The Role of Burnout in Predicting PTSD Among Community Service Providers Following a Mass Shooting Event

Background: On October 27, 2018, 11 congregants were murdered at the Tree of life Synagogue in the Squirrel Hill neighborhood of Pittsburgh, Pennsylvania, resulting in a devastating impact on the community. Previous studies have revealed that first responders and health-care providers working with survivors and victims’ families of mass casualty events often experience secondary or vicarious trauma. However, there is scant research regarding PTSD as a concern for professionals within agencies in the affected neighborhoods providing services to the broader community. In this paper, we evaluate the mediating role of burnout on the effect of social supports on PTSD.

Methods: Eleven months after the synagogue shootings, we emailed executives of 12 social service and educational agencies within the community asking them to distribute a scripted email to their staff including a link to an anonymous online survey. A reminder email was sent one month later. Eight agency executives distributed the emails to their staffs (N=374); 147 (39.3%) provided complete mental health and work-related information.

The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), a 5-item validated screen, was utilized to identify respondents with probable post-traumatic stress disorder in the past month. Social support was measured using the emotional/informational subscale in the Rand MOS study and burnout was assessed using ten items from the Professional Quality of Life scale. Control variables included hours worked, primary work role, age, religious identity, and gender. Crosstabs and binary correlations were used to describe the relationships between variables. Using Baron and Kenney’s method, path analysis was conducted to test the mediation effect of burnout in the relationship between social support and PTSD.

Results: About one-fifth (19.9%) of the respondents had a positive PTSD screen. The demographic or work-related characteristics were not associated with a positive screen. In Step 1 of the mediation model, higher social support was significantly associated with a reduced chance of having PTSD (OR=.974, p<.01). In step 2, lower social support was significantly related to higher burnout (B = -.119, p<.001). In the final step including social support and burnout, social support was no longer statistically significantly related to PTSD while burnout (OR=1.26, p<.001) was significantly associated with PTSD; a unit increase in burnout increased the chance of having a positive PTSD screen by 26%. The bootstrap confidence intervals derived from 5,000 samples indicated that the indirect effect coefficient was significant, B= -.028, CI=-.057, -.015 confirming burnout as a mediator of the social support and PTSD relationship; given social support was not significantly related to PTSD (OR=-.997, p=.815), burnout fully mediates the social support and PTSD relationship.

Implications: While the prevalence rate of probable PTSD among first responders ranges from 10 to 15%, we found a higher percentage of PTSD for community service providers who work in the neighborhood where traumatic events occur. Social workers are well suited for assisting agencies to assess organizational factors that result in staff burnout. Agencies need to examine their organizational capacity for addressing secondary trauma and related mental health concerns following community-wide traumas.