47 Burnout in Various Professions

Burnout in Various
Professions
PART 1: BURNOUT IN VARIOUS PROFESSIONS

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Over the last five decades, innumerable studies have documented
burnout in nurses, teachers, doctors, police, and managers. All of
these high stress jobs are people professions, involving steady and
regular interaction with other people, often making heavy emo-
tional demands which over time can be very tiring and can induce
different levels of stress and may lead to burnout.
Burnout has long been considered an inevitable nemesis await-
ing those involved in the human service or health care professions.
Providing compassionate care to the patients and those in need is
the cornerstone of the caring professions, but unfortunately, this
primary purpose gets defeated when the professionals get caught
in the stress-inducing atmosphere and go downhill ending up
burnt out. In the process, the attitude and commitment to work
goes through different stages, starting from compassion for the
plight of others fueled by the passion towards their work to utter
callousness and total exhaustion. Bombarded with ever-increasing
responsibilities and demands with little time in which to complete
them, the resultant pressure can lead to a severe depletion of the
individual’s resources, enthusiasm, and idealism, and a concomi-
tant negative attitude of increased cynicism, anger, irritation,
apathy, and overall diminished capacity for empathizing with the
clients takes the place of earlier ideals.
63
Occupational stress is created by the work conditions in the
workplace. In this section, a few studies specific to each profession
are reviewed. Here an attempt is made to bring together a wide
array of researches undertaken across the globe on different pro-
fessionals regarding the nature of stress and burnout to highlight
the ubiquity of the phenomenon.
Stress and Burnout in Managers

Pines and Aronson (1988a, 1988b) found in their many workshops
with managers that almost for all the managers, the most stressful
aspects of their work corresponded very closely with their initial
hopes and expectations regarding their role, status, autonomy,
and the available resources that had been frustrated. Going
further, in their exploration of what drives the managers in their
work, they found that it is the desire to find the meaning of their
life in their work that motivates them. When their aspirations to
attain a certain goal or to simply get some work accomplished are
thwarted due to political, administrative, economic, or any other
reasons, and when this happens time and again, frustration builds
up and finally the manager succumbs to burnout. In a supportive
environment with such positive features as adequate resources,
autonomy to make decisions and recognition for accomplished
work, the performance of manager speaks which further fuels
their motivation. While some of the studies, cited in the para-
graphs below, simply explore the nature of stress experienced by
the managers, some are comparative studies across different coun-
tries, and still others look at the differences in the stress experi-
ences of managers in different sectors and due to different factors.
International Studies
Cooper and Worrall (1995) reported the results of a UK survey of
the views, attitudes, impressions, and expectations of 1040 respon-
dents about the nature and extent of stress of the senior most
level of management in the company. While 46.3% of the respon-
dents belonged to the manufacturing sector, 9.3% were from the
64 Executive B urnout
service industry. The results of this survey undertaken by Price
Waterhouse and the universities of Wolverhampton and Warwick
revealed that more than one-fourth (29%) felt that the work of
their senior managers was extremely stressful and 60% thought
they were moderately stressful. Furthermore, 17% reported stress-
related causes as the reason for the senior executives taking time
off from the work. Competitive pressures, volume of work, and
meeting performance targets together accounted for 81% of execu-
tive stress, followed by other sources of stress such as relation-
ships with colleagues, domestic issues, and other reasons for
stress. An interesting finding of the survey was that while in
organizations employing between 200 and 999 employees, the pro-
blem and intensity of stress was more severe, this pattern declined
in firms employing more than 1000 employees. Additionally,
extreme stress was found to afflict the proprietors/partners and the
directors of an organization, and higher incidence of extreme stress
could be seen in organizations with a significant decline in their
employment.
In an Australian study (Sharpley & Gardner, 2001) exploring
stress and its effects among senior managers from large, successful
organizations through semi-structured interviews, the managers
unanimously testified to the damaging effects of stress on
employee health (100%). They looked at stress in terms of loss of
control in physical, emotional, or behavioral domains (94%) and
felt it led to reduced productivity (89%). Stress was seen as a
source of great concern to the organization and it was agreed that
work-related factors were responsible for half the stress (80%), it
being a reaction to events rather than the events themselves (55%).
