Top

Administration and Policy in Mental Health and Mental Health Services Research

Published in:

01-09-2012 | Original Paper

Burnout in Mental Health Services: A Review of the Problem and Its Remediation

Authors: Gary Morse, Michelle P. Salyers, Angela L. Rollins, Maria Monroe-DeVita, Corey Pfahler

Published in: Administration and Policy in Mental Health and Mental Health Services Research | Issue 5/2012

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. 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.

Acker, G. (2010). The challenges in providing services to clients with mental illness: Managed care, burnout and somatic symptoms among social workers. Community Mental Health Journal, 46(6), 591–600.PubMedCrossRef

Ahola, K., Honkonen, T., Isometsä, E., Kalimo, R., Nykyri, E., Aromaa, A., et al. (2005). The relationship between job-related burnout and depressive disorders—results from the Finnish Health 2000 Study. Journal of Affective Disorders, 88(1), 55–62.PubMedCrossRef

Awa, W. L., Plaumann, M., & Walter, U. (2010). Burnout prevention: A review of intervention programs. Patient Education and Counselling, 78(2), 184–190.CrossRef

Bittman, B., Bruhn, K. T., Stevens, C., Westengard, J., & Umbach, P. O. (2003). Recreational music-making: A cost-effective group interdisciplinary strategy for reducing burnout and improving mood states in long-term care workers. Advances in Mind-Body Medicine, 19(3–4), 4–15.PubMed

Boyer, S. L., & Bond, G. R. (1999). Does assertive community treatment reduce burnout? A comparison with traditional case management. Mental Health Services Research, 1(1), 31–45.CrossRef

Burke, R. J., & Richardsen, A. M. (1993). Psychological burnout in organizations. In R. T. Golembiewski (Ed.), Handbook of organizational behavior. New York: Marcel Dekker.

Canfield, J. (2005). Secondary traumatization, burnout, and vicarious traumatization: A review of the literature as it relates to therapists who treat trauma. Smith College Studies in Social Work, 75(2), 81–101.CrossRef

Carney, J., Donovan, R., Yurdin, M., & Starr, R. (1993). Incidence of burnout among New York City intensive case managers: Summary of findings. Psychosocial Rehabilitation Journal, 16(4), 25–38.

Carson, J., Cavagin, J., Bunclark, J., Maal, S., Gournay, K., Kuipers, E., et al. (1999). Effective communication in mental health nurses: Did social support save the psychiatric nurse? Nursing Times Research, 4(1), 31–42.

Chemiss, C. (1980). Staff burnout: Job stress in the human services. Beverly Hills, CA: Sage.

Corrigan, P. W. (1990). Consumer satisfaction with institutional and community care. Community Mental Health Journal, 26(2), 151–165.PubMedCrossRef

Corrigan, P. W., McCracken, S. G., Edwards, M., Kommana, S., & Simpatico, T. (1997). Staff training to improve implementation and impact of behavioral rehabilitation programs. Psychiatric Services, 48(10), 1336–1338.PubMed

Deegan, P. E., Rapp, C., Holter, M., & Riefer, M. (2008). Best practices: A program to support shared decision making in an outpatient psychiatric medication clinic. Psychiatric Services, 59(6), 603–605.PubMedCrossRef

Ducharme, L. J., Knudsen, H. K., & Roman, P. M. (2008). Emotional exhaustion and turnover intention in human service occupations: The protective role of coworker support. Sociological Spectrum, 28(1), 81–104.CrossRef

Dunkley, J., & Whelan, T. A. (2006). Vicarious traumatisation: Current status and future directions. British Journal of Guidance & Counselling, 34(1), 107–116.CrossRef

Edwards, D., Burnard, P., Coyle, D., Fothergill, A., & Hannigan, B. (2000). Stress and burnout in community mental health nursing: A review of the literature. Journal of Psychiatric and Mental Health Nursing, 7, 7–14.PubMedCrossRef

Emmons, R. A., & Shelton, C. M. (2001). Gratitude and the science of positive psychology. In C. Snyder & S. Lopez (Eds.), Handbook of positive psychology (pp. 459–471). New York: Oxford University Press.

Ewers, P., Bradshaw, T., McGovern, J., & Ewers, B. (2002). Does training in psychosocial interventions reduce burnout rates in forensic nurses? Journal of Advanced Nursing, 37(5), 470–476.PubMedCrossRef

Fallot, R. D., & Harris, M. (2008). Trauma informed approaches to systems of care. Trauma Psychology Newsletter, 3(1), 6–7.

