MHM Magazine

26 | MENTALHEALTHMATTERS | Issue 4 | 2021 MHM Dr Fitzgerald is in fact a qualified yoga instructor. It has become a metaphor for the frustrations experienced by professionals with a special interest in workplace mental health when they see employers either placing the blame for burnout on the employee or come up with an airy-fairy wellbeing strategy that has no basis in any scientific evidence whatsoever.  Dr Fitzgerald articulates it well; “Unless the company also addresses their HR policies, communication approach, leadership training and management structure, they don’t have a wellbeing strategy. If you have poor people infrastructure, with complicated policies, and issues of bullying and harassment, then all the yoga in the world is not going to support your employees’ wellbeing. It’s your rigid management approaches that need more flexibility, not your employees.” WHAT IS BURNOUT? Burnout is referred to in ICD 11 as an “occupational phenomenon” and not a mental illness, occurring in the context of work. This means employers and workplaces are necessary conditions for burnout. In other words, burnout isn’t just an individual phenomenon but the consequence of working in a dysfunctional system. The solutions from the erroneous assumption that burnout is due to employee weakness, targets the individual, followed by recommendations like mindfulness, meditation or time management training or “baby goat yoga”. Burnout is a symptom that something is wrong in the organisation, not the individual; an underlying organisational disease that must be diagnosed and cured . THE SYMPTOMS OF BURNOUT The World Health Organisation describes burnout as a state of vital exhaustion. The word ‘vital’ conjures up images of energy and liveliness, essential for a fulfilling and meaningful life.  How sad if one‘s chosen profession causes you to lose your ‘vitality for life’. It’s said when a person suffers from burnout energy turns to exhaustion, engagement turns into cynicism and disengagement and efficacy turns into ineffectiveness and self-doubt. Christina Maslach defines burnout as a “prolonged response to chronic job stress” and “ a point at which important, meaningful and challenging work becomes unpleasant, unfulfilling, and meaningless”. CAUSES OF BURNOUT Many doctors will probably relate to the following infographic by the Agency for HealthCare Research and Quality, capturing the average day in the life of a doctor; the addition of electronic health record keeping and medical aid administrative demands nowadays being a common complaint by private practitioners. Source: https://www.ahrq.gov/prevention/clinician/ahrq-works/burnout/ index.html However, the most quoted reasons for burnout are: • Overload o Work overload depletes the capacity of a person to meet the demands of the job, when there is little opportunity to rest, recover and restore balance. • Control o When one can’t exercise professional autonomy without access to resources to do an effective job. • Recognition o Lack of recognition and reward devalues both work and the worker. • Community o Refers to the relationships that employees have with other people on the job. When characterised by lack of support and bullying, there’s a greater risk of burnout. • Fairness o Refers to the extent to which work decisions are perceived as fair, in the absence of which, cynicism and anger is likely to arise. • Values o When there is a values conflict or a gap between individual and organisational values, moral distress may arise. A value clash may occur for example when what is said (in the vision/mission statement of a company) contradicts how people treat each other and what happens in the workplace (toxic work culture).