Despite this awareness of the detrimental effects of stress, most
managers did not attend stress intervention workshops for the
fear of appearing weak or failing to others within their own
organization.
Lu, Tseng, and Cooper (1999) investigated the sources of stress,
level of job satisfaction, health, and the moderating effects of per-
sonality and the coping strategies that were used in a sample of
Taiwanese managers. The results revealed that managers experi-
enced high amounts of stress which could be a detrimental factor
Bu rn ou t in V ario us Pro fes sio ns 65

to their mental and physical health. Though internal control was
linked with more job satisfaction, it left a negative impact on a per-
son’s psychological well-being when it interacted with job stress.
Furthermore, a link was also drawn between poor physical health
and Type A behavior.
Widerszal-Bazyl et al. (2000) conducted a study on stress in 269
managers working in different organizations from the state, pri-
vate, and intermediate sectors in Poland. The results showed bet-
ter psychological well-being in the managers of the private sector
organizations and this was related to their having greater eco-
nomic effectiveness. It was also found that economic sector can be
used to predict certain types of stresses since low organizational
support and excessive workload along with job satisfaction are
associated with the sector the organization belongs to.
In a comparative study done on managers in the United
Kingdom and Taiwan by Lu, Kao, Cooper, and Spector (2000), the
relationship between work pressure and strain, and the moderating
effects of coping and locus of control were investigated with the
help of Cooper’s Occupational Stress Indicator-2 (1988) and
Spector’s Work Locus of Control Scale (1988). It was seen that
while for the Chinese managers, recognition and managerial role
could be seen as significant predictors of strain, for the UK man-
agers, however, it was relationships, organizational climate, and
personal responsibility that were significant. Also, the mediating
effects of internal locus of control could be seen for Taiwanese man-
agers. In another comparative study (Spector, Cooper, & Aguilar-
Vafaie, 2002) between 207 Iranian and 120 U.S. managers, sources
of job pressure (constraints, managerial role/tasks, home/work,
nonwork support) and job strain (job dissatisfaction, mental strain,
physical strain, intention of quitting the job, absences) were
assessed using the Occupational Stress Indicator and the Work
Locus of Control Scale. The Iranian managers were found to have
more of an external orientation and scored more on pressure and
all the sources of job strain. While higher intercorrelations for
strain, except for absence, could be seen in the American managers,
in the case of the Iranian managers they showed higher correlations
among sources of job pressure. Another disparity found was a
strong relation between marital status and job stressors and strains
in the Iranian managers, which was not the case for the American
managers. Both sets of managers were found to show a similar pat-
tern of relation between pressure and job strains along with a
strong association between internal locus of control and low strain.
In a cross-cultural study on the interplay between gender, cul-
ture, and work stress as experienced by 822 managers from South
Africa, United Kingdom, United States, and Taiwan, Miller,
Greyling, Cooper, and Lu (2000) could find little evidence for gen-
der differences in work stress, and only limited support could be
garnered as for the interaction between gender and country on
work stress. But both similarities and differences across genders
could be found in an Australian study (Lindorff, 2000) that investi-
gated the relations between strain and perceived and received
social support, and the effect of gender on the effectiveness of sup-
port among managers. While for both the genders lowered strain
was associated with perceived support and receiving information,
and tangible assistance was not associated with strain, in the case
of men receiving emotional support was considered to cause more
strain whereas it caused no such strain among women managers.
Also, received emotional support and received tangible assistance
was found to have a strong buffering effect on perceived support
for the male managers. In yet another study exploring gender dif-
ferences in the nature and experience of stress among Swedish
managers, Lundberg (1999) reported a more favorable picture for
men. Although both men and women felt their work to be suffi-
ciently challenging and stimulating, higher norepinephrine levels
were found in women both during and after work, the levels being
particularly high in women at home if they had children. In
women, greater stress was due to the added responsibilities of
home and their feeling that they had more unpaid workload than
their male counterparts.
Many more recent studies can be found in Chen and Cooper
(2014) and in Cooper and Robertson (2013), from a variety of
countries, which highlight many of the traditional topics (e.g.,
control, work-life balance) and some of the newer ones (e.g., well-
being, the happy-productive worker, sustainable workforce).

