A latent and lasting effect of the pandemic has been the emotional toll it’s taken on behavioral health clinicians. Here, we’ll review the state of burnout in mental health professionals, statistics on mental health in America, and strategies and interventions to help those who help us.
Mental health workers were never trained to be the pillars of strength for a nation struggling through a global pandemic. Yet, when COVID-19 shook society into a state of crisis, our behavioral health specialists answered the call of duty — and they’re now paying the price.
Professional burnout is a job-related stress condition experienced by many in the workforce.
But what happens when the psychiatrists, psychologists, therapists, and social workers we rely on to treat our own mental health conditions become burnt out themselves?
This is the situation we’re facing today as behavioral health providers are pushed to the limits of their mental, emotional, and professional bandwidth with no signs of reprieve.
COVID-19 impacts on mental health professionals
Through the pandemic, economic recession, and civil unrest that claimed 2020, the nation saw increased prevalence of mental health illness across populations.
According to data collected by Mental Health America, over half a million people reported having signs of depression and/or anxiety between January and September of 2020, with screenings for anxiety and depression up 634% and 873%, respectively.
As a result, demand for telemental health services skyrocketed with virtual therapy and psychiatry usage growing 302% compared to averages reported pre-COVID-19.
Psychologists and therapists took the wave of suffering clients head on — with little protection from the inevitable physical and mental consequences to come.
It can be easy to brush off the psychological challenges of those most experienced in managing them, but mental health providers are spouses, parents, caregivers, and breadwinners with the same vulnerabilities to emotional distress as the rest of us.
Tamara Hubbard, MA, LCPC, a Licensed Counselor & Family Therapist spoke on her experience practicing during the pandemic saying, “Being a therapist and having insight into effective coping skills doesn’t mean I’m going to get through a global pandemic unscathed. I’ve absolutely felt more burnt out than normal these past 10 months. Who hasn’t?”
In the early days of lockdown we celebrated and empathized with our hospitals’ healthcare heroes; next it was our frontline workers. But a forgotten care contingent, lost among the mundane yet draining slog of a year-long pandemic, has been every professional in our mental health care workforce.
Burnout rates for mental health providers
78%: self-reported burnout in psychiatrists from a 2020 study
16%: psychiatrists screening for major depression in the same 2020 study
21-61%: average rate of mental health practitioner burnout (pre-COVID)
90%: self-reported burnout in a study of college counseling center practitioners in 2020
As the demand for behavioral health services becomes overwhelming in scale, and significant health concerns over mental health professional burnout reach an all-time high, it’s time we recognize the pandemic’s latent and lasting implications on mental health care workers in this country.
Here, we’ll unpack the situation that’s brought us here today, acknowledge the psychological effects of burnout on mental health providers, and outline strategies for prevention and intervention.
What are the driving factors behind psychiatrist and therapist burnout?
Three themes have contributed to the soaring burnout rates among behavioral health clinicians: historic and pervasive lack of government funding, a professional shortage, and a growing desire to serve at all costs.
1. The mental health crisis in America
The mental health crisis in America is an ongoing pandemic first brought to light in the 1960’s. Between 2009 and 2012, states cut mental health budgets by nearly 4.3 billion dollars, and have been slow to provide adequate funding and resources for mental health care ever since.
Increasing instances of depression, anxiety, and other conditions brought on by the world events of 2020 created an unforeseen need for mental health services, which the healthcare system was not equipped to provide.
2. A shortage of mental health providers
Major concerns over the lack of mental health providers, especially the shortage among psychiatrists, predates the pandemic.
In 2016, the US Department of Health and Human Services (HHS) predicted demand for 250,000 additional mental health workers by 2025. With reported rates of anxiety and depression surging in 2021, from 1 in 10 to 4 in 10 American adults, this number is likely now too conservative.
The HHS has also designated 5,733 mental health professional shortage areas in the U.S. — these are geographic areas where the ratio of mental health professionals to residents is less than 1 per 30,000 people.
With stats like these, an already strained mental health infrastructure was destined to collapse when the pandemic hit. Despite the exhaustive efforts of our mental health workers to expand their hours and caseloads, many vulnerable people in our communities still do not have adequate access to the critical mental health services they need.
3. Diminishing professional boundaries in mental health care
Behavioral health professionals know the importance of boundaries in the workplace, but an ingrained drive to help others superseded personal wellbeing for many care providers during the pandemic.
According to the American Psychological Association, nearly one-third of psychologists said they are seeing more patients since the start of the pandemic.
To accommodate growing caseloads, longer waitlists, and requests for more frequent consults from existing clients, many mental health workers felt pressure to lift essential professional boundaries by extending working hours.
Full caseloads and overbooked schedules left psychiatrists and therapists with little time for self care as the line between their professional and personal lives blurred.
How is burnout affecting mental health providers today?
Psychologists and therapists such as social workers and counselors are experiencing a myriad of detrimental effects to their mental health and overall wellbeing.
Growing empathy fatigue
“The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet.”
- Rachel Naomi Remen, Kitchen Table Wisdom, 1996
Empathy fatigue and compassion fatigue are forms of vicarious trauma experienced by those with direct or secondary exposure to the trauma and emotional distress of others.
Mental health care providers and professionals in the helping field with little time for breaks in between appointments, are often unable to emotionally refuel and recuperate after client interactions, eventually leading to the onset of empathy fatigue.
