(PS5-30) Protecting Mental Health Providers from Burnout: The Roles of Trauma-Informed Organizational Climate and Leadership Characteristics

Abstract Text: The consequences of the ongoing mental health workforce crisis, characterized by high turnover and staffing shortages, are further compounded by the concurrent youth mental health crisis.1,8 Burnout is one of the strongest predictors of turnover.9 To mitigate the adverse effects of these crises, trauma-informed care (TIC) has emerged as a potential evidence-based solution.3
TIC involves system-wide incorporation of trauma awareness and competence into organizational culture, practices and policy.5 The protective relationship between TIC and burnout has been replicated across studies in the general healthcare workforce.7,11 However, this has been less studied in the context of community mental health providers. Positive leadership (e.g., transformational leadership), has also been identified as a key factor in reducing burnout among mental health providers.4,6
The current study aims to examine the relationship between community mental health workers’ perceptions of trauma-informed organizational climate and self-reported burnout. We hypothesized that this relationship would be stronger at higher levels of positive leadership. Secondary analyses were conducted on program evaluation data from 283 mental health professionals across three community-based learning collaboratives (CBLCs). Prior to evidence-based practice (EBP) training, CBLC participants completed baseline surveys about factors that might impact their implementation success. Surveys included the Trauma-Informed Systems Change Instrument (TISCI)10, Implementation Leadership Scale2, and the Maslach Burnout Inventory12. Participants came from 37 community mental health agencies and included direct service providers (n = 180), case coordinators (n = 69) and senior leadership (n = 34).
We ran multiple regression analyses examining the relationship between each of the TISCI subscales and the MBI subscales. Significant main effects were found for five of the six relationships indicating that higher levels of trauma-informed climate predicted lower levels of burnout-related emotional exhaustion and depersonalization (DP). Regression models examining the moderating effect of proactive leadership on the relationship between TISCI policy and DP had a significant interaction (B = .68, t(262) = 2.12, p = .04). This relationship was stronger at low levels of leadership proactiveness (i.e., 1 SD below the mean; B = -2.25, SE = .64, t = -3.53, p < .001) than at high levels of proactiveness (i.e., 1 SD above the mean; B = -.65, SE = .72, t = -.90, p = .37). This pattern was also observed for the relationship between TISCI practice and DP (B = .69, t(262) = 1.97, p = .05) with a stronger relationship at low levels of leadership proactiveness (B = -3.13, SE = .72, t = -4.35, p < .001) than at high levels of proactiveness (B = -1.51, SE = 1.11, t = -1.37, p = .17). Contrary to our hypothesis, agencies’ incorporation of trauma-informed care into policy and practice seems to be a protective factor against burnout in the face of poor leadership. Thus, trauma-informed organizational climate is especially important for protecting providers from burnout when leadership is not proactive. Future research should examine changes in this relationship at different stages of EBP implementation.