Indian Studies
Sharma (2002) in her study on executives from Indian industry
used MBI developed in 1982 which was largely based on people
occupations (like nurses and teachers) and later extended to non-
service occupations. Her study revealed that there was a difference
in the dimension of diminished personal accomplishment which
was not valid on the Indian sample. Those suffering from burnout
did not have low personal accomplishment; on the contrary, high
achieving executives were mostly found to suffer from burnout.
Also, some dimensions which were vital for Indian executives
were not covered by MBI. Therefore, Sharma (2005, 2007) evolved
the construct of “Executive Burnout” covering additional dimen-
sions, viz., ambiguity; dissatisfaction and powerlessness; inade-
quacy and physical exhaustion, which were found empirically
vital for executives in the Indian industry covering both manufac-
turing and service industry (IT, financial services, and engineering
services, etc.). As regards the determinants of executive burnout,
stress personality emerged as the most important predictor of
executive burnout. Role-related factors causing burnout were role
expectation conflict, role stagnation, self-role distance, role over-
load, role erosion, resource inadequacy, inter-role distance, and
role ambiguity (Sharma, 2013). Emotional intelligence was found
to play a significant role in executive burnout which mediates and
leads to high or low personal effectiveness that moderates experi-
enced stress. Low emotional intelligence, together with low perso-
nal effectiveness, leads to distress and maladjustment and
consequently to executive burnout. Sharma (2006b) in a study of
300 managers found that executive burnout was higher among
finance and IT professionals in India. The research further
revealed that spiritual interventions mitigate cognitive, physical,
and behavioral symptoms of executive burnout. Sharma and
Sharma (2015) in their study of perceived gender equity on Indian
sample of 373 managers found that lack of equity at workplace
leads to executive burnout. They found that there is positive rela-
tionship between the internal locus of control and the work
engagement (vigor, dedication, and absorption). Employees with
the internal locus of control are less prone to burnout as they
determine their course of action and work accordingly.
Tripathy (2002) undertook a study to explore the Burnout Stress
Syndrome in 118 managers in the manufacturing industry. Various
variables were studied in relation to burnout such as the managerial
level, age, gender, educational qualifications, marital status, working
hours per week, work experience, number of times leave taken for
outing, and optimism/pessimism. The original 22-item version of
MBI was used to measure burnout. The results revealed that middle
level managers experienced the highest level of emotional exhaustion
and depersonalization aspects of burnout, while the frontline
managers experienced the highest level of burnout on the personal
accomplishment dimension. The production department managers
were found to be the most burnt out on all the three burnout dimen-
sions. Employees between the ages of 41 and 50 years showed the
highest emotional exhaustion and depersonalization, while the most
burnout as per their personal accomplishment scores were those
below 30 years of age, and the individuals with a work experience
of 21 30 years were found to show the maximum burnout. On
all the three subscales, the males showed higher scores than the
females, and the married more than their unmarried counterparts.
Individuals who worked for more than 72 hours a week showed the
least burnout while those who worked between 41 and 50 hours a
week showed the highest incidence of burnout. The findings that
those who work 20 30 hours lesser per week burnout more look
strange; a possible explanation could be cultural difference and
nonsuitability of the scale to the sample of Indian managers from
manufacturing sector. Finally, those characterized as optimists
showed the least burnout while pessimists showed more burnout.
Pant and Bhardwaj (1992) conducted a study on executive stress
male public sector managers across the three (top, middle, and
first) managerial levels. They used the Episodic Work Related
Stress Evaluation Questionnaire and the Chronic Work Related
Stress Evaluation Questionnaire by Adams (1980), Organizational
Commitment Questionnaire by Porter and Smith (1970), and the
Workaholism Questionnaire and Coping Checklist by McLean
(1979). Stress was found to exist at all the levels of management

though varying in degrees. The top level managers were found to
have the highest levels of stress and were workaholics. But they
were equipped with inadequate coping mechanisms in relation to
the perceived stress and they showed the least amount of organiza-
tional commitment. As for the first level managers, though they
experience more stress as compared to their middle level counter-
parts, they also had better coping mechanisms and were not worka-
holic. The middle level managers experienced less stress, but due to
poor coping abilities were found to be more prone to mental ill
health and had a strong inclination towards workaholism. Though
on the whole the managers did not show very high levels of worka-
holism, the middle and top level managers were found to be mildly
workaholic. The study found a negative relation between organiza-
tional commitment and stress across the three levels. Here, it should
be noted that the middle level manager who shows high organiza-
tional commitment also has the requisite coping skills and therefore,
would experience low chronic work-related stress, while the top
level manager who is high on organizational commitment would
show less episodic work-related stress. In the case of the first level
managers, it was seen that a highly committed manager shows low
chronic work stress but high amounts of episodic work stress. A
positive correlation was found between workaholism and organiza-
tional commitment for all the three managerial levels though highly
significant values were found only for the first level managers.
