Overview Promoting mental health and preventing mental and/or substance use disorders are fundamental to SAMHSA’s mission to reduce the impact of behavioral health. Health news, features and advice from the Telegraph newspaper. Includes a searchable archive of health stories. A Review of the Problem and Its Remediation. Abstract. Staff burnout is increasingly viewed as a concern in the mental health field. In this article we first examine the extent to which burnout is a problem for mental health services in terms of two critical issues: its prevalence and its association with a range of undesirable outcomes for staff, organizations, and consumers. PESI is the leader in continuing education seminars, conferences, in-house training, webcasts and products for mental health professionals. Featuring the world’s.We subsequently provide a comprehensive review of the limited research attempting to remediate burnout among mental health staff. We conclude with recommendations for the development and rigorous testing of intervention approaches to address this critical area. Keywords: burnout, burnout prevention, mental health staff. Introduction. Burnout has been defined a number of ways (Burke & Richardsen, 1. Thanks so much for supporting my efforts to help our program! People like you, who care about our goals, make the difference. Mental health and mental illness. Chemiss, 1. 98. 0; Pines & Aronson, 1. Stalker & Harvey, 2. Maslach and colleagues (1. Order and download substance abuse and mental health issues related publications from the SAMHSA Store. Taking a mental health screening is one of the quickest and easiest ways to determine whether you are experiencing symptoms of a mental health condition. The dimension of emotional exhaustion refers to feelings of being depleted, overextended, and fatigued. Depersonalization (also called cynicism) refers to negative and cynical attitudes toward one’s consumers or work in general. A reduced sense of personal accomplishment (or efficacy) involves negative self- evaluation of one’s work with consumers or overall job effectiveness (Stalker & Harvey, 2. Many researchers consider burnout to be a job- related stress condition or even a “work- related mental health impairment” ((Awa, Plaumann, & Walter, 2. ICD- 1. 0 diagnosis of job- related neurasthenia (Maslach, Schaufeli, & Leiter, 2. Organization, 1. 99. Although burnout is correlated with other mental health conditions, such as anxiety and depression, research also supports that burnout is a construct distinct from these other mental health disorders, from a general stress reaction, and from other work phenomena such as job dissatisfaction (Awa, et al., 2. Maslach, et al., 2. Burnout is also distinct from secondary traumatization, vicarious traumatization, and compassion fatigue (Canfield, 2. Dunkley & Whelan, 2. Figley, 1. 99. 5). Since burnout was first described in the early 1. As research has burgeoned over the past three decades, it has become clear that burnout, which occurs cross culturally, is prevalent across a variety of occupations, including teachers, managers and clerical workers, and in a variety of fields, including education, business, criminal justice, and computer technology (Leiter & Schaufeli, 1. Stalker & Harvey, 2. Not surprisingly, burnout is also thought to be common among mental health service providers and administrators, and to be increasing for employees in public service systems (Awa, et al., 2. In public mental health, burnout is considered to be costly and “economically wasteful”, especially given the expense of recruiting and training staff (p. Gilbody et al., 2. Recently, the United States federal government also identified burnout as one key factor driving the “major problem” of retaining competent staff in “treatment organizations and state behavioral health systems” (p. Hoge et al., 2. 00. Some studies have examined limited aspects of burnout among mental health providers, but there have been relatively few systematic attempts to better understand or ameliorate burnout in mental health; this is both surprising and ironic, given the goals of mental health organizations for improving the behavioral health of individuals and the fact that burnout is a stress- related psychological condition that arises within the workplace. Given the complexity of the topic and the vast prior work on burnout, this review is not meant to be exhaustive; instead, we focus on two key questions: 1) To what extent is burnout a problem for mental health staff and the service delivery system? What can — and should — be done to address burnout among mental health providers? We build upon a prior review of burnout and mental health (Leiter & Harvie, 1. Throughout the paper, we seek to identify areas important for further research and intervention, before making final conclusions and recommendations for research and practice. While another useful review of mental health and burnout was recently published (Paris & Hoge, 2. Burnout: The Scope of the Problem for the Mental Health Field. We will examine the extent to which burnout is a problem in the mental health field in terms of two key areas: 1) the prevalence of burnout among mental health providers, and 2) the association of burnout with other problems for mental health staff and service delivery. Prevalence. Across several studies, it appears that 2. In a study of 1. 