1. Gnanavelu Panchasharam
Emotional Burnout
Gnanavelu Panchasharam

2. Gnanavelu Panchasharam
A SURVEY OF BURNOUT OF THE MENTAL HEALTH OCCUPATIONAL THERAPY STAFF IN THE PSYCHIATRIC HOSPITAL, BAHRAIN
Gnanavelu Panchasharam
Reference: Jahrami H. (2009) A Survey of Burnout of the Mental Health Occupational Therapy Staff in the Psychiatric Hospital, Kingdom of Bahrain, British Journal of Occupational Therapy, 72(10),
Gnanavelu Panchasharam

3. Project Background Zahra Al-Shuwaikh M.D., Haitham Jahrami Ph.D,
Gnanavelu Panchasharam M.Sc.
Innovation in Psychiatry, The 2nd Psychiatric Conference, Arabian Gulf Psychiatric Association, Kingdom of Bahrain, Manama November 2007
Gnanavelu Panchasharam

4. Gnanavelu Panchasharam
Project Continuation
This research was linked with Canadian Accreditation process as of evidence based.
We have under submission of Burnout among the Medical Doctors in the Psychiatric Hospital, Bahrain in British Journal of Psychiatry (Royal College of Psychiatrists)
Gnanavelu Panchasharam

5. Gnanavelu Panchasharam
The researcher conducted a computer search of peer-reviewed, English language research studies published since 1970
PubMed (US Library of Medicine),
PsycINFO (American Psychological Association),
CINAHL (Cumulative Index of Nursing and Allied Health),
BNI (British Nursing Index)
ProQuest Medical.
The search used four lists of key terms and examined all possible combinations containing one term each from lists A, B, C and D:
List A: mental health, psychiatry
List B: clinical, clinician(s), professionals
List C: burnout, burn out
List D: Arab, Arabic
Gnanavelu Panchasharam

6. Gnanavelu Panchasharam
Burnout
Definition: Syndrome of emotional exhaustion, depersonalisation, and reduced personal accomplishment that can occur among people who do “people work” of some kind (Maslach, 1982).
Burnout is therefore most frequently characterised as a syndrome of physical and emotional exhaustion resulting from the development of negative self-concept, negative job attitudes, and a loss of concern for clients (Maslach, 1976).
Gnanavelu Panchasharam

7. Burnout and Occupational Therapy
Occupational therapists are the healthcare professionals who, through the use of purposeful, goal oriented and scientifically guided occupation, attempt to make participation the key to the achievement of maximum levels of health, well-being and independence for the client.
The work conditions in which occupational therapists have to operate are varied. The Job stress is high in mental health rehabilitation, where the exposure of staff and patient contact is the most common determinants of Burnout.
Gnanavelu Panchasharam

8. Maslach Burnout Inventory (MBI)
The MBI is designed to asses the three components of the burnout syndrome:
Emotional Exhaustion,
Depersonalisation,
Personal Accomplishment.
High degree of burnout is reflected in high scores on the emotional exhaustion and depersonalisation and low scores on personal accomplishment. Average degree of burnout is reflected in average scores on the three subscales. Low burnout is reflected in low score on emotional exhaustion and depersonalisation and high scores on personal accomplishment
Gnanavelu Panchasharam

9. Gnanavelu Panchasharam
Sub Scales
Emotional Exhaustion (9): feelings of being emotionally overextended and drained by others
Depersonalization (5): feelings of callous, cynical and detached responses toward clients
Reduced Personal Accomplishment (8): decline in one’s feelings of competence and successful achievement in work with people
Gnanavelu Panchasharam

10. Gnanavelu Panchasharam

11. Gnanavelu Panchasharam
Literature Review
No previous research has been conducted in Bahrain or any other Arab countries to study burnout among occupational therapy staff working in mental health.
Prosser et. al. (1996) NHS, UK ;Community staff scored significantly higher on burnout measures compared to Hospital-based staff
Gnanavelu Panchasharam

12. Gnanavelu Panchasharam
Harper and Minghella (1997): conducted a survey among community mental health staff to identify the pressures and rewards of working in mental health. Staff reported generally low levels of burnout on the MBI.
Gnanavelu Panchasharam

13. Gnanavelu Panchasharam
Maslach and Jackson (1981): This the first study on burnout and occupational therapy, reported lower levels of burnout on the three MBI subscales, indicating that burnout was not an issue for occupational therapists.
Recent study by Lloyd and King (2004) indicated that occupational therapists are experiencing high level of burnout.
Gnanavelu Panchasharam

14. Gnanavelu Panchasharam
Research Aim
To determine the extent of burnout experienced by occupational therapy staff in the Psychiatric Hospital, Kingdom of Bahrain.
To compare OT burnout score with other mental health professionals.
Gnanavelu Panchasharam

15. Gnanavelu Panchasharam
Research Design
Cross-Sectional Survey
Questionnaires were sent to all clinicians in the Psychiatric Hospital, Bahrain (N=261). Effective response rate of 58% (N=153) was achieved, 13 were from occupational therapy department.
Gnanavelu Panchasharam

