Practice Management Blog

How to Address (and Prevent) Employee Burnout in Your Mental Health Practice

Burnout rates among mental health professionals are at an all-time high. A 2018 review that analysed over 30 years of research on the topic (involving 9000 psychotherapists) found that over 50% report moderate or high burnout with symptoms including emotional exhaustion due to compassion fatigue, depersonalisation characterised by a cynical attitude to their work and lower self-evaluation that reduces their sense of personal accomplishment.

Burnout has been listed by the WHO as an occupational phenomenon, “a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed”. If you think about it for a moment, it’s not difficult to understand why mental health practitioners are vulnerable to burnout. Burnout in the workplace is common, arising from a “rise and grind” attitude that celebrates the idea of being “always-on” and relentless hustling. Those pressures also exist in mental health practice, heightened by the stresses that are specific to mental health work. Your day-to-day job is to walk with clients that may have significant emotional issues and deep trauma in their background, and that’s without factoring in concerns about board review and lawsuits.

What is burnout?

While burnout is not considered a mental illness, it is a mental health issue that becoming more common in the workplace, particularly in more developed economies, and during times of lower economic growth and higher unemployment. It’s more likely to happen to employees that have high expectations of themselves, consistently feel that their work isn’t good enough, feel inadequate or unappreciated, are overworked, or are in a role that is not a good fit for them.

For mental health professionals, particular issues that can lead to burnout include:

  • Emotional fatigue, through continually working with clients who have complex, often painful, psychological issues (and may lead to vicarious traumatisation).
  • Client feedback, without objective input from colleagues and managers, the therapist may be subject to grandiosity or demonisation by clients that can erode their confidence.
  • Anxiety and worry – most therapists find it difficult to switch off from work entirely, especially when dealing with suicidal or homicidal threats.
  • Helplessness – it can take a long time before a mental health professional sees any results from their efforts which can contribute to a sense of helplessness.
  • Worry about lawsuits and board reviews – the stringent requirements placed on therapists can be debilitating as it creates a sense of imminent threat.
  • Saviour-complex – by constantly focusing on helping other people with their problems, many therapists neglect their own growth and forget to prioritise themselves.
  • Inability to connect in their personal lives – having a therapeutic stance during the day often spills over into the therapist’s private life and can make it difficult for them to connect with friends and family.

How can you recognise the signs and symptoms of burnout?

In general, especially in today’s performance culture, most employees will keep showing up for work, so absenteeism isn’t a good enough measure. In addition, asking employees directly about their mental health may not give you the answer you need either as they may not be willing to discuss their situation, they may be unaware of it, or they might just chalk it up to ‘feeling stressed’.

Burnout out typically looks a bit different from stress. Stress is usually characterised by a sense of anxiety and urgency, while burnout is more likely to present with feelings of helplessness or hopelessness (or even apathy).

To give you an idea of whether a staff member may be struggling with burnout, you can look at their levels of:

  • Energy;
  • Motivation;
  • Efficiency;
  • Productivity;
  • Error-making;
  • Physical health;
  • Patience;
  • Compassion fatigue.

Burnout, if left unaddressed, can result in self-medication (in the form of alcohol or other substances), clinical depression, and poor physical health, among many other outcomes. In particular, it is essential to watch for “compassion fatigue”, where the therapist begins to take on the pain and suffering of their clients, which can quickly spiral into vicarious trauma.

Burnout doesn’t only affect the individual though; there are some important repercussions for your practice, such as:

  • Poor workplace morale;
  • Increased risk of accidents;
  • Increased absenteeism;
  • Lower productivity;
  • Higher staff turnover.

Unfortunately, burnout affects both the health as well as the performance of employees so, if you can prevent it from happening in the first place, you can protect the wellbeing of your employee and the productivity of your practice.

10 Burnout Prevention Strategies

1. Set clear, realistic expectations

Your staff needs to have a clear understanding of their role and what you expect of them. This should be reviewed regularly to ensure that each employee has been assigned duties that are fair and reasonable.

2. Equip employees to meet expectations

There’s no point in setting expectations that your staff are unable to meet. Ensure that they have access to systems, e.g. mental health practice management software, as well as written processes and policies, to fulfill their duties effectively and efficiently.

3. Provide ongoing training

Regular workshops and training sessions help your staff to upskill and improve their competency. It’s often effective to have a weekly training session that each therapist leads on a specific, relevant topic.

