Department of Psychiatry, Child and Adolescent Services Research Center, University of California, San Diego.
Psychol Serv. 2014 Feb;11(1):41-9. doi: 10.1037/a0035299.
Public-sector mental health care providers are at high risk for burnout, which negatively affects not only provider well-being but also the quality of services for clients and the functioning of organizations. This study examines the influence of demographics, work characteristic, and organizational variables on levels of burnout among child and adolescent mental health service providers operating within a public-sector mental health service system. Additionally, given the dearth of research examining differences in burnout levels among mental health subdisciplines (e.g., social work, psychology, marital and family therapy) and mental health programs (e.g., outpatient, day treatment, wraparound, case management), analyses were conducted to compare levels of burnout among multiple mental health disciplines and program types. Surveys were completed by 285 providers across 49 mental health programs in a large urban public mental health system. Variables representing dimensions of organizational climate and transformational leadership accounted for the greatest amount of variance in provider reported burnout. Analyses demonstrated significantly lower levels of depersonalization among wraparound providers compared to traditional case managers. Age was the only demographic variable related to burnout. Additionally, no significant effects were found for provider discipline or for agency tenure and caseload size. Results suggest the need to consider organizational development strategies aimed at creating more functional and less stressful climates and increasing levels of transformational leadership behaviors in order to reduce levels of burnout among clinicians working in public mental health settings for youth and families.
公共部门的精神卫生保健提供者面临着职业倦怠的高风险，这不仅对提供者的健康产生负面影响，也对客户服务质量和组织的运作产生负面影响。本研究考察了人口统计学、工作特征和组织变量对在公共精神卫生服务系统中运作的儿童和青少年精神卫生服务提供者的倦怠水平的影响。此外，鉴于缺乏研究检查精神卫生亚专业（如社会工作、心理学、婚姻和家庭治疗）和精神卫生计划（如门诊、日间治疗、全面服务、个案管理）之间倦怠水平的差异，进行了分析以比较多个精神卫生学科和计划类型之间的倦怠水平。在一个大型城市公共精神卫生系统的 49 个精神卫生计划中，有 285 名提供者完成了调查。代表组织氛围和变革型领导维度的变量解释了提供者报告的倦怠的最大差异。分析表明，与传统的个案管理者相比，全面服务提供者的去人格化程度明显较低。年龄是唯一与倦怠相关的人口统计学变量。此外，提供者的学科或机构任期和案件数量与倦怠无关。结果表明，需要考虑组织发展策略，旨在创造更具功能性和压力较小的环境，并提高变革型领导行为的水平，以减少在公共精神卫生环境中为青年和家庭服务的临床医生的倦怠水平。
