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Organizational change is just as important as self-care when combatting clinician burn out

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As the COVID -19 pandemic lurches into another wave, burnout among clinicians is widespread. Some data indicates up to about 67% of mental health workers are dealing with burnout. The highest rates are seen among community mental health agency leaders and social workers.

Angela Rollins is an associate director with the U.S. Veterans Affairs’ Center for Health Information and Communication, and a research scientist at the Regenstrief Institute. She is also the lead author on a new study from the two organizations looking at organizational drivers of clinician burnout.

“There is plenty of attention on burnout these days, but the approaches we use to combat it are often centered around building coping skills for staff,” she said. “But burnout isn’t something we can just train out of people. Resiliency and self-care workshops can be helpful to some people but are not enough.”

Rollins said mental health care workers are familiar with self-care strategies – they teach then to their clients. But if they themselves don’t have the time or space or practice it, then self-care isn’t an effective strategy.

“I liken it to treating the symptoms of the illness instead of the disease,” she said.

The study focused on 40 clinicians recruited from an array of mental health service programs, ranging from homeless outreach to psychiatric rehab to substance abuse services. Participants revealed several themes:

They yearn to return to patient centered care.

Specifically, survey participants cited organizational culture driven by high workloads and productivity expectations, metrics and documentation demands. These not only contribute to burnout, they say, but also negatively impact client care.

They need skilled supervisors who can coach both those workers who perform well and those who need more constructive feedback.

“Because there's nothing that erodes morale more than a good performer having to pick up the slack for a poor performer,” Rollins said.

Especially valued: supervisors who are willing to stick their necks out and really advocate for their team’s needs.

They want to work for organizations that allow for professional development -- and they’re not talking about online training.

“They want things like actually learning a new practice, learning a new innovation,” Rollins said.

Having supervisors who can coach and reinforce the new training is especially valued.

They want their organization to prioritize self-care.

“So the example that one person brought up was, ‘You can give me vacation time and tell me that it's a good idea to take my vacation time, but if my workload or my productivity standards don't allow for it, you know, that's sort of a hollow benefit’,” Rollins said.

But are organizations willing or capable of addressing any of these themes? Rollins refers to organizational change as “the next frontier” but suggests changing leadership practices and working with frontline supervisors is the easiest place to start.

“Making sure they have the tools that they need to really, really help their staff effectively,” Rollins said.

Tools like better communication and conflict resolution.

“We have had a couple of supervisors tell us... ‘I know how to be a good clinician but no one taught me how to manage people,” Rollins said.

Some participants acknowledged their organizations may not be able to fix the root of all problems, but said genuine listening skills go a long way toward helping burned out workers hang on.

“I just want to feel like somebody hears me,” one respondent said.

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