Many psychiatrists are emotionally exhausted by working conditions

• Sander Zurhake

  healthcare editor

Nearly half of psychiatrists in the Netherlands and Flanders suffered from emotional exhaustion in 2023, a core symptom of burnout. This is evident from research by De Jonge Psychiater, a professional website that examines the mental state of psychiatrists every three years.

This is a significant increase compared to the previous study, with figures for 2020. At that time, 33 percent of psychiatrists still suffered from emotional exhaustion.

Psychiatrist Laudine Fuld (41) suffered a burnout last year due to the enormous workload in the overloaded mental health care system. “For example, I structurally did not have the minimum time that we as a professional group consider responsible to make a good diagnosis. I always had to run to the next patient. There was often no time for lunch.”

According to Fuld, she never made a mistake in the diagnosis, but she constantly feared it. “Because you have to work in such a hurry, doubts always arise. Even when you are at home or free. Because you always wonder whether you have overlooked anything. That is why you never relax.”

Moreover, Fuld had just completed her training as a specialist in 2021. But she was immediately thrown into the deep end when she started in a closed clinic for elderly people with the most serious psychiatric problems. Her colleague psychiatrist soon dropped out, leaving Fuld to bear the weight of the number of patients for two doctors, including the supervision of three trainee psychiatrists.

She soon felt that this would not actually work, but nevertheless tried to keep it up for her patients. Her attitude seems typical of her profession, given the results of the research.

It turns out that despite everything, psychiatrists are very committed and enthusiastic when it comes to their patients. Because even with the high number (44 percent) of psychiatrists who experience emotional exhaustion, 98 percent of the almost 1,000 participating psychiatrists indicate that they often get satisfaction from seeing patients.

“That involvement is wonderful, but it makes our profession emotionally very difficult,” says research leader Joeri Tijdink, also a psychiatrist. “Because if a patient’s situation really deteriorates while you can’t do anything because there is no room, it hits you extra hard.”

In addition, half of the psychiatrists surveyed experience that they have insufficient influence on the way in which mental health care is organized. So there is powerlessness when it comes to waiting lists, for example.

More than 20 percent of the participants in the survey indicate that they are considering leaving their profession. Data from the Capacity Body, which investigates the future required capacity of professionals in healthcare, shows that the number of vacancies has increased since 2021. From approximately 1,000 vacancies per quarter in 2021 to 1,200 to 1,500 per quarter in 2022 and 2023. About 400 of those vacancies will remain unfilled for a long time.

The waiting lists in mental health care are therefore getting longer. The latest inventory by the Dutch Healthcare Authority showed that almost 100,000 people now have to wait a long time for treatment.

This means that the pressure on employees in mental health care is constant and is only increasing. Especially in the case of serious psychiatric disorders where treatments are often complicated and lengthy. For example, in 2023 Fuld suffered a migraine attack that lasted three weeks.

Then came the diagnosis of a burnout and she quit the closed institution against her will. “Because this in itself was my dream job: working with complex patients in a closed ward in geriatric psychiatry. If the number of patients had been manageable, I would have stayed,” says Fuld.

She now works in a different place, with fewer responsibilities and slightly less serious problems.

“The research shows that psychiatrists can deal with stress better over time,” says Tijdink. “The younger psychiatrists in particular are emotionally exhausted. We see that these complaints become much less as they age.”

Tijdink does not yet have a full explanation. “But we suspect that the older, very experienced psychiatrist has already been through so much that he is less likely to become stressed and therefore suffers significantly less from emotional exhaustion.

“At the same time, people in their thirties and forties with their young families naturally have to keep many more balls in the air. That also plays an important role.”