Mohan and Chauhan (1999) carried out a study to ascertain the
level of burnout, the relation between burnout, and performance in
terms of the role efficacy, and the effect of locus of control on burnout
in middle level managers across government, public, and private sec-
tors. The instrument used to measure burnout was Warley’s Burnout
Inventory (1992) in which burnout is understood as alienation and is
measured in terms of the three factors — perception of the job con-
tent, immediate supervisor, and organization. Pareek’s (1982) Locus
of control inventory and Pareek’s Role Efficacy questionnaires were
also used for the study. The results revealed an absence of burnout
in all the three sectors. In fact, they showed job satisfaction and ful-
fillment. Furthermore, there were no inter-sector differences in the
overall burnout or in terms of the subdimensions, which the authors
attributed to the similarity of the level of managerial functioning. As
for the locus of control, there were again no inter-sectoral differences
in terms of the orientation. All the employees from the three sectors
showed an internal orientation, though higher internal orientation
was found in the managers from the private and government sectors
as compared to the managers from the public sector. A similar pat-
tern of lack of significant variation in scores across the three sectors
could be seen in role efficacy, and a negative correlation was found
between burnout and role efficacy. Further analysis showed the exis-
tence of a negative relation between burnout and internal locus of
control. It has to be kept in mind that individuals who show an inter-
nal locus of control are less prone to stress since they feel more cap-
able of influencing their job-related outcomes.
A study on 250 junior and middle level executives from seven
private and three public sector organizations was conducted by
Singh (1989) to examine the nature of the stress experienced by
them. It was seen that various forms of stress were experienced in
varying degrees and intensities by the executives depending on the
inadequacy of role authority, experience of inequity, job difficulty,
role ambiguity, lack of leadership support, lack of group cohesive-
ness, constraints of change, role overload, mismatch between job
requirement, and capability to role conflict. A similar qualitative
picture emerged as far as the overall stress experience was con-
cerned inter-sectorally as well as across different managerial levels.
There are a number of studies on stress conducted in a variety of
sectors on stress which have been documented by Pestonjee and
Pareek (1997), psychological perspective on stress and health, stress
in extreme conditions on military personnel (Kumar, Prakash, &
Mandal, 2013) and work-family conflict (Rajadhyaksha & Ramadoss,
2013), and stress and work but there is no book on burnout in India
and there is paucity of a recent book internationally too.
Burnout among Teachers

Studies over the years bear testimony to the fact that teachers in
the education system are vulnerable to stress. Heavy workloads,

low autonomy, high pupil-teacher ratio, poor working condi-
tions, relations with colleagues, poor salaries, role overload, and
challenging student behaviors force many teachers to shift to an
alternative profession, and several of those who persist succumb
to burnout. Whitehead, Ken, and O’Driscoll (2000) undertook a
study on job burnout among teachers and principals at 47 pri-
mary schools in New Zealand. Besides confirming the construct
validity of MBI, the major finding of this study was that these
teachers showed significantly higher scores on emotional exhaus-
tion when compared with the normative sample of the teachers
from the United States. In another study conducted among
female teachers in Israel using the Pines Burnout Measure
(Weisberg & Sagie, 1999), the impact of burnout on teachers’
intention to quit their current job was investigated. The results
showed that while on one hand, both emotional exhaustion and
teacher’s age were not significant factors to impact the intention
to leave, on the other hand, physical exhaustion and mental
exhaustion both showed positive and significant impact. A sig-
nificant negative correlation was found between tenure and
burnout, and also between tenure and intention to leave.
