Reassessing burnout definitions and interventions: a qualitative study of mental health care providers’ responses to individual-focused approaches to burnout

Background Mental health care providers (MHPs) in the Veterans Health Administration (VHA) report high levels of burnout, and the VHA named burnout as an organizational priority at the time this study was conducted. However, a lack of consensus persists regarding burnout’s definition, and although organizational causes of burnout are well-understood, most burnout interventions target individuals through wellness and training programs, which may result in a gap between available interventions and the needs of MHPs. This study sought to contribute to efforts to clarify the definition of burnout and determine what interventions are most appropriate based on MHPs’ experiences of burnout. Methods We conducted an exploratory qualitative study using semi-structured interviews with 54 MHPs (social workers [ N = 19], psychologists [ N = 20], psychiatrists [ N = 12] and behavioral health leadership [ N = 3]) across nine VHA sites with varying levels of facility-wide burnout and MHP staffing levels. We used content analysis to analyze interview data. Results According to participants’ definitions and experiences, burnout is a relational phenomenon between individuals and the workplace that emerges when employees continually encounter problems with who has power in deciding allocation of resources, who gets held responsible for burnout, who has influence over workplace conditions, who has power and autonomy in how they do their work, the relative importance of worker well-being, structural limitations on employees’ ability to carry out the purpose of their job, and work cultures that normalize “do more with less.” Participants described individual-targeted burnout interventions as “victim-blaming” and overlooking systemic causes of burnout. Participants not experiencing burnout reported using individualized tactics such as seeking positions with caseload caps and setting “hard boundaries” regarding workload. Participants suggested organization-targeted burnout interventions. Conclusion Our findings problematize framing burnout as a phenomenon that exists within individuals and the predominance of individual-targeted burnout interventions. Burnout may be conceptualized as a distinct form of distress produced by detrimental dynamics within organizational contexts for which individual-targeted interventions alone do not work. Processes of medicalization may explain the persistence of defining and addressing burnout on an individual level rather than an organizational level. To implement systemic changes, healthcare systems may need to confront social, political, and economic limitations on those changes. Clinical trial number Not applicable.