Today, behavioral health providers are trying to keep up with the increased demand for their services. Driven by the turmoil of the pandemic and its evolving impact – which continues to push mental health clinicians to increase their caseload on top of already busy schedules – these circumstances make for a serious recipe for burnout.
It is defined as “a long-term stress response marked by emotional exhaustion, depersonalization, and a lack of personal accomplishment” by Agency for Healthcare Research and Quality, burnout is an endemic problem. Self reporting burnout rates among psychiatrists hover at a staggering 78% while almost 50% of psychotherapists report job burnout. This is not surprising given that clinicians have little time for self-care and additional clients mean an endless list of administrative tasks, making it nearly impossible to keep up.
Covid: Fuel to the fire
The Covid-19 pandemic has stopped almost every aspect of societytriggering a 25% global increase in anxiety and depression, as well as addiction and substance abuse, and is causing a surge in demand for mental health services. This surge in client volume, combined with therapists moving toward telehealth and virtual care delivery, has forced clinicians into increasingly reactive states as they grapple with change and uncertainty at every turn. For those who continue to do personal work, exposure risks remain as a layer of stress. For those who can work remotely, the initial refuge in the safety of their homes has gradually changed to isolation and fewer opportunities for peer interaction and colleague support.
As mental health victims continue in the long-tail Covid arena in what is being called the “shadow pandemic,” a lesser-known aspect of burnout experienced by clinicians is the increase in compassion fatigue reducing their ability to empathize with clients and provide the best treatment. in at least some cases, compassion fatigue has caused therapists to leave the field, further contributing to the clinician shortage. As clinicians leave the profession or retire in greater numbers, it is critical to mitigate levels of burnout, alleviate compassion fatigue, and provide a clear path forward in support of primary mental health care.
Guiding organizational change to support clinicians
Trends affecting mental health treatment are having a huge impact on community behavioral health clinics as therapists struggle with an ever-increasing caseload. The management of these clinics is aware of the challenges faced by their clinicians, many of whom began their careers as therapists themselves. They work to reduce burnout and compassion fatigue among their clinical teams through administrative and organizational initiatives and by providing mental health promotion resources. The aim is to use all available means to reduce the pressure on clinicians and provide appropriate support to increase their effectiveness.
In our work with mental health clinics, we’ve seen forward-thinking organizations address the new challenges their clinicians face by rethinking everything from management styles to clinical workflows to the use of new technologies. In short, realizing that things don’t have to be done the way they’ve always been done and making sensible changes to procedures and policies go a long way toward mitigating the onset of burnout and compassion fatigue.
Here are some of the principles we’ve seen effective organizations adopt to reduce burnout that can serve as a guide for the larger mental health clinic community.
- Keep the lines of communication open.
Leaders who commit to providing support for their clinical teams and encourage two-way communication so that therapists can share their challenges openly find greater success in reducing burnout. Therapists, especially those providing care via telehealth, may be increasingly isolated and need additional support. By providing forums for input, whether through check-in calls, surveys or other means, clinic management can better assess the overall strain their teams face and encourage people to access support whether is through the EAP or other systems, formal and informal, established for this purpose.
- Increase work flexibility.
Although clinicians’ schedules are incredibly tight, leaders encourage as much flexibility as possible. Therapists are encouraged to take their own mental health days and work flexible hours as needed. Some clinics build staff wellness breaks into their schedules that they can use to re-center between sessions. Research shows that providing flexibility to teams can increase job satisfaction and reduce burnout and stress. Allowing therapists time to relax, enjoy time with their families, and take care of themselves can go a long way in mitigating burnout.
- Technology enabled clinical workflows
The pandemic has given providers an unprecedented opportunity to rethink how services are delivered and increased the use of technologies such as telehealth. At the same time, clinical leaders are looking critically at clinician workflows to determine what is working and what needs to be revised, and where new technologies can make a difference.
One area that is ripe for improvement and smart use of technology is documentation. Documentation burden on clinicians drains clinicians’ limited capacity and has been shown to be a major factor contributing to burnout. On average, clinicians spend about a a third of your time documenting customer data to meet electronic health record (EHR) and insurance coding requirements. These processes have the potential to divert time and focus providing real customer care in ways that further exacerbate time and energy shortages, compounding clinician overload.
Any technological tools that allow for reduced documentation time will have a significant impact on the physician’s ability to stay in touch with their original goal. In the past, there weren’t many options for documenting and creating session notes outside of manual documentation. Today, however, there are a number of advanced technologies, including artificial intelligence tools, that enable a level of automation in documentation that did not exist before. Clinics that embrace technology to help reduce the amount of time clinicians spend on paperwork create a safeguard against burnout.
Protecting the welfare of the clinician
Mental health clinics are not immune to larger social forces impacting workplaces, including The Great Resignation, which are driving a greater focus on employee well-being. This extends to a focus on burnout, which requires new methods to address the emotional, cognitive, and physical consequences of caregiving. Empowering clinicians with the tools and support they need allows them to focus on the well-being of clients without sacrificing their own health and ability to do their jobs. Clinics that embrace these principles are better positioned to retain and recruit clinicians so they can meet the growing needs of their communities.