In a study (Van Horn, Schaufeli, & Enzmann, 1999) of burnout
among 249 Dutch elementary and secondary school teachers in
the Netherlands, burnout was seen in terms of the exchange of
investments and outcomes at two levels — the interpersonal
(teacher-student) and the organizational (teacher-school). The
results showed that higher levels of emotional exhaustion could
be seen in teachers when they invested much more than what
they got back from the school. Also, higher burnout levels were
associated with lower outcomes from the students at the inter-
personal level, while at the organizational level, higher burnout
levels in the teachers were associated with low investments.
Abel and Sewell (1999) conducted a study on 51 rural and 46
urban secondary school teachers in Georgia and North Carolina to
look into the sources of their stress and the symptoms of burnout.
The results showed that while for both urban and rural teachers,
pupil misbehavior and time pressures were more stressful than
poor working conditions and poor staff relations; for urban
teachers, poor working conditions and poor staff relations were
significantly more stressful. For the rural teachers, poor working
conditions and time pressures could be used to predict burnout, on
the other hand, in the case of urban school teachers, pupil misbeha-
vior coupled with poor working conditions predicted burnout.
In a study in the Slovak Republic (Daniel & Schuller, 2000) on
445 basic (46%), special (19%), and high school (35%) teachers, an
attempt was made to study the relation between the personality of
the individual and the state of health including burnout, age, years
of practice, anxiety, and other social variables. Contrary to expec-
tations, the results did not show the expected high burnout levels
in the teachers though significantly high scores were found among
the older teachers for classic phobias and exhaustion.
Additionally, both, the teachers just beginning to teach and those
with many years of teaching practice, showed high scores on
social anxiety. A strong positive correlation was found between
the dimension of emotional exhaustion and other variables like
classic phobias, social anxiety, stage fright, depersonalization, neu-
roticism, and gastrointestinal and cardiovascular problems.
Griffith, Steptoe, and Cropley (1999) undertook a study, which
explored the relation between teacher stress, coping strategies, and
social support along with the plaintive set caused by the negative
affectivity in 780 primary and secondary school teachers in the
United Kingdom. One of the major findings of this study was that
both social support and the coping strategies of behavior disen-
gagement and suppression of competing activities could predict
the existence of job stress independent of other factors like age,
gender, the class size, occupational grade, and negative affectivity.
These two coping responses are maladaptive and detrimental to
the teaching environment since they might further lead to higher
job stress. Social support and the two coping responses were also
found to impact an individual’s appraisal of the environmental
demands as stressful or not.
Neumann and Finaly-Neumann (1991) explored the relation
between support variables (work significance, collegial support,
chairperson’s support) and two indicators of faculty burnout
(emotional exhaustion and personal accomplishment), along with

the relationship between faculty burnout and its potential conse-
quences on organizational commitment and recent research per-
formance in faculty members across the departments of Physics,
Sociology, Electrical Engineering and Education in U.S. research
universities. The results showed that the support indicators were
strong determinants of emotional exhaustion and personal accom-
plishment in Physics, while they exhibited a weak link with emo-
tional exhaustion and personal accomplishment in Education and
with emotional exhaustion in Sociology. Additionally, a strong
relation between emotional exhaustion and commitment and
recent published articles existed in the hard sciences which was
not the case in the soft sciences. As for personal accomplishment
and commitment, a strong relation existed within all fields, and
there was a stronger relation of personal accomplishment with
recent published articles in the hard sciences.
The teachers in the field of special education are believed to
experience extremely high levels of stress and burnout. After
extensive review of international literature, Antoniou, Polychroni,
and Walters (2000) reported that teaching in the Special Education
Needs area is one of the most stressful occupations due to many
reasons such as very high workload, limited progress of the stu-
dents, and low salaries. Above all, these jobs involve a lot of emo-
tional investment along with the additional pressures created in
meeting the needs of the students who have either a sensory-
motor, physical, or mental impairment. This prolonged exposure
to excessive demands on the teachers’ emotional resources brings
about very high levels of stress and burnout in them. A study was
undertaken by Antoniou et al. (2000) with a sample of 110 teachers
of special education needs (61% males) in Greece to find out the
various sources of job stress and professional burnout and the cop-
ing mechanisms used. The results revealed that moderate to high
levels of stress were experienced by these teachers, the three main
categories of stressors for them being handling the difficult chil-
dren, work overload/lack of time, and lack of support from gov-
ernment. The authors suggest that often unable to have a positive
tangible impact on the behavior of the children with special needs,
the teachers feel extremely frustrated, develop low self-esteem and
gradually give into burnout. As for burnout, this set of teachers
showed moderate to high levels of emotional exhaustion, moder-
ate levels of depersonalization along with low levels of personal
accomplishment. The results suggest that the teachers still retained
their sense of self-efficacy, competence, and achievement even in
the face of the high levels of stress experienced by them.