Feingold, A. (2005). Sustaining stamina at the interface of HIV and mental health practice. Mental Health AIDS, 6(2), 6–9.

Feingold, A. (2008). Kicking it upstairs. Mental Health AIDS, 9(2), 8–9.

Figley, C. R. (1995). Compassion fatigue as secondary traumatic stress disorder: An overview. In C. R. Figley (Ed.), Compassion fatigue: Coping with secondary traumatic stress disorder in those who treat the traumatized (pp. 1–20). Philadelphia, PA, USA: Brunner/Mazel.

Garman, A. N., Corrigan, P. W., & Morris, S. (2002). Staff burnout and patient satisfaction: Evidence of relationships at the care unit level. Journal of Occupational Health Psychology, 7(3), 235–241.PubMedCrossRef

Geller, G., Bernhardt, B. A., Carrese, J., Rushton, C. H., & Kolodner, K. (2008). What do clinicians derive from partnering with their patients? A reliable and valid measure of “personal meaning in patient care”. Patient Education and Counseling, 72(2), 293–300.PubMedCrossRef

Gilbody, S., Cahill, J., Barkham, M., Richards, D., Bee, P., & Glanville, J. (2006). Can we improve the morale of staff working in psychiatric units? A systematic review. Journal of Mental Health, 15(1), 7–17.CrossRef

Glisson, C., Dukes, D., & Green, P. (2006). The effects of the ARC organizational intervention on caseworker turnover, climate, and culture in children’s service systems. Child Abuse and Neglect, 30(8), 855–880. discussion 849–854.PubMedCrossRef

Goldmacher, S. (2009, November 19, 2009). California’s budget woes will continue for years, report says, The Los Angeles Times. Retrieved from www.latimes.com/news/local/la-me-budget-deficit19-2009nov19,0,433593.story.

Gowdy, E. A., Carlson, L. S., & Rapp, C. A. (2003). Practices differentiating high-performing from low-performing supported employment programs. Psychiatric Rehabilitation Journal, 26, 232–239.PubMedCrossRef

Halberg, I. R. (1994). Systematic clinical supervision in a child psychiatric ward: Satisfaction with nursing care, tedium, burnout, and the nurses’ own report on the effects of it. Archives of Psychiatric Nursing, 8(1), 44–52.CrossRef

Halbesleben, J. R. B., & Buckley, M. R. (2004). Burnout in organizational life. Journal of Management, 30(6), 859–879.

Halbesleben, J. R. B., Osburn, H. K., & Mumford, M. D. (2006). Action research as a burnout intervention: Reducing burnout in the federal fire service. Journal of Applied Behavioral Science, 42(2), 244–266.CrossRef

Halbesleben, J. R., & Rathert, C. (2008). Linking physician burnout and patient outcomes: Exploring the dyadic relationship between physicians and patients. Health Care Management Review, 33(1), 29–39.PubMedCrossRef

Hayes, S. C., Bissett, R., Roget, N., Padilla, M., Kohlenberg, B. S., Fisher, G., et al. (2004a). The impact of acceptance and commitment training and multicultural training on the stigmatizing attitudes and professional burnout of substance abuse counselors. Behavior Therapy, 35(4), 821–835.CrossRef

Hayes, S. C., Follette, V. M., & Linehan, M. M. (2004b). Mindfulness and acceptance: Expanding the cognitive-behavioral tradition. New York: Guilford Publications, Guilford Press.

Hoge, M. A., Morris, J. A., Daniels, A. S., Stuart, G. W., Huey, L. Y., & Adams, N. (2007). An action plan for behavioral health workforce development: A framework for discussion. Rockville, MD.

Holmqvist, R., & Jeanneau, M. (2006). Burnout and psychiatric staff’s feelings towards patients. Psychiatry Research, 145(2–3), 207–213.PubMedCrossRef

Kerns, C. D. (2006). Gratitude at work: Counting your blessings will benefit yourself and your organization. Graziado Business Review, 9(4). Retrieved from http://gbr.pepperdine.edu/2010/08/gratitude-at-work/.

Knudsen, H. K., Ducharme, L. J., & Roman, P. M. (2008). Clinical supervision, emotional exhaustion, and turnover intention: A study of substance abuse treatment counselors in the Clinical Trials Network of the National Institute on Drug Abuse. [Research Support, N.I.H., Extramural]. Journal of Substance Abuse Treatment, 35(4), 387–395.

