May is Mental Health Awareness Month. Mental health providers play a critical role in promoting awareness and working to improve the lives of others. Yet, compassion fatigue and burnout are very real issues for those in the field. For the next two weeks, the PAR blog will explore these issues within the mental health community and provide guidance on how those in the mental health field can prioritize self-care to protect their own mental health needs.
Mental health providers with prolonged or cumulative exposure to compassion stress may be vulnerable to burnout if early steps to counteract excessive empathetic involvement are not taken.
A major part of a mental health professional’s job is the ability to empathize with clients. Developing a successful therapeutic alliance leads to better outcomes and correlates with the capacity to identify, comprehend, and share an individual's feelings, thoughts, and experiences. However, prolonged exposure to distressing information can negatively affect a mental health professional and is a risk factor for secondary traumatic stress.
Studies have shown that health professionals have moderate to high levels of burnout and secondary traumatic stress, but few present the prevalence of compassion fatigue and burnout found among mental health professionals.
Past studies have reported that people who work in helping professions have prevalence rates of compassion fatigue ranging from 7.3% to 40% and estimate that 21% to 61% of mental health practitioners experience signs of burnout.
According to an APA survey, the number of psychologists who said they could not keep up with patient demand increased from 30% in 2020 to 41% in 2021 to 46% in 2022. Similar amounts were recorded in 2020 (41%) and 2021 (48%), with nearly half (45%) of respondents in 2022 reporting feeling burned out.
Secondary traumatic stress (compassion stress) negatively impacts mental health and can lead to psychological issues such as strained relationships, insomnia, poor sleep hygiene, severe depressive disorder, and compassion fatigue. Mental health providers with prolonged or cumulative exposure to compassion stress may be vulnerable to burnout if early steps to counteract excessive empathetic involvement are not taken.
Compassion fatigue is caused by extended exposure to traumatized individuals. Mental health providers belong to a profession that demands constant empathy. While empathy is essential to your work, persistent and excessive demands for empathy can become emotionally exhausting and depleting without adequate time to recharge.
Compassion fatigue stems from exposure to vicarious trauma and can affect people differently, but common signs to watch for include the following:
• Chronic emotional and physical exhaustion
• Anger or irritability
• Weight loss
• Increased anxiety or irrational fears
• Issues with intimacy
• Decreased sympathy and/or empathy toward patients or coworkers
• Dread in working with certain patients
• Negative feelings separate from the work environment about work, life, or others
• Negative coping behaviors, like alcohol and drug use
• Increased absenteeism
• Feelings of inequity and pessimism
• Low job satisfaction
Sometimes compassion fatigue and burnout are used interchangeably. There is a distinction. The onset of compassion fatigue is more abrupt, whereas burnout develops gradually over time.
The World Health Organization (WHO) defines burnout as a “syndrome conceptualized as resulting from chronic workplace stress that has not been fully managed.” The WHO's definition of burnout distinguishes that “burnout refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.”
There are three key signs of burnout, which include:
• Exhaustion: Individuals often feel emotionally exhausted or drained, unable to cope, and have low moods and energy. They may also experience physical symptoms such as GI problems.
• Loss of interest in work-related activities: Individuals often feel increasingly frustrated and stressed by their jobs. They may experience growing cynicism about their work environment or colleagues and emotionally withdraw and feel numb regarding their work.
• Decreased effectiveness or performance: Burnout affects daily tasks at work or home, and individuals are often very pessimistic, have difficulty concentrating, lack creativity, and lack energy and enthusiasm.
Mental health professionals work with patients with mild to severe depression, anxiety, trauma, abuse, neglect, addiction, and other mental health illnesses, all of which can take an emotional, mental, and psychological toll on providers. Aside from the psychosocial issues, Patel and colleagues divide the contributing factors for provider burnout into workplace, organizational, and personal characteristics.
There are many factors related to the workplace, such as excessive workloads, increased stress levels in overworked providers, the need to keep meticulous records, and time-consuming clerical duties. One national survey found that each hour spent interacting with patients added 1-2 hours of additional work with no additional compensation. Long work hours, lack of downtime at night or during the weekend, and the need to bring work home instead of taking time for themselves are also factors in burnout.
Organizational factors include negative leadership behaviors, little to no reward or room for advancement, poor social support, and lack of interpersonal collaboration.
Personal characteristics include self-criticism, unhealthy coping strategies, perfectionism, poor work-life balance, poor sleep habits or lack of sleep, and inadequate support systems outside of work may also contribute to burnout. Studies have also shown that new and younger health providers have twice as much stress as older colleagues. Age and gender may impact levels of burnout, and studies have shown that younger workers and women may be at higher risk for burnout.
There are many downstream effects that burnout causes, such as:
• Providers are at increased risk for developing cardiovascular disease, depression, or substance dependence.
• Providers who lose their empathy could invite secondary harm to patients.
• Increased healthcare costs are more common when providers suffer from burnout.
• Compassion fatigue may lead to decreased retention and increased turnover and may lead some mental health professionals to leave the field.
Though empathy is the cornerstone of a strong connection and ability to treat and improve the mental health of their patients, mental health professionals must remember to prioritize their own physical and mental health. For health professionals to give their patients the best care possible and enhance client's quality of life, taking time off from work is essential to unplug, decompress, and practice self-care.
Come back next week to learn self-care tips meant specifically for those in the mental health field.