Yoga vs Antidepressants: Defining Workplace Burnout Over Mental Health Issues

National surveys estimate that nearly half of all US physicians reported feelings of burnout in their workplace during 2021—an ever-climbing rate during the second year of the COVID-19 pandemic that, given the state of systemic and staffing turbulence, may again increase after 2022.

But with self-reported burnout continuing to rise amid similar pandemic-driven disarray in the field of psychiatry, one expert is emphasizing the need to clearly define the differences between burnout and mental health disorders.

In an interview with HCPLive during the American Psychiatric Association (APA) 2022 Annual Meeting in New Orleans last week, Carol A. Bernstein, MD, a psychiatrist and vice chair for faculty development and wellbeing with Montefiore Health System, discussed the overuse of phrases including “wellbeing” and “burnout” in relation to mental health issues including anxiety and depression.

“Burnout generally is considered to be an individual’s response to systemic challenges—but it’s an individual response to the system,” Bernstein explained. “And we all bring to the system our own particular vulnerabilities.”

Burnout is not equivalent to mental health, Bernstein said; rather, the 2 overlap only in particular circumstances. The issues within health care-related burnout are systemic: clinicians’ complaints around electronic health record compliance, shortened length-of-stays, increasing complexities of medical illnesses or the ability to constantly measure the means of health care. All these issues may drive a sense of burnout, which is generally attributable to them losing sight of the importance of their work.

“If you’re burned out, even if you’re not struggling with another mental health condition…what COVID’s done to an extent is (make) the work so hard and so challenging, and there’s so many other issues involved with it, that we lose our capacity to feel compassion for ourselves, to take care of ourselves,” Bernstein said. “And if we don’t do that, we can’t do a good job of taking care of our patients.”

Bernstein stressed the need for psychiatry specialists to become leaders in distinguishing between burnout and mental health conditions among their colleagues—and to help adequately refer and treat those who are affected by either.

“Psychiatry needs to stand at the interface, because we understand what symptoms and what conditions really need mental health interventions, and which need redesign of the EMR, issues in the workplace, more control and autonomy, new leave policies—all of which are really important,” Bernstein said. “But we really need to focus on getting good access to mental health services for the work force.”

Lastly, Bernstein discussed the effect of industry-borne stigma and a lack fo parity on current efforts to curb increasing rates of burnout and mental health conditions.

“The inequities in reimbursement mean that the providers don’t accept the insurance, there aren’t enough providers in the first place, so nobody can get to the care,” she explained. “And it’s often very confusing for people to know what they need: do you need a counselor? Do you need family treatment? Do you need peer-to-peer support? Do you need psychotherapy and medication?”