Burnout among psychiatrists in the Veterans Health Administration

• We examined patient and workplace factors as predictors of burnout in VA psychiatrists.
• High burnout levels were found, with high cynicism predicting the intent to leave.
• Suspected malingering, lack of control, and poor team cohesion predicted cynicism.
• Unfair supervisors and lack of resources predicted exhaustion.
• Efforts to prevent and treat burnout in this VA population are recommended.

Research suggests that mental health workers are at high risk for burnout, and that burnout can increase staff turnover and reduce quality of care. The Veterans Administration (VA) employs over 3000 psychiatrists across the United States, but little is known about burnout in this population. This study was conducted to examine predictors of burnout and intent to leave the VA among a national sample of VA psychiatrists. Participants (N = 125) responded to an anonymous online survey. Regression analyses were used to examine relationships between workplace variables, patient characteristics, and burnout as measured by the Maslach Burnout Inventory-General Survey – which includes sub-scales for cynicism, exhaustion, and professional efficacy – as well as intent to leave the VA. Based on established cut-off scores, 90% of the sample reported high cynicism, 86% reported high exhaustion, and 74% reported high professional efficacy. High cynicism predicted the intent to leave the VA (p = .004). Not feeling part of a coherent team predicted greater cynicism (p = .01), and patient characteristics such as suspected malingering showed a positive trend with cynicism (p = .05). Workplace characteristics such as unfair treatment by supervisors (p = .03) and insufficient resources (p = .001) predicted greater exhaustion. The current findings suggest that burnout is prevalent in the VA psychiatry workforce. Specific administrative measures to reduce burnout may have potential to improve the emotional health of that workforce and ensure high quality of care for the veteran population it serves. The size of both the VA psychiatry workforce and patient population underscores the importance of greater understanding of burnout as it occurs in the VA.