Such studies on people working in the field of education have
been conducted in India as well. In a comparative study, Upadhyay
and Singh (1999) explored the occupational stress experienced by 20
college teachers and 20 executives in Bhopal. Both the groups dif-
fered significantly on the experience of stress as seen on the Occu-
pational Stress Index. These differences were on factors such as
role overload, intrinsic impoverishment and status. An attempt
was made to investigate the relation between life stress and burn-
out (Sahu & Misra, 1995) in 120 female degree college teachers in
India. The results revealed that a significant positive relation
exists between life stress and two dimensions of MBI-emotional
exhaustion and depersonalization, while this is not the case with
personal accomplishment. Additionally, similar relations could be
seen between family-related stress and the MBI dimensions, that
is, a significant positive relation existed between family-related
stress and emotional exhaustion and depersonalization while
there was a negative relation with personal accomplishment.
Furthermore, society-related stress was found to relate with only
depersonalization.
Burnout among Nurses, Doctors, and other

Health Professionals
After an extensive review of literature, Goelman and Guo (1998)
identified factors like poor wages and working conditions, unclear
job descriptions, little social support or communication at the
workplace, personality, employment history, educational back-
ground, and the worker’s perception of childcare work as having
a substantial impact on burnout among childcare workers. In
a study (Thornburg, Townley, & Crompton, 1998) on 226 adult
family childcare providers, an attempt was made to investigate

the relation between competence and burnout. It was observed
that variables like age, educational level, use of lesson plans, per-
ceived adequacy of space, satisfaction with material and equip-
ment had a significant impact on an individual’s level of
competence and burnout. Furthermore, the older and less satisfied
(with the material and equipment) providers were more prone to
burnout, while the more educated and more satisfied (with the
material and equipment) were found to be more competent.
A group of 55 psychiatrists in Russia (Lozinskaia, 2002) were
rated on emotional exhaustion, depersonalization, professional
growth, and tedium on the basis of some interviews and the MBI.
While the majority of psychiatrists showed unsatisfactory ratings
in relation to professional growth, less than half showed unsatis-
factory ratings vis-à-vis emotional exhaustion, depersonalization,
and tedium. A positive relation was found between emotional
exhaustion, depersonalization, and tedium, and some factors such
as inadequate administration and patient behavior, lack of satis-
faction in the patients and their relatives due to their unrealistic
expectations of the outcome of therapy, impossibility of establish-
ing an informal relation with the clients, and lack of social support
emerged as contributing to the development of burnout.
In a group of 84 forensic doctors in the Netherlands (Van der
Ploeg, Dorresteijn, & Kleber, 2003), the relation between acute and
chronic stressors and self-reported health measures such as post-
traumatic responses, fatigue, and burnout were investigated. The
results showed that the greater the experiences of traumatic
events, the greater are the problems faced in dealing and coping
with these traumatic events. Also, a relation was found between
chronic job stressors and posttraumatic responses of intrusions
and avoidances along with burnout and fatigue.
Baird and Jenkins (2003) made an attempt to explore vicarious
trauma or what is known as compassion fatigue, in a set of 101
trauma counselors by investigating the relation between factors
such as client exposure, workload, and the fact of being paid as a
staff member versus being a volunteer, and the burnout subscales.
The results revealed that while, on the one hand, less vicarious
trauma was reported by the more educated counselors and also
by those who saw more clients, on the other hand, higher levels of
emotional exhaustion were seen in the younger counselors and in
those with more trauma counseling experience.