4. Recognise and reward employees

It’s easy to get caught up in the daily tasks of running a practice, but your staff is your practice’s most important asset. Take time to regularly reinforce your appreciation for the value that each employee adds and their contribution to the overall goals of the practice.

5. Monitor each employee’s workload

Highly driven and motivated employees (especially those that have trouble saying ‘no’), can easily find themselves taking on more responsibilities which they are capable of doing, but may not have the time to complete within the hours of a working day. Redistribute work if necessary, or sit with the employee to come up with productivity-enhancing strategies.

6. Enforce reasonable work hours

If your staff are struggling to get through their workload in their workday, the answer is not to have them stay later or take their work home with them. While this may need to happen sometimes, it should not be the norm. Rather, help those who are feeling pressured to remain after work by assessing their workload, reviewing their productivity and, if they lack good boundaries, sending them home to get some rest.

7. Encourage your employees to work together

Competition in the workplace might benefit your bottom line in the short run as employees seek to outperform each other. But, ultimately, it will lead to a toxic working environment and poor staff morale. Instead, it can be helpful to encourage cooperation and teamwork, such as joint training presentations, group feedback sessions or the occasional team pizza lunch.

8. Encourage respect

How you see your staff is reflected in every action you take and the words you say. It’s easy for your staff to discern whether you are invested in them personally, or if you view them as an important, yet ultimately dispensable, a contributor to your bottom line. This also extends to your workplace culture. Mutual respect and support can help reduce stress. Model this respect by always speaking well of your employees whenever the opportunity arises.

9. Set a good example

If you’re at your desk all hours of the night and have poor boundaries, your employees will learn from your example, or they may feel that to succeed they need to emulate you. Everyone has different requirements for optimal performance; for some, it may be a few hours of extra sleep every night, while for others, it might be a daily exercise. Be sensitive to the needs of your employees and set a good example in terms of maintaining your own work-life balance.

10. Have an open-door policy

Stress, anxiety, even burnout, all need to be handled with compassion and sensitivity. If an employee approaches you for help, be on full alert for symptoms of burnout. An open-door policy where your staff feel comfortable to approach you may help you to address symptoms of burnout before it progresses.

But what do you do if you have an employee that is already burned out?

4 Things You Can Do to Support Recovery from Burnout

There are many ways to support team members, and it helps to have a toolkit of options that allow you to respond in a way that is both sensitive and effective. To support employees struggling with burnout, you can:

Develop a personalised Workplace Support Plan

This is a practical strategy that is developed in conversation with an employee who is struggling with burnout around questions like:

  • How can I work with you to be successful in your position?
  • What will you do from your side to ensure that this plan is effective for you?
  • How can we deal with future issues in a way that is healthy for you?

Set manageable expectations

If possible, this should be done together with the employee. Here you would work with them to organise and prioritise their workload, reducing responsibility if necessary. A loss of confidence in their own competency is one of the characteristics most commonly associated with burnout, so a temporary reduction of stress may help them recover their belief in their own abilities.

Encourage and support self-care

Mental health professionals, whether struggling with burnout or not, tend to be better at advocating the importance of self-care while neglecting it themselves. This may mean setting strong boundaries about when you may be contacted, taking breaks between appointments, sticking to a regular exercise schedule and eating well. It won’t be the same for everyone, but the key is to set boundaries that are appropriate for the individual.

Have open, honest conversations

There is a stigma attached to burnout as it is often seen as an indication that “you couldn’t hack it”. If you can walk alongside employees who are struggling and help them to get the support they need, you can reduce the levels of guilt and shame, and ensure that the employee is equipped during their recovery. This openness can also help support other team members who may be struggling and build loyalty as they will know that they can also bring any issues to you without fear of judgement.

Rates of burnout in the workplace are on the rise, and it’s no surprise that in the mental health field, the numbers are higher than in most other industries. The pressure to perform, coupled with significant mental and emotional stressors, make it a challenging space in which to thrive.

For practice managers, there is then an added responsibility. On top of managing the administration and day-to-day processes in the practice, you need to be looking after your most important asset: your staff.

It’s true that, like with most things, burnout prevention is better than a cure, both for your employees and your mental health practice. Proactive support strategies can help you identify symptoms of burnout before they get worse. But burnout, if it happens, isn’t the end of the world and there are a number of simple steps you can take to support your team and the individual employee in a way that allows you to walk alongside the employee and brings you closer together as a team.

If you would like to learn more about this topic, read our article Balance or Burnout.

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