Burnout indicators among operators of Lebanon’s national suicide prevention lifeline during the 2024 war: organizational correlates and implications for hotline practice

Suicide prevention hotlines provide critical support for individuals experiencing acute psychological distress and suicidal crises. Operators act as frontline responders and are routinely exposed to emotionally demanding interactions, increasing vulnerability to burnout, particularly in crisis and conflict settings. This study examined the prevalence and factors associated with burnout indicators among operators of Lebanon’s National Lifeline during the 2024 war. A cross-sectional online survey was conducted in February 2025 among trained Lifeline operators active throughout the conflict period spanning September 2024 until the ceasefire. All 96 eligible operators were invited to participate, and 51 completed the survey (response rate: 53.1%). Burnout was assessed using the Maslach Burnout Inventory-Human Services Survey, measuring emotional exhaustion, depersonalization, and personal accomplishment. Adjusted logistic regression models examined associations between individual, organizational, and contextual factors and burnout outcomes. Sensitivity analyses were conducted using alternative burnout classifications and Firth penalized logistic regression. Fifty-one operators participated, of whom nine (17.6%) met criteria for burnout. Participants reported moderate emotional exhaustion, moderate depersonalization, and relatively preserved personal accomplishment. Concurrent employment (holding an additional job alongside the Lifeline role) was associated with higher emotional exhaustion, whereas organizational and relational factors, including satisfaction with the role, perceived organizational support, supervision, clear communication, and professional development opportunities, were associated with more favourable burnout indicators. Sensitivity analyses showed a generally similar pattern of findings, although some associations varied according to the operational definition of burnout. Among crisis hotline operators working during an active conflict, burnout indicators were associated with organizational, relational, and occupational factors. Although the findings are exploratory, supervision, organizational support, communication processes, professional development opportunities, and operational flexibility were associated with more favourable burnout indicators and warrant further investigation in longitudinal and intervention studies.