Professionals increasingly face depression and burnout

Human stress is simply a result of our modern society forcing us to try and exceed our genetic design specs. We are simply not designed to live in a materialistic unequal society and work in the ways and for the long hours that we do.

The increasing level of workplace stress throughout the world and its effect on mental and physical health is a subject that I've returned to over and over again. But an article in Clinical Practice & Epidemiology in Mental Health really brought it home and illustrated why professionals of all kinds are suffering.

What the researchers say

The piece begins by looking at how the current financial crisis has heavily impacted workers from the public health sector who are highly exposed to a number of job stressors, ranging from work overload, time pressures, low support and lack of role clarity. My colleague Alicia Fortinberry and I have found this to be increasingly the case among a wide range of professionals — and, to a lesser extent, workers in general.

Research literature suggests that burnout, depression, and a low quality of life are common among healthcare workers. This significantly affects both quality of care and job satisfaction. The team behind this latest research investigated the risk of depression, burnout levels and quality of life, in a sample of workers in two major hospitals.

They found a high prevalence of depression, as measured by self-reports, among the healthcare workers, with statistically higher risk in physician and nursing staff than in administrative staff and technicians. This ties in very closely with previous US DHSS research among professionals in general. Women and staff over 40 years old also experienced a self-perceived poor working quality of life. The risk of burnout was linked to depression and a poor working quality of life. Overall, the greatest risk of depression and poor working quality of life was found among surgeons, who also experienced the highest rate of burnout.

The study results are in line with other recent European studies. These have highlighted the impact of poor quality of mental health and a higher risk of burnout of healthcare workers on patient safety and the quality of patient care. The researchers noted an increase in medical errors due to burnout and concluded that dedicated interventions aimed at reducing poor mental health and low working quality of life in medical staff are urgently needed.

So what? 

Because comparatively few readers are physicians the increasing number of studies showing health worker burnout and depression may not have come onto the radar of most of you. However, the pattern seen by the researchers behind this study — increasing demands leading to greater stress, perceived low quality of working life, depression, and burnout – is hardly limited to medical workers.

Some stressors may not be so obvious. One of the factors that was noted in a recent OECD report on job stress in the US was the "job-lock" effect created by a system of employer-provided health insurance. Others such as increased bullying, the threat of job loss, underemployment, increasing demands, the introduction of new technologies, isolation due to new workspace arrangements have had more publicity. These all exist in the health sector and were first noticed in studies carried out back in the 1990s.

In a sense, the healthcare sector is the canary in the mine. The burden of dealing with the extra ill-health caused by workplace stress falls most immediately on it. We used to think the problem was limited to overworked interns. Then it was nurses that came on the academic radar. In the late 1990s and the early years of this century, Alicia and I worked with major medical centres (teaching hospitals) in the US and Australia to help with stress among physicians and the breakdown in relationships between doctors and other staff.

In our more recent work with the DHSS, we found exactly the same patterns of relational stress, depression, and burnout in all professions — especially law, accounting and related industries, farming, risk and compliance professionals, those in the banking and finance industries and law enforcement.

What now? 

Many of the causes of workplace stress are not difficult to ameliorate. Some, like the increasing mechanisation, digitisation, and robotisation of work are very difficult to cope with. Some, like the shrinking economic pie leading to virulent cost-cutting by employers, are maybe inevitable.

But we can, and must, look at the stressors we can deal with — particularly those linked to relationship breakdown, workplace layout, dysfunctional leadership styles and the 24/7 work schedule expected of many professionals. These we can quite easily and cheaply do something about.