Health

Improving Behavioral Health Factors that Lead to Burnout

Behavioral health encompasses mental, emotional, and physical well-being; it is the biological study of mental well-being.  Patients having difficulty with behavioral health be struggling with stress, anxiety, addiction, depression, and mood disorders.  These patients may also be impacted by learning disabilities, ADHD, and other cognitive disorders.  One common element associated with behavioral health outcomes is burnout. Burnout occurs as a result of extraneous stress associated with physical, emotional, and mental health constraints.  It affects productivity and leaves individuals with feelings of hopelessness, resentfulness, and depression.  It can also lead to the diagnosis of more severe mental health disorders such depression, mania, and bipolarism.  According to the National Alliance on Mental Health (NAMI), 1 in 5 U.S. adults or 46.6 million people are experience mental health disorders annually.  Additionally, 1 in 25 (11.2 million) are severely affected in a manner that impacts daily life, which costs America approximately, $193.2 billion dollars in lost wages annually.  Patients with mood disorders such as depression and bipolarism account for 1/3rd of healthcare costs nationwide.  Generationally, viewpoints on stress and burnout differ.  Yet, burnout continues to remain a target goal for improving behavioral health outcomes.  To substantiate this, the World Health Organization (WHO), recently recognized burnout medical diagnosis by further clarifying its definition.

Signs and Symptoms of Burnout

When individuals find themselves feeling spiritually, mentally, physically, and emotionally fatigued due to excessive stress, burnout can occur.  Burnout out has been defined in the WHO’s, International Classification of Diseases (ICD-11), as an occupational phenomenon and “chronic workplace stress that has not been successfully managed.”  And while the WHO does not officially deem it as a medical condition, it has been outlined in the ICD-11 chapter that discusses “factors influencing health status or contact with health services.”  The mere recognition of burnout as a mitigating health factor by the WHO, solidifies the need to proactively address the behavioral health factors associated with it.

Burnout leads to a loss of interests in daily activities, dissociation, and depersonalization.  It affects one’s professional and personal life; it can also increase susceptibility to certain illness such as the cold or flu. If the signs and symptoms of burnout are not addressed at its earliest stages, it can gradually progress overtime. Physical, emotion, and behavioral symptoms of burnout include:

  • Irritability, exhaustion, and fatigue
  • Headaches and migraines
  • Decreased appetite
  • Sleeplessness
  • Feelings of self-doubt, helplessness, and failure
  • Loss of motivation
  • Reduced personal and job satisfaction
  • Failing to meet responsibilities
  • Self-isolation
  • Anger and projection
  • Increased utilization of drugs and alcohol
  • Missing work more frequently

While excessive stress is associated with burnout, stress is a normal part of daily life.  The WHO’s definition of burnout specifically states, that it leads to “feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and reduced professional efficacy.” Behavioral health factors associated with how individuals deal with stressors are linked to increased burnout rates.  Balancing the components of health such as physical, spiritual, social, environmental, emotional, environmental, and intellectual reduces the likelihood that burnout will occur.

Generational Differences and Burnout

Perspectives on burnout can be also be affected by generational differences, Baby Boomers, for example, have differing values, communicate differently, and have different expectations than their younger counterparts.  Statistically, they also report lower levels of burnout and higher levels of resiliency.  Millennials, individuals born between 1981 and 1996, are known as the “Burnout Generation.”  Overburdened with student loans, personal debt, and work demands, many Millennials began to suffer from career and personal burnout at an early age due to feeling overwhelmed.  The 2018, American Psychological Association (APA), Stress in America Survey, focused on how stress affects Generation Z.  Generation Z consists of youth born in the mid-1990s through the mid-2000s; this population currently outnumbers Baby-Boomers and Millennials.  Additionally, they consider themselves as open-minded, competitive, spontaneous, curious, and adventurous.  According to the APA survey, primary causes of stress for Generation Z include:  work 77%, money 81%, health-related concerns 75%, and the economy 46%.  Except for the economy, when compared to other U.S. adults, Generation Z reported an average of 10% higher levels of stress.  They are also approximately 10% less likely to report that their mental health status is excellent or very good.  There is also an alarming approximately 30% gap between Generation Z and older adults.  In a society that consistently demands more time commitment, debt, and personal sacrifice to succeed, many younger people are have opted out of the traditional careers and corporate America in general.

Advantages of Burnout as a Diagnosis and Treatment Options

Researchers have studied the impact of burnout for years, and having it deemed as an official diagnosis allows healthcare providers to better assist patients.  Much of the research that has been done on burnout is specifically related to healthcare provider burnout prevention.  There is a shortage of qualified healthcare professionals, and medical providers often work long hours, in fast-paced, high demand settings caring for patients.  One survey revealed more than 50% of physicians report feelings of burnout, and this directly impacts the quality of care provided to patients.  Because burnout has been a prevalent, ongoing discussion within the healthcare community, most physicians already know what to look for when it comes to their patients.  Beginning in 2022, healthcare providers will be able to officially diagnosis patients with burnout by utilizing the guidelines provided within the WHO’s ICD-11 diagnosis manual.  The straightforward definition outlined in the ICD-11 requires healthcare providers to rule out depression and mood disorders, prior to officially diagnosis patients with burnout.  Patients will receive a more concise diagnosis and can seek treatment options that best fit their needs.  NAMI recommends a 10-fold process that combines several approaches to include:

  • Self-direction: allowing patients the autonomy to make their own decisions
  • Individualized and person-centered care: assisting patients in the manner that best fits their needs
  • Empowerment: educating patients on their options
  • Holistic: promoting treatment methods that improves all dimensions of health
  • Non-linear: allowing for setbacks and embracing continuous growth
  • Strengths-based: building upon each patient’s strengths
  • Peer supported: fostering an environment of mutual support
  • Respect: reducing the stigma associated with receiving help and promoting self-acceptance
  • Responsibility: teaching patients about personal responsibility and self-care
  • Hope: providing patients with motivating, positive guided messaging

Working with mental health professionals, who specialize in supporting patients and burnout prevention may be one option available to healthcare providers and organizations to better support patients and employees.

Sources:

  1. NAMI, https://namitm.org/mhr/10fcr/
  2. APA, https://www.apa.org/news/press/releases/stress/2018/stress-gen-z.pdf

http://thenationshealth.aphapublications.org/content/48/8/1.3

  1. Mayo Clinic, https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/burnout/art-20046642

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