This condition profoundly alters a person’s worldview and can create an inability to express compassion and empathy for others, along with a cynical attitude towards clients and their profession - which can be devastating symptoms when these capabilities are an essential component of one’s job function.
Mental health providers can be challenged to overextend their capabilities and resources to support a laundry list of clients, exposing them to chronic stress.
Ongoing pressure and high levels of stress from compounding responsibilities at work and at home contribute heavily to emotional fatigue.
One of the leading symptoms of burnout, this condition can be difficult to pinpoint as it typically presents itself in a range of physical, mental, and emotional symptoms.
Some signs and symptoms of emotional fatigue include:
Changes in mood such as lack of motivation, anger, anxiety, hopelessness, and irritability
Difficulty thinking such as lack of concentration and forgetfulness
Physical changes such as loss of appetite and headaches
Negative effects on work and personal relationships
Depersonalization towards clients
In addition to emotional exhaustion and empathy fatigue, burned out psychiatrists and therapists can develop an altered perception of themselves and their environment through a phenomenon called depersonalization.
Providers with this disorder can find themselves detaching and forming a detached, callous, or dehumanized attitude towards clients as they are perceived to be a source of stress and anxiety.
Symptoms for depersonalization disorder can last anywhere from a few days to years and can lead to other mental health conditions like depression, anxiety, and panic disorders.
The severity of this threat to behavioral health care providers cannot be underestimated, and clinicians are at high risk of developing these types of conditions given the nature of their profession in today’s climate.
Reduced feelings of personal accomplishment
When tasked with fixing an unsolvable problem, feelings of low personal accomplishment can be expected.
Mental health professionals are seeing increased referrals and requests for more frequent consults. Having to turn down clients leaves providers feeling guilty for not being able to help people in desperate need of care.
As the expectations of the behavioral health workforce become more demanding, psychiatrists and therapists may feel they can’t sufficiently perform their jobs as a result of declining professional self-esteem and negative self-evaluation of their performance.
Prevention and intervention for mental health provider burnout
Despite glaring statistics, burnout is not an inevitability. The pandemic challenged us all to take notice of what’s important, slow down where possible, and in many ways, reevaluate our state of being, working, and living.
Mental health professionals intuitively know how to initiate positive change, but it can be a greater challenge to gracefully take one’s own advice.
Here are three reminders of how to shift the tides toward better life balance.
Reminder 1: Know and respect your limitations as a psychiatrist or therapist
Burnout in mental health care workers can be difficult to treat, but the impact of the condition can be mitigated when measures are put in place to prevent behaviors that cause it. By acknowledging their limits as people and providers, behavioral health care workers can recognize when boundaries are being overstepped.
Refill your tank before refilling that of others. For example, schedule augmentation, like restricting working hours and adjusting work schedules to create space for personal priorities and obligations, ensures you have adequate time to tend to personal needs and recharge.
Check in with yourself. How are you really feeling today? Paying attention to the initial signs of burnout can prompt mental health clinicians to take action and seek help before long-term issues take effect.
Your work is valuable, but so are you. Preserving the distinction between what your role is and is not in the client-provider relationship, creates safer and more ethical client-provider collaboration that is ultimately more effective for both parties long-term.
Reminder 2: The importance of self care for mental health professionals
Making time for personal restoration through activities that not only meet basic needs but bring joy and fulfillment, can replenish energy stores in providers.
These are some self-care tips for mental health providers experiencing burnout:
Get back to the basics and try maintaining good hygiene, a healthy diet, regular exercise, and a routine sleep schedule.
Make time for activities you enjoy like seeing friends and family, spending time in nature, or working on passion projects and hobbies outside of work.
Seek professional help when signs of burnout begin to show.
Reminder 3: Find social support
Finding a support group or community of people who can relate to their circumstance gives providers an outlet to discuss shared obstacles and emotions, letting them know they’re not alone in their struggles.
Commiserating with others in the same field of practice helps to reduce feelings of loneliness and isolation for many working in behavioral health care. Growing a network of friends, family members, and peers establishes a readily available support network for when stressors and challenges threaten to destabilize the mental state of providers.
With so many mental health care professionals moving their practices online and out of a shared office space, this work can be isolating. Find and actively engage with professional community groups online. Or consider starting a mastermind group of your own, and make time to connect with peers on a monthly or quarterly basis.
Benefits of telehealth for mental health providers
Many mental health professionals have already moved part or all of their private practices online, but with the growing demand for services, new opportunities to provide care with emerging digital health companies have skyrocketed.
In fact, now might be one of the most exciting times to work in the behavioral health field because of the diversity and sheer volume of working opportunities. The challenge can be sorting through the options to find the right fit for one’s experience, interests, and scheduling boundaries.
Why do mental health providers work with Wheel?
Working in telemental health with an organization like Wheel makes it simple. Wheel pre-vets virtual care partners for the utmost in clinical quality, patient safety, and professional protection, giving psychiatrists and psychotherapists the opportunity to supplement their private practices with a flexible part-time or full-time virtual practice providing mental healthcare online.
How do mental health professionals work with Wheel?
Wheel connects behavioral health professionals with a variety of high-quality telehealth opportunities in one singular destination. With just one application, one credentialing effort, and one schedule, our teletherapists and telepsychiatrists can start working with clients and patients across multiple companies and in all regions of the United States (based on a clinician’s state licensure).
Wheel is the simpler way to practice virtually with multiple telehealth companies.