Emotional Exhaustion and Quiet Quitting Among Psychiatric Healthcare Workers: The Differential Mediating Roles of Emotional Labor Strategies

Background/Objectives: Psychiatric healthcare workers (HCWs) face unique emotional demands and may be particularly vulnerable to emotional exhaustion and quiet quitting. This study aimed to examine the association between emotional exhaustion and quiet quitting and the differential mediating roles of emotional labor strategies in this association. Methods: This multicenter cross-sectional study included 440 HCWs from three psychiatric hospitals in Hangzhou, China, between July and August 2025. Emotional exhaustion, emotional labor strategies, and quiet quitting were assessed using validated scales. Correlation, hierarchical regression, mediation, and network analyses were conducted. Results: Emotional exhaustion was positively associated with quiet quitting (β = 0.228, p < 0.001). Surface acting was positively correlated with emotional exhaustion and quiet quitting and partially mediated the association between them (indirect effect: β = 0.116, 95% CI: [0.071, 0.217]). Natural expression was negatively correlated with both emotional exhaustion and quiet quitting and also partially mediated their association (indirect effect: β = 0.056, 95% CI: [0.029, 0.115]). Deep acting was negatively correlated with quiet quitting but showed no significant indirect association. Network analysis identified lack of initiative, emotional exhaustion, and surface acting as central nodes, while emotional exhaustion, surface acting, and lack of motivation emerged as bridge nodes within the network. Conclusions: Emotional labor strategies showed distinct patterns in the association between emotional exhaustion and quiet quitting. Surface acting and natural expression showed significant indirect associations, whereas deep acting did not. These findings highlight the relevance of emotional exhaustion and strategy-specific emotional labor patterns in understanding quiet quitting among psychiatric HCWs.