In yet another research study (Collins & Long, 2003), the effects
of doing therapeutic work with seriously traumatized people were
studied in a team of trauma and recovery workers set up in the
wake of the Omagh bombing which took place in 1998. The
Compassion Satisfaction/Fatigue test, the Life Status Review
Questionnaire, and open-ended questionnaires were administered
to these workers four times during the period from 1998 to 2001.
The findings of this study revealed an increase in the levels of
compassion fatigue and burnout over the first year, and a decrease
in the levels of compassion satisfaction and levels of satisfaction
with one’s life and life status. The most positive aspects of the
work were linked to the satisfaction in seeing the clients recover,
team spirit, and camaraderie. Furthermore, the authors concluded
on the basis of their results that the likelihood of increase in both
compassion fatigue and burnout decreased with an increase in
compassion satisfaction, compassion satisfaction being a possible
protective shield against compassion fatigue and burnout.
In a study in Northern Ireland on nurses working in a large hos-
pital, it was seen that job stress and outcome health variables were
unrelated to gender differences and higher levels of stress are
found in older nurses. Additionally, the results showed that while
the nurses’ physical health was significantly determined by Type
A behavior pattern, it was (internal) locus of control which
showed a strong relation with occupational stress (lower), job
satisfaction, and the overall mental health of the individual
(Kirkcaldy & Martin, 2000). In order to investigate the effect of
locus of control and work-related stress on burnout in hospital
nurses, a sample of 361 staff nurses in Germany were adminis-
tered the MBI, Locus of Control Questionnaire, and a Work-
related Stress Inventory. The results showed that poor locus of
control in the nurses was related to more work-related stress and
burnout, and that the perceived degree of control plays a crucial
role in helping nurses cope with stress and burnout (Schmitz,
Neumann, & Oppermann, 2000).

Gueritault-Chalvin, Kalichman, Demi, and Peterson (2000) con-
ducted a study to investigate the coping skills used in dealing
with burnout in nurses working in the HIV/AIDS area. The
results showed significant impact of the external and internal cop-
ing styles used by the nurses on their burnout levels and this was
over and above the role of other factors like age, perceived work-
load, and locus of control. Further analysis showed the mediating
role played by an individual’s external coping style vis-à-vis the
effect of locus of control on burnout. However, this mediation was
not found in the case of those with an internal coping mechanism.
Thus, it was concluded that an individual’s cognitive and beha-
vioral coping style play an important role in dealing with burnout
in nurses dealing with HIV/AIDS patients.
Chandra Sekhar (1996) carried out a study on 120 nurses, 40
each from corporate, university, and government hospitals, to
investigate the nature of stress and burnout experienced by nurses
working in hospitals differing in the ownership pattern. It was
hypothesized that the nature of the stress and burnout experi-
enced by these nurses would differ on the basis of the type of hos-
pital they belonged to, and secondly, that their stress and burnout
levels would differ according to the number of patients they cared
for. The MBI was used to assess the nurses on the three dimen-
sions of burnout, Parker’s and DeCotiis’ (1983) scales were used to
measure time stress and work-related anxiety, while helplessness
was measured using the Ashforth’s and Mael’s scale (1989). Both
the hypotheses were supported by the results. It was seen that
compared to the other two sets of nurses, the corporate nurses
showed higher time stress and overall job stress while being mod-
erate on helplessness, while the government hospital nurses scored
the highest on helplessness. The highest scores on burnout were
reported by the government hospital nurses. However, there
were no significant differences with regard to depersonalization
amongst the nurses, which attests to the commonality of this
experience of depersonalization in this profession. While the cor-
porate nurses showed high scores on emotional exhaustion, it was
the university nurses who showed the lowest scores on both the
stress and burnout dimensions. With regard to the second
hypothesis, the results showed a strong impact of the number of
patients on the depersonalization and the personal accomplish-
ment dimensions of burnout.
Another study which looked into the different levels of burn-
out on the basis differences in the practice setting was the one
undertaken by Vredenburgh, Carlozzi, and Stein (1999) on 521
counseling psychologists. It was seen that while the lowest level
of burnout was seen in the psychologists in private practice, it
was the psychologists working in hospitals who showed the
highest levels of burnout, with males in both the settings show-
ing more depersonalization than females. The results showed
the existence of an inverse relation between age and burnout,
and a positive relation between an individual’s sense of perso-
nal accomplishment and the number of hours of client contact
per week.
