As researchers, when we are preparing to launch a study, we dedicate a lot of time to creating policies and procedures to ensure that our participants are well taken care of during their time working with us . We have long discussions about warning signs that indicate when a participant may be worsening and how to respond during crisis situations. Conversations about burnout among research staff when working with high-risk participants are much less common.
Job burnout is a state of physical, emotional or mental exhaustion combined with doubts about your competence and the value of your work. Predictors of occupational burnout include: lack of control, unclear job expectations, dysfunctional workplace dynamics, mismatch in employer-employee values, poor job fit, work that requires constant energy to remain focused, a lack of social support, and work-life imbalance. It has a host of unpleasant physical and emotional consequences including: fatigue, insomnia, depression, anxiety, obesity, Type 2 diabetes, and stoke, to only name a few.[i]
There is also evidence to suggest that exposure to sensitive areas of study, such as mental health, can have high emotional costs for those involved[ii]. However, this literature often focuses on the experiences of clinically trained health professionals rather than non-clinical researchers. While this evidence does show that chronic exposure to at-risk populations has a significant negative impact on well-being, non-clinical research staff may feel even more ill-equipped to handle the emotional labour that is required of them in these roles. In a study conducted in New Zealand, researchers conducted interviews with eight Research Assistants (RAs) who were involved in a large suicide prevention study[iii]. During the study, the RAs were tasked with reviewing the clinical notes of those who presented to the Emergency Department with intentional self-harm in order to extract data. During the interviews, the RAs reported finding the data collection process stressful and not feeling adequately prepared for the level of detail present in the notes. As a result, a number of the RAs interviewed reported feelings consistent with those of burnout, such as emotional exhaustion and indifference towards work.
Preventing burnout among our research staff is a key priority in the BEACON Study. Given that we are working exclusively with men who present to the Emergency Department with self-harm, a very high-risk population, we reasonably expect that some participants will die by suicide. In an effort to address the impact that this may have on our research staff, we plan to:
1. Develop training materials for the therapists who will deliver the intervention which focuses on the importance of self-care;
2. Complete regular assessments of burnout among research staff, which will allow for early detection of the warning signs associated with burnout;
3. Ensure that all research staff, both therapists and RAs, receive appropriate internal supervision by a Psychiatrist;
4. Encourage research staff to seek external supervision from someone outside of the study, when needed;
5. Development of a Suicide Risk Management protocol that includes debriefing of all study staff should a participant under their care die by suicide.
It is crucial that research teams focusing on interventions for high-risk groups not only provide their staff with the appropriate resources, but also foster a stigma-free environment in which staff can come forward when they are struggling. If we are to make real, impactful changes in regards to mental health, we all need to “walk the talk”.
[i] Mayo Clinic Staff. Job Burnout: How to Spot it and Take Action. 2015. http://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/burnout/art-20046642?pg=1
[ii] Johnson B and Clarke JM. Collecting Sensitive Data: The Impact on Researchers. Qual Health Res. 2003 13:421-434.
[iii] Mckenzie SK, Li C, Jenkin G, Collings S. Ethical Considerations in Sensitive Suicide Research Reliant on Non-Clinical Researchers. Res Ethics. 2016. DOI: https://doi.org/10.1177/1747016116649996