51 community mental health workers in Northern California, Webster and Hackett (1. In Rohland’s (2. 00. Iowa, over two- thirds reported high emotional exhaustion and low personal accomplishment. Further, almost half reported high levels of depersonalization. Siebert (2. 00. 5) surveyed a state chapter of social workers, and of the 7. The investigators also used a single item burnout measure and 1. I currently have problems with burnout.” Oddie and colleagues (2. UK, and 5. 4% reported high rates of emotional exhaustion. Prior United Kingdom studies reviewed by Oddie and colleagues (2. Differences in burnout between various mental health occupational types have yielded some evidence for higher burnout among community social workers compared to nurses and psychiatrists in one study in two European cities (Priebe, Fakhoury, Hoffmann, & Powell, 2. Great Britain (Onyett, Pillinger, & Muijen, 1. Maslach Burnout Inventory (MBI; Maslach, Jackson, & Leiter, 1. Some research has noted lower job satisfaction for social workers compared to psychiatrists (Prosser et al., 1. For instance, many studies either focus on burnout rates for single professional groups of interest (e. Leiter & Harvie, 1. Taris, 2. 00. 6)). Rupert and Kent (2. Comparative rates of problematic burnout could give helpful clues on whether and/or how to target and package burnout interventions for various disciplines or program types. Even though burnout is frequently mentioned as a problem in the mental health field (e. Edwards, Burnard, Coyle, Fothergill, & Hannigan, 2. In order to help address this issue, Maslach, Jackson, and Leiter (1. MBI to conceptualize low, average, and high levels of burnout based on large normative samples for various occupations. For mental health workers, high levels of burnout included emotional exhaustion scores of at least 2. Research shows that continuous data scores on the MBI are predictive of other problems (see Maslach et al., 2. MBI is lacking. Therefore, literature using these cut- offs should be evaluated with some skepticism, namely that the low cut- off scores for “high” burnout in mental health may inflate the prevalence of burnout in some studies. On the other hand, one could argue that lower rates of burnout still deserve attention, since even “mild” burnout has been associated with increased risk for mental health problems (Ahola et al., 2. Either way, external validation studies with strong methodologies (e. For instance, validation studies might determine what levels of burnout are associated with poor staff performance measures, staff intentions to leave the organization, staff health problems, or poor consumer outcomes. Stability of the burnout construct is another area of need in future research. Burke and Richardsen (1. Of particular interest is Burke and Richardsen’s conclusion that burnout often becomes a chronic condition, and that after one year, about 4. The lack of longitudinal research in the mental health field makes this topic another important area for further study. Although methodological problems are common in many prevalence studies, the rates across studies indicate that burnout may indeed be widespread among mental health workers, and there is reason to believe that rates will continue to increase. As public sector funding for mental health is either constant or reduced (see California’s recent state budget cuts to social services, e. Goldmacher, 2. 00. In an already stressful work domain, the added pressures and responsibilities are likely to be triggers for greater levels of burnout. Associated Problems for the Mental Health Field. Burnout has been associated with a large number of negative conditions affecting different types of employees, their organizations, and the consumers they serve. These undesirable situations are briefly highlighted below. We refer the reader to reviews in the general literature and larger population- based studies, and highlight studies specifically addressing mental health workers where data are available. One important caveat – we refer to consequences or outcomes of burnout, although many of these findings are derived from cross- sectional studies, making it difficult to firmly conclude whether the conditions are the outcomes of burnout rather than noncausal correlates or even antecedents. The empirical and theoretical literature suggests that the consequences of burnout can be severe and far- reaching. Employees who experience burnout often experience impaired emotional and physical health and a diminished sense of well- being (Stalker & Harvey, 2. Some population- based studies, not specifically focused on mental health workers, have shown correlations between burnout and aspects of physical and mental health. For example, Peterson and colleagues (2. Swedish city (N = 1. Burnout was associated with increased depression, anxiety, sleep problems, impaired memory, neck and back pain, and alcohol consumption. Ahola and colleagues (2. Finland. Based on a standardized clinical interview, individuals with mild burnout were at 3. The risk of having a major depressive disorder with severe burnout was greater for men than for women, with the risk of a major depressive disorder 1. Health issues have also been linked to mental health provider burnout. In a study of 5. 91 social workers in NY, Acker (2.
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