The study by Proctor and Steadman (2003) looked into the dif-
ferences in the job satisfaction, burnout, and the perceived effec-
tiveness levels between an in-house group of school psychologists,
that is, those who served a single school, and the traditional group
which comprised of those school psychologists who served several
schools concurrently. The in-house group fared much better on all
the dimensions than the traditional group, the levels of satisfaction
and perceived effectiveness being higher and the levels of burnout
being lower in the in-house group.
In a comparative study in Switzerland (Cocco, Gatti, de
Mendonca Lima, & Camus, 2003), the stress and burnout levels
were investigated in caregivers from nursing homes and acute ger-
iatric wards of general hospitals. The results obtained from the
sociodemographic data, General Health Questionnaire, the MBI,
and the Stressful Events Questionnaire showed that the general
hospital caregivers had higher scores on depersonalization and
emotional exhaustion and lower scores on personal accomplish-
ment. On further analysis, it was seen that high emotional exhaus-
tion scores were caused by the general hospital work setting,
professional role, gender (female), and the patient-caregiver ratio,
while high depersonalization scores were more associated with
general work setting and disability.

Robinson (2003) undertook a review of articles published in the
preceding 15 years focusing on the nature and consequences of
stressors faced by women physicians. It was seen that women
physicians showed much higher rates of successful suicides and
divorces. There were a number of stressors such as slow promo-
tions, lower salaries, much lesser resources at disposal, lack of
mentors for guidance, and a range of other micro-inequities. There
were additional pressures arising from conflicts in fulfilling the
roles of a mother, wife, and career woman. Surprisingly, even in
the wake of these stressors and pressures, which can cause many
impediments and obstructions in their life, stress reactions and
psychological problems, the women physicians seem satisfied
with their careers.
In a study on 200 female nurses in Thailand, it was seen that
crying did not lead to substantial reduction in stress levels of the
nurses even though crying was found to be important in dealing
with home/work stress and pressures created in the process of
dealing with patients. The benefits of crying were seen in only
those nurses who showed low intrinsic job satisfaction, while the
dissatisfied nurses who cried infrequently were found to have the
highest levels of stress (Pongruengphant & Tyson, 2000). In
another study conducted on 648 ward-based mental health nurses
in the United Kingdom, the authors concluded that burnout is
much less a significant problem in the mental health nurses than
what has been reported by previous research (Carson, Maal,
Roche, & Fagle, 1999).
Burnout in Sports
The concept of burnout has gained tremendous popularity in the
field of sports. Caccese and Mayerberg (1984) were the first to
examine burnout in the sports setting. Many definitions of burn-
out across disciplines exist in the literature. To triangulate existing
academic definitions through coaches’ experiential knowledge,
Raedeke, Lunney, and Venables (2002) conducted a study on 13
senior swimming coaches to examine their perspectives to describe
defining signs and symptoms of athlete burnout. Through content
analysis of these interviews, Raedeke et al. defined burnout as “a
withdrawal from [sport] noted by a reduced sense of accomplish-
ment, devaluation/resentment of sport, and physical/psychologi-
cal exhaustion.”
Raedeke and Smith (2001) carried out two studies to develop a
psychometrically sound measure of athlete burnout in the United
States. In study 1, exploratory factor analysis was done on 236
swimmers that revealed burnout dimensions reflective of emo-
tional/physical exhaustion, reduced sense of swimming accom-
plishment, and swimming devaluation. In study 2, psychometric
properties of the refined measure were examined. Confirmatory
factor analysis and alternative model testing supported the speci-
fied three-factor burnout model. Construct validity of the instru-
ment was established by positive correlation of burnout with trait
anxiety, motivation, and stress, and negative correlation with cop-
ing, commitment, intrinsic motivation, and enjoyment indices
across the two studies.
Cresswell and Eklund (2006) conducted a study to explore the
extent to which burnout characteristics as conceptualized by
Maslach (1982) are appropriate for elite rugby players. About 15
professional rugby players were interviewed for the study. The
results of the study revealed that conceptualization adopted by
Raedeke and Smith (2001) (i.e., exhaustion, reduced accomplish-
ment, and sport devