Triggered: A Qualitative Approach Exploring Compassion Fatigue Among Mental Health Providers in Saint Louis, MO and Beyond

Background and Purpose: Amid the Covid-19 pandemic, there is an increasing demand for mental health providers. Prior to the pandemic behavioral health business-organizations were working to address the shortage of in-person mental health providers. Such demand places these providers at risk of developing compassion fatigue. This study presents insight to providers' previous experience of compassion fatigue and how their organization responded long before the outbreak. Compassion fatigue (CF) has been described as an empathic strain and general exhaustion that has developed from dealing with people that are in distress over time. CF causes physical and emotional exhaustion that affects an individual ability to feel empathy and compassion for others. This study seeks to gain an understanding of how behavioral health organizations address CF and burnout.

Methods: The study used a mixed method with a quantitative survey (n= 138) and qualitative semi-structured interviews involving ten mental health providers presently working with distressed clients or clients known to have experienced distress. The sample is predominately female (90% female, 10% male), African American (50%; White; 30 %, Hispanic/Latino; 10%, Indian- Native American; 10%), and average a salary between $50,000-$75,000 and predominately providers licensed as a clinical social 50%; LPC, 20%, 20% not licensed). For the qualitative portion, participants were recruited via social media platforms, emails forwarded to mental health organizations and social servants departments through known associates. Multiple linear regression analysis to examine compassion fatigue scores through utilization of the Professional Quality of Life Scale Pro-Qol-V scale adjusting for sociodemographic characteristics. Interviews elicit the providers experience of compassion fatigue, including preventive measures taken to reduce CF, the organizations and leadership attitude towards CF, and recommendations for future clinicians and organizations. Interviews were transcribed verbatim and coded thematically by interviewers, guided by the principles of grounded theory and an inductive approach to qualitative analysis.

: The study found providers are (i) more willing to disclose their CF with coworkers rather than leadership (ii) attitudes towards their relationship with leadership (supportive vs. un-supportive) determines their willingness to discuss CF experiences, (iii) providers felt remorseful for disclosing to leadership, providers advocated for the utilization of external support system (e.g. supervision, life coach, therapist) to process CF. Lastly, providers felt their organizations lack addressing and implementing policies and procedures to reduce CF.

Conclusions and Implications: The findings provide useful insights into the providers’ experiences of compassion fatigue, more specifically, their response to how they managed their CF with lack of support from organizations, and how they used resilience to combat CF. The research provides clear direction for future research the organizational, clinical education, and interpersonal levels.