A recent study published in Psychiatric Services found that community mental health workers in Australia who identify as having their own lived experience of mental illness may be less susceptible to workplace burnout.
Burnout—chronic work-related physical and psychological stress and exhaustion—is high amongst mental health professionals, particularly those working in under-resourced settings. Burnout has been deemed a public health concern on a global scale, with some previous research even suggesting it as a syndrome closely related to depression. Burnout is not only harmful for workers’ well-being, but has also been linked to lower job engagement and worse treatment outcomes for consumers:
“Client-related burnout is associated with negative job attitudes, lower job engagement, poorer workplace well-being, and increased intentions to resign. Burnout among health care workers may also result in poorer outcomes for clients, including decreased satisfaction with treatment and lower reported quality of care, and may be more common in settings where client progress is slow and uneven.”
Studies investigating drivers of burnout in the mental health field have found that workers’ perceptions of their inability to help clients who they see as making limited progress in treatment are key contributors to burnout.
A growing body of research highlights the importance and effectiveness of peer workers in mental health and addiction treatment settings. However, while peer specialists are hired specifically due to their lived experience, many additional mental health professionals also have histories of navigating the mental health system as a consumer, a fact that often goes unacknowledged in research and clinical contexts and that is often undisclosed by employees.
A team of researchers at the University of Queensland in Australia, led by Courtney von Hippel, argue that this first-hand experience may protect staff against client-related burnout:
“Staff with lived experience of mental health issues have first-hand experience with their own recovery challenges, as well as with the difficulties in navigating the mental healthcare environment as consumers. As a consequence, staff with lived experience may be less susceptible to client-related burnout caused by feelings that their help has resulted in little client progress, because they understand that recovery can be slow and uneven.”
To test their hypothesis that lived experience buffers burnout, researchers surveyed staff at a community mental health organization in Australia. Questionnaires were completed online by staff in October and November of 2020. Respondents completed a demographic survey along with questionnaires related to burnout, job satisfaction, job engagement, and workplace well-being. Participants also answered questions related to their own lived experience as mental health service recipients and their perceptions of their clients’ treatment progress and recovery.
While the survey invitation was sent via email to all staff currently employed at the organization, it had only a 23% response rate, totaling 179 participants. Sixty-three percent (112) of survey respondents reported lived experience of mental illness. Results indicate that overall, participants believed that their clients were improving as a result of treatment. However, when staff perceived that clients were not improving, they experienced higher levels of burnout, lower job satisfaction, poorer workplace well-being, and a higher intention to quit.
Consistent with the researchers’ central hypothesis, results of a moderated mediation analysis revealed that lived experience had a buffering effect on the relationship between perceptions of clients’ limited improvement and burnout: amongst staff who believed that their clients were not improving, those who identified as having lived experience experienced less burnout compared to staff without lived experience. Results point to a previously undocumented benefit of lived experience as a protective factor against burnout.
The researchers propose that the observed buffering effect of lived experience may be explained by staff’s first-hand knowledge that recovery is an individualized and nonlinear process which, in turn, may bolster their empathy for their clients and motivation at work.
A few key limitations of the current study are noteworthy. The low response rate (23%) and self-selected nature of survey participation may suggest that the findings are not widely representative of the sample of interest (community mental health workers). Authors noted that the high rates of lived experience (63%) in the sample was surprising, and may be due to the self-selected nature of participation. Alternatively, findings may suggest a high rate of lived experience within community mental health professionals that is difficult to estimate due to a widespread “culture of non-disclosure.”
Researchers call for future research that leverages their initial findings to explore whether client outcomes differ when their mental healthcare provider has lived experience. Additionally, they close their paper by laying out the need to better understand the underlying mechanisms of the protective effect of lived experience:
“Given the high rates of burnout in the mental health profession, future research should explore why lived experience protects staff from client-related burnout. This information can aid in the development of interventions to boost worker resilience, engagement, and longevity in the field.”
von Hippel, C., Brener, L., & Rose, G. (2022). Lived experience as a protective factor for mental health workers. Psychiatric Services, 73(9), 999–1004. https://doi.org/10.1176/appi.ps.202100468 (Abstract)