Why it’s crucial to support mental health in healthcare
To successfully address practitioner burnout, a combination of systemic and individual steps can help protect mental healthcare providers.
As we close out the year, let's take a moment to celebrate the increasing mobilization in support of mental health.
One of my key takeaways from 2023 is that mental health needs to be a universal human right. This is a rallying cry for those of us who have committed our professional lives to caring for others and as an aspiration for health systems across the globe.
From managing stress to managing relationships, achieving better mental health is fundamental to everyone’s emotional, psychological and social well-being at every stage of life. Both therapists and patients deserve the opportunity and resources to flourish in every aspect of their lives. It’s more important than ever before to make sure that we’re supporting the mental health practitioners dedicating their lives to this task – especially with the continuous rise of practitioner burnout.
Practitioner burnout is a contributor to the shortage of practitioners; those who experience burnout are more likely to leave or consider leaving the profession. Burnout is multifactorial, and there are both societal and broader healthcare ecosystem issues that impact burnout, including perceived low reimbursement rates for mental healthcare services and issues with insurance.
The work environment, including scheduling requirements and administrative tasks, also influences practitioner burnout. In addition, personal aspects of the work – such as managing work/life balance, secondary trauma and compassion fatigue – also contribute to burnout.
Challenges to service access
To ensure that mental health becomes a universal human right, we must build a sustainable mental health care ecosystem that promotes and supports access to care. Unfortunately, today in the United States, many factors contribute to the difficulty in providing access to these important services.
The first is a serious shortage of mental health practitioners. A recent report from Mental Health America, found that only one mental health provider was available for every 350 individuals. This issue is particularly severe in rural communities. There is also a need for improved and equitable insurance coverage.
Practitioner burnout has obvious downstream effects on patients. To ensure access to mental healthcare, practices, individuals and health systems must support mental health practitioners and commit to preventing burnout. In addition, mental health practitioners need simple tools to make their lives easier, streamline processes, simplify insurance issues, and enhance provider and patient experiences.
Systemic causes of burnout
There are many causes of practitioner burnout. Mental health is a high demand area, and the U.S. healthcare system is not structured to adequately support patients in need. These systemic issues, in turn, cause stress for practitioners, who experience moral injury when the systems in which care is provided conflicts with their beliefs about how care should be managed.
A good example is when a practitioner believes a client needs a higher level of care but is unable to make it happen because of systemic issues. Insurance difficulties are another example. According to a recent survey of 550 therapists, practitioners who accept insurance are more likely to feel overwhelmed by administrative tasks than those who do not accept insurance.
Many practitioners also suffer because there is a lack of a true spectrum of care in many systems and regions. This deficiency means that therapists are often dealing with clients or patients who are unable to access care for serious comorbidities, making the experience of trying to help the patient feel like an uphill climb if not impossible.
Structural stigmas for mental health or restrictions on the rights or opportunities of persons living with mental illness can also discourage both patients and practitioners. In addition, providers are often subject to changing regulations for care that often lack clarity and increase administrative barriers.
Combating practitioner burnout
The symptoms of burnout vary across individuals. Many practitioners report feelings of exhaustion, which manifest in thoughts such as “I can’t keep going,” and feeling tired and sad. These thoughts and feelings can result in behaviors such as being unable to keep up with personal activities or caseloads and having more difficulty completing paperwork.
Cynicism and detachment are also symptoms of burnout. Practitioners may have thoughts such as “I don’t want to do this” and feel anger or frustration at the lack of movement or change with their clients or their practice, which may result in not enjoying their work. The sense of ineffectiveness is another symptom, whereby practitioners may begin to think, “I can’t make a difference” or feel like an imposter.
Practitioners should keep an eye out for the early warning signs of burnout. These may include irritability; sleep problems, fatigue, headaches; wanting to talk about work all the time; inability to maintain boundaries; loss of motivation and procrastination; and stopping activities they enjoy.
There are several ways to prevent burnout. The first is identifying systemic barriers that are particularly stressful in any work setting and identifying which ones you may be able to influence. The second is developing a wellness plan that includes making physical health a priority, as well as identifying areas of your work that most excite you and focusing on those areas as much as possible.
Social connection is vitally important, including both time with family and friends, and establishing network of peers who can support you with work specific stressors. Advocating for yourself, and for local and larger systems level changes can be empowering when you are able. Committing to developing a personalized prevention plan, identifying your personal warning signs, and remembering to revisit your plan can also help.
However, even if you have taken the necessary steps to prevent burnout, it still may happen. That’s when it can be useful to have an “emergency” plan for burnout. This can include taking a couple days away from work, establishing a network that you can trust to be an emergency contact if you need to step away for an extended period of time and seeking out your own mental health support.
Strategies that have helped those experiencing burnout include self-care activities, prioritizing physical wellness, modifying schedules and setting boundaries with clients. In addition, a professional can enhance the experience of providing care by reducing administrative burdens with tools designed to streamline processes, improve coverage and insurance issues, and provide a centralized jumping off point to manage the business.
As we look into 2024, let’s strive to make mental health a universal human right for both practitioners and patients. We must recognize that when mental health professionals are supported and adequately resourced, they can develop professionally and experience greater job satisfaction while helping patients. By empowering mental health practitioners to prevent and manage burnout and efficiently manage their businesses, by making it easier to accept insurance and expanding coverage, we can generate a sustainable workforce of mental healthcare professionals and increase access to vital mental health services.
Lindsay Oberleitner, PhD, LP is the education director at SimplePractice Learning.