16. Gnanavelu Panchasharam
Instrument
Maslach Burnout Inventory (MBI):
Self-administered tool
22 items divided into three subscales
7-point Scale (ranging from 0, "never" to 6, "every day").
Demographic Sheet
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17. Gnanavelu Panchasharam
Data Collection
All 261 clinicians (September 2007)of the Psychiatric Hospital, Bahrain were surveyed using the MBI and a basic demographic sheet.
The survey pack was dispatched with an accompanying letter, instruction sheet, and a self-addressed envelope for the return of information.
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18. Gnanavelu Panchasharam
Ethical Approval
Ethical approvals were sought and granted from the appropriate research authorities in the hospital
Dr. Charllotte Kamel (Chair, Research Committee) approved on 2007.
MOH approval been sought through the Chairman Office.
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19. Gnanavelu Panchasharam
Data Analysis
Statistical Package for Social Science (SPSS) Version 16.0 for windows.
Descriptive Statistics of the MBI
Analysis of Variance (ANOVA)-One Way
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20. Gnanavelu Panchasharam
Results
Effective response rate 58% (N=153)
Most of them fall in Age groups of 26~31 and the 32~37 years
Males (48%) , Females (52%)
78.5% being nurses, 9.2% being medical doctors, and 12.3% being other healthcare professionals
Bahraini clinicians accounted for approximately 56%.
13 Occupational Therapy staff which includes four therapists and nine technicians.
Gnanavelu Panchasharam

21. Gnanavelu Panchasharam
Descriptive Values
Total Population (N=153)
Mean (S.D)
Burnout Level
Emotional Exhaustion
Depersonalisation
Personal Achievement
18.96 (13.81)
6.69 (5.26
34.28 (8.05 )
Gnanavelu Panchasharam

22. Gnanavelu Panchasharam
Medical Doctors
(N=14)
Mean (S.D)
Burnout Level
Emotional Exhaustion
Depersonalisation
Personal Achievement
18.78 (9.08)
4.64 (2.95)
39.21 (4.44 )
Gnanavelu Panchasharam

23. Gnanavelu Panchasharam
Nurses (N=120)
Mean (S.D)
Burnout Level
Emotional Exhaustion
Depersonalisation
Personal Achievement
18.14 (14.34)
6.40 (5.14)
33.49 (8.55 )
Gnanavelu Panchasharam

24. Gnanavelu Panchasharam
Occupational Therapy Staff (N=13)
Mean (S.D)
Burnout Level
Emotional Exhaustion
Depersonalisation
Personal Achievement
28.14 (10.67)
11.92 (5.67)
36.49 (5.72 )
Gnanavelu Panchasharam

25. Gnanavelu Panchasharam
Social Workers (N=2)
Mean (S.D)
Burnout Level
Emotional Exhaustion
Depersonalisation
Personal Achievement
5.50 (0.70)
5.00 (1.41)
31.50 (0.70 )
Gnanavelu Panchasharam

26. Gnanavelu Panchasharam
Psychologists (N=4)
Mean (S.D)
Burnout Level
Emotional Exhaustion
Depersonalisation
Personal Achievement
21.25 (13.59)
6.75 (6.65)
36.50 (2.51 )
Gnanavelu Panchasharam

27. Gnanavelu Panchasharam
One-Way ANOVA
MBI means were to compare between occupational therapy staff and the other professional background
MBI Sub Scales
*Significant
P<0.05
Emotional Exhaustion Depersonalisation Personal Achievement
0.08
0.01*
0.10
Gnanavelu Panchasharam

28. Gnanavelu Panchasharam
Discussion
Occupational therapy staff experienced high level of emotional exhaustion, moderate depersonalisation, and high personal accomplishment.
Occupational therapy staff differed from other groups on the depersonalisation scale with occupational therapy staff scoring higher than any other job group.
Gnanavelu Panchasharam

29. Gnanavelu Panchasharam
Maslach et. al. (1996), emotional exhaustion dimension is the scale that is most responsive to the organisational environment and social interactions that characterise human service work (Ex: Mental health care).
Emotional exhaustion is seen as mediating the environment’s relationships with depersonalisation.
Personal accomplishment is less closely associated to emotional exhaustion in structural ways.
This is contrastingly evident in this study by observing that a sense of achievement or competence operate as indistinct from emotional exhaustion with both being high rates.
Gnanavelu Panchasharam

30. Gnanavelu Panchasharam
Limitations
To the author’s best knowledge, this is the first study that has examined the burnout levels of the mental health occupational therapy staff in the Arab World.
1. the design was limited to participants working in a single hospital
2. the sample sizes of medical doctors, nurses and other healthcare professionals were not equally distributed.
3.the sample size of the occupational therapy staff is very small N=13
Gnanavelu Panchasharam

31. Gnanavelu Panchasharam
Implications
It is very important to establish why occupational therapy staffs have different burnout profile than other professional groups.
It is expected that the occupational therapy staff work environment can be improved, because greater knowledge about the levels of burnout should facilitate the prevention or early recognition and treatment of burnout.
Generalising these findings to other Arab countries where psychiatric morbidity, organisation of mental health services and staff make up may be different.
Gnanavelu Panchasharam

32. Gnanavelu Panchasharam
Conclusions
Stress and fatigue in the form of burnout will continue to be a critical area for research for all clinicians working in mental health.
The burnout profile of occupational therapy staff showed that occupational therapy staff statistically differs from other groups in the depersonalisation scale and experiencing high level of burnout.
This perspective provides in-depth analysis of how perceptive factors and objectives related to family, organisational, community and cultural contexts interact to have an impact on professionals' psychological output.
Gnanavelu Panchasharam

33. Thank you Happy New Year 2010
Gnanavelu Panchasharam

34. Gnanavelu Panchasharam
Further Readings
Gnanavelu Panchasharam