toll continues to make its mark today, and it especially affects public behavioral health care clinicians who are vulnerable to burnout due to the intensity of the job itself.

The mental health situation in our country burgeons with the American Psychological Association reporting that “More than a quarter of U.S. adults say they’re so stressed they can’t function.” Most adults cite inflation, violence and crime, political climate, and racial climate as significant sources of stress.

With our mental health caregivers already subject to burnout, and continuously in high demand, we must ask who is caring for our caregivers? Who is looking out for those caring for others?

Burnout Research and Statistics

Over 50 percent of behavioral health care providers report experiencing symptoms of burnout, per SAMSHA, and “burnout will likely increase given continued growth in the number of people seeking behavioral health care along with behavioral health staffing and retention challenges.”

In a compilation of research focused on the prevalence and causes of burnout among practitioner psychologists, emotional exhaustion is reported as the most common dimension (McCormack et al. (2018). The individual’s hours worked (time pressure), administrative work (paperwork), negative client behaviors, and over-involvement with clients are vastly attributed to the occurrence of emotional exhaustion.

Clinicians practicing in the private sector, which means having more control over clients, hours worked, and case variability, are reported as having experienced lower levels of burnout compared to those working in the non-private (public) sector.

The Cause and Symptoms of Burnout

Per SAMSHA, burnout results from chronic workplace stress and it typically appears in three main areas:

  • Exhaustion – feeling emotionally depleted, overextended, and fatigued
  • Depersonalization – being detached from oneself and emotionally distant (lacking empathy) from one’s clients and work
  • Feelings of inefficacy – having a reduced sense of professional accomplishment

Burnout is described by SAMSHA as a spectrum with many symptoms that include:

  • Sense of failure
  • Procrastination
  • Physical illness
  • Helplessness
  • Loss of motivation
  • Withdrawal from relationships and responsibilities

When treating clients who are victims of trauma, therapists may find themselves traumatized by the emotionally intense experience of engaging in this type of therapy. This is called vicarious traumatization (also referred to as secondary traumatic stress or compassion fatigue), and it can be a component of burnout, per Jeffrey E. Barnett, Psy.D., ABPP, from the Society for the Advancement of Psychotherapy.

The symptoms of vicarious trauma, per Good Therapy, are different for everyone, and are typically exhaustive and can be debilitating:

  • Emotional symptoms – grief, anxiety, sadness, distraction, irritability, anger
  • Behavior symptoms – isolation, substance abuse, altered eating habits, difficulty sleeping
  • Physiological symptoms – headaches, rashes, ulcers, or heartburn
  • Cognitive symptoms – negativity, difficulty concentrating, memory struggles, difficulty making decisions
  • Spiritual Symptoms – loss of hope, decreased sense of purpose, feelings of disconnection

Symptoms of vicarious trauma also include difficulty separating work and personal life, which can lead clinicians to increase their workload and find it difficult to stop thinking about the trauma experienced by a person in their care.

Related: 4 Ways That Trauma-focused Therapy Is Different From Regular Mental Health Counseling

What You Can Do to Avoid Burnout

Self-care and awareness are vital to prevent burnout as a behavioral health clinician.

Psychological Wellness and Self-Care as an Ethical Imperative, published by Jeffrey E. Barnett, Psy.D., ABPP, provides science-backed insight into self-care and awareness:

Self-care includes:

  • Making time for yourself regularly
  • Do things that you enjoy in life
  • Take care of yourself physically and spiritually
  • Learn to say no
  • Do not isolate yourself
  • Focus on prevention
  • Watch out for burnout symptoms
  • Avoid perfectionism
  • Strive for balance
  • Seek out personal psychotherapy
  • Use colleague assistance programs
  • Participate in peer support groups

Create a self-care checklist for coping and awareness. For example, ask yourself these daily questions:

  • Am I taking time for myself (including regular breaks during the workday, and vacations away from work)?
  • Am I regularly partaking in the things in life that I enjoy?
  • What am I doing to take care of myself physically and spiritually?
  • Am I limiting my work hours and caseload?
  • Am I participating in peer support, clinical supervision, personal therapy, and/or journaling, as preventive strategies?
  • Am I showing any symptoms of burnout?

Organizational-Level Interventions to Address Burnout

Professional burnout prevention should not rest entirely on individual clinicians. SAMSHA gives highlights of organizational-level interventions in their publication, Addressing Burnout in the Behavioral Health Workforce through Organizational Strategies, saying:

“Organizations should do what they can with the resources available to create and sustain interventions.”

This includes identifying outcome measures and assessing impact (e.g., stress, burnout) over time, and using evaluation methods that maximize workplace and individual wellness.

Some studies, such as the one by McCormack et al. (2018), credit resources such as social support, work-based support, and supervisor support as positive mechanisms for reducing burnout in clinical psychologists. The education of supervisors and the forming of open discussions with their clinicians promote self-awareness and self-care practices among those they supervise.

Are You Experiencing Burnout?

If you are experiencing burnout, we want to help.

Region Five is the central point of access for mental health support services for the Greater Tidewater Hampton Roads Area. Our Region Five Community Service Boards (CSBs – Chesapeake, Colonial Eastern Shore, Hampton Newark, Middle Peninsula Northern Neck, Norfolk, Portsmouth, Virginia Beach, and Western Tidewater) are available with same-day access.

Visit our CSB page for more information.

If you reside in the state of Virginia, outside of the Region Five area, visit the Virginia Department of Behavioral Health & Developmental Services location board to find a CSB in your area.

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