Individual and Organizational Factors Impacting Secondary Traumatic Stress and Burnout Among Mental Health Workers during COVID-19

Background and Purpose: Mental health is a demanding field given the complexity and severity of client need, exposure to client suffering, and high levels of organizational demand and workload. While many mental health workers (MHW) experience positive benefits from their work, the associated challenges and stressors can contribute to a variety of adverse responses. In particular, concerning levels of burnout (Newell & MacNeil, 2011) and secondary traumatic stress (STS; Elwood et al., 2011) have been reported, both of which can negatively affect clinician wellbeing and reduce the quality of client care (Bride et al., 2007; Newell & MacNeil, 2011). As a result, attention has focused on identifying contributing factors and developing effective intervention strategies. This need has only intensified during COVID-19, which has placed additional stressors on MHW and increased client need. Consequently, the purpose of this study was to assess levels of STS and burnout among MHW during COVID-19, assess differences among subpopulations, and examine individual- and organizational-level predictors within a social-ecological framework.

Methods: Non-probability sampling methods were utilized to recruit a national sample of MHW (including professionals and paraprofessionals) to complete an online survey that queried respondents’ use of self-care practices, perceptions of organizational supports and barriers, as well as included demographic questions and items related to work setting and role. The Secondary Traumatic Stress Scale (Bride et al., 2004) assessed levels of STS, the Professional Quality of Life Scale (ProQOL; Stamm, 2002) measured burnout and compassion satisfaction, the Brief Resilience Scale (Sinclaire & Wallston, 2004) measured resilience, and the Self-Compassion Scale (Neff, 2003) measured self-compassion. The geographically diverse sample (N=634) worked in a range of service settings, and 34.8% identified as Black, 4.7% as American Indian or Alaskan Native, 3.6% as Asian, 3.5% as Bi- or Multiracial, 1.6% as Native Hawaiian or Pacific Islander, and 37% as White. Thirty-seven percent identified as cisgender female, 41.5% as cisgender male, 17.5% as transgender, and 1.0% as non-binary.

Results: Overall, concerning levels of burnout and STS were reported, although significant differences were identified with regard to gender, race, and work role. Results of multiple regression analyses indicated compassion satisfaction, self-compassion, self-care practices, negative organizational factors, and burnout significantly predicted STS [F(8, 599)=72.64, p<.001, adjR²=.49], and the final model accounted for nearly 50% of variance in STS scores. With regard to burnout, compassion satisfaction, self-compassion, negative organizational factors, and STS significantly contributed to the model [F(8, 599)=111.99, p<.001, adjR² =.59], and accounted for nearly 60% of variance in burnout scores.

Conclusions and Implications: STS and burnout are real concerns for MHW, and require concerted efforts to better understand these phenomena and identify potential pathways for prevention and intervention. Findings from this study help to understand current rates of STS and burnout among MHW during COVID-19. In addition, important differences among subgroups were revealed that have implications for intervention. Results of regression analyses illuminated significant individual- and organizational-level predictors of STS and burnout among this sample, and implications for prevention and intervention stemming from these findings are explored.