Krasner, M. S., Epstein, R. M., Beckman, H., Suchman, A. L., Chapman, B., Mooney, C. J., et al. (2009). Association of an educational program in mindful communication with burnout, empathy, and attitudes among primary care physicians. JAMA: Journal of the American Medical Association, 302(12), 1284–1293.PubMedCrossRef

Leiter, M. P., & Harvie, P. L. (1996). Burnout among mental health workers: A review and research agenda. International Journal of Social Psychology, 42, 90–101.CrossRef

Leiter, M. P., Harvie, P., & Frizzell, C. (1998). The correspondence of patient satisfaction and nurse burnout. Social Science and Medicine, 47(10), 1611–1617.PubMedCrossRef

Leiter, M. P., Laschinger, H. K. S., Day, A., & Oore, D. G. (in press). The impact of civility interventions on employee social behavior, distress, and attitudes. Journal of Applied Psychology.

Leiter, M. P., & Schaufeli, W. B. (1996). Consistency of the burnout construct across occupations. Anxiety, Stress & Coping: An International Journal, 9(3), 229–243.CrossRef

Mancini, A. D., Moser, L. L., Whitley, R., McHugo, G. J., Bond, G. R., Finnerty, M. T., et al. (2009). Assertive community treatment: Facilitators and barriers to implementation in routine mental health settings. Psychiatric Services, 60(2), 189–195.PubMedCrossRef

Maslach, C. (1993). Burnout: A multidimensional perspective. In W. B. Schaufeli, C. Maslach, & T. Marek (Eds.), Professional burnout: Recent developments in theory and research (pp. 19–32). Washington, DC: Taylor & Francis.

Maslach, C., Jackson, S. E., & Leiter, M. P. (1996). Maslach burnout inventory manual (3rd ed.). Palo Alto, California: Consulting Psychologists Press.

Maslach, C., & Pines, A. (1979). Burnout, the loss of human caring. In A. Pines & C. Maslach (Eds.), Experiencing social psychology. New York: Random House.

Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job burnout. Annual Review of Psychology, 52, 397–422.PubMedCrossRef

Melchior, M. E., Philipsen, H., Abu-Saad, H. H., Halfens, R. J., van de Berg, A. A., & Gassman, P. (1996). The effectiveness of primary nursing on burnout among psychiatric nurses in long-stay settings. Journal of Advanced Nursing, 24(4), 694–702.PubMedCrossRef

Murphy, L. R. (1996). Stress management in work settings: A critical review of the health effects. American Journal of Health Promotion: AJHP, 11(2), 112–135.PubMedCrossRef

Oddie, S., & Ousley, L. (2007). Assessing burn-out and occupational stressors in a medium secure service. The British Journal of Forensic Practice, 9(2), 32–48.CrossRef

Onyett, S., Pillinger, T., & Muijen, M. (1997). Job satisfaction and burnout among members of community mental health teams. Journal of Mental Health, 6(1), 55–66.CrossRef

Paris, M., Jr., & Hoge, M. A. (2010). Burnout in the mental health workforce: A review. Journal of Behavioral Health Services & Research, 37(4), 519–528.CrossRef

Peterson, U., Demerouti, E., Bergström, G., Samuelsson, M., Åsberg, M., & Nygren, Å. (2008). Burnout and physical and mental health among Swedish healthcare workers. Journal of Advanced Nursing, 62(1), 84–95.PubMedCrossRef

Pines, A., & Aronson, E. (1988). Career burnout: Causes and cures. New York, NY, USA: Free Press.

Pines, A., & Maslach, C. (1978). Characteristics of staff burnout in mental health settings. Hospital & Community Psychiatry, 29(4), 233–237.

Priebe, S., Fakhoury, W. K. H., Hoffmann, K., & Powell, R. A. (2005). Morale and job perception of community mental health professionals in Berlin and London. Social Psychiatry and Psychiatric Epidemiology, 40(3), 223.PubMedCrossRef

Prosser, D., Johnson, S., Kuipers, E., Szmukler, G., Bebbington, P., & Thornicroft, G. (1997). Perceived sources of work stress and satisfaction among hospital and community mental health staff, and their relation to mental health, burnout and job satisfaction. Journal of Psychosomatic Research, 43(1), 51–59.PubMedCrossRef

Robey, K., Ramsland, S. E., & Castelbaum, K. (1991). Alignment of agency and personal missions: An evaluation. Administration and Policy In Mental Health, 19(1), 39–45.CrossRef

Rohland, B. M. (2000). A survey of burnout among mental health center directors in a rural state. Administration and Policy In Mental Health, 27(4), 221–237.PubMedCrossRef

Rollins, A., Salyers, M., Tsai, J., & Lydick, J. (2010). Staff turnover in statewide implementation of ACT: Relationship with ACT fidelity and other team characteristics. Administration and Policy in Mental Health and Mental Health Services Research, 37(5), 417–426.PubMedCrossRef

Rupert, P. A., & Kent, J. S. (2007). Gender and work setting differences in career-sustaining behaviors and burnout among professional psychologists. Professional Psychology: Research and Practice, 38(1), 88–96.CrossRef

Salyers, M. P., Hudson, C., Morse, G., Rollins, A. L., Monroe-DeVita, M., Wilson, C., et al. (2011). BREATHE: A pilot study of a one-day retreat to reduce burnout among mental health professionals. Psychiatric Services, 62(2), 214–217.PubMedCrossRef

Scarnera, P., Bosco, A., Soleti, E., & Lancioni, G. E. (2009). Preventing burnout in mental health workers at interpersonal level: An Italian pilot study. Community Mental Health Journal, 45(3), 222–227.PubMedCrossRef

Schulz, R., Greenley, J. R., & Brown, R. (1995). Organization, management, and client effects on staff burnout. Journal of Health and Social Behavior, 36(4), 333–345.PubMedCrossRef

Schwab, R. L., Jackson, S. E., & Schuler, R. S. (1986). Educator burnout: Sources and consequences. Educational Research Quarterly, 10, 15–30.

Siebert, D. C. (2005). Personal and occupational factors in burnout among practicing social workers: Implications for research, practitioners, and managers. Journal of Social Service Research, 32(2), 25–44.CrossRef

Smoot, S. L., & Gonzolas, J. L. (1995). Cost-effective communication skills training for state hospital employees. Psychiatric Services, 46, 819–822.PubMed

Stalker, C., & Harvey, C. (2002). Professional burnout: A review of theory research, and prevention Partnerships for Children and Families Project. Waterloo: Wilfrid Laurier University.

Taris, T. W. (2006). Is there a relationship between burnout and objective performance? A critical review of 16 studies. Work & Stress, 20(4), 316–334.CrossRef

Toppinen-Tanner, S., Ojajärvi, A., Väänänen, A., Kalimo, R., & Jäppinen, P. (2005). Burnout as a predictor of medically certified sick-leave absences and their diagnosed causes. Behavioral Medicine, 31(1), 18–27.PubMedCrossRef

van Dierendonck, D., Garssen, B., & Visser, A. (2005). Burnout prevention through personal growth. International Journal of Stress Management, 12(1), 62–77.CrossRef

van Dierendonck, D., Schaufeli, W. B., & Buunk, B. P. (1998). The evaluation of an individual burnout intervention program: The role of inequity and social support. Journal of Applied Psychology, 83(3), 392–407.CrossRef

van Dierendonck, D., Schaufeli, W. B., & Buunk, B. P. (2001). Burnout and inequity among human service professionals: A longitudinal study. Journal of Occupational Health Psychology, 6(1), 43–52.PubMedCrossRef

Webster, L., & Hackett, R. K. (1999). Burnout and leadership in community mental health systems. Administration and Policy In Mental Health, 26(6), 387–399.PubMedCrossRef

World Health Organization. (1992). The ICD-10 classification of mental and behavioral disorders. Geneva: World Health Organization.

Title: Burnout in Mental Health Services: A Review of the Problem and Its Remediation
Authors: Gary Morse
Michelle P. Salyers
Angela L. Rollins
Maria Monroe-DeVita
Corey Pfahler
Publication date: 01-09-2012
Publisher: Springer US
Published in: Administration and Policy in Mental Health and Mental Health Services Research / Issue 5/2012
Print ISSN: 0894-587X
Electronic ISSN: 1573-3289
DOI: https://doi.org/10.1007/s10488-011-0352-1

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Burnout in Mental Health Services: A Review of the Problem and Its Remediation

Abstract

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 5/2012

National Guard Service Members Returning Home After Deployment: The Case for Increased Community Support

Expanding the Domains of Attitudes Towards Evidence-Based Practice: The Evidence Based Practice Attitude Scale-50

Key processes, Ingredients and Components of Successful Systems Collaboration: Working with Severely Emotionally or Behaviorally Disturbed Children and Their Families

Evaluating Patient Adherence to Antidepressant Therapy Among Uninsured Working Adults Diagnosed with Major Depression: Results of the Texas Demonstration to Maintain Independence and Employment Study

Therapist Perspectives on Community Mental Health Services for Children with Autism Spectrum Disorders

Mental Health Service Utilization Among Noncitizens in the United States: Findings From the National Latino and Asian American Study