Occupational burnout among PTSD specialty clinic providers in the Veterans Health Administration: Perceptions of bureaucratic and political oversight

Background and objectives: Prior research suggests a link between occupational burnout and perceived vulnerability to organizational oversight. The purpose of this exploratory study was to examine the relationship between perceptions of political and bureaucratic oversight (e.g., by Congress, media, or policies, rules, and performance metrics) and occupational burnout among mental health providers working in Veterans Health Administration (VHA) PTSD specialty clinical teams (PCTs). Design: This cross-sectional study included 481 prescribing and non-prescribing PCT providers throughout the VHA system. The sample was mostly female (70%), Caucasian (84%), and psychologists (48%). Method: Participants completed an online survey that assessed demographics, perceptions of political and bureaucratic oversight, and burnout. Burnout was evaluated using the Maslach Burnout Inventory-General Survey. Results: High levels of emotional exhaustion (55%), cynicism (55%), and professional efficacy (53%) were found. Results indicate that burnout in PCT providers was associated with: feeling vulnerable to complaints to media, Congress, and VHA leadership; reporting “political influence” on PTSD diagnoses or treatment offerings; and feeling care delivery is hindered by the large volume of VHA policies, rules, and performance metrics. Conclusion: Results suggest increasing providers’ sense of psychological safety and reducing metric overload may support burnout prevention in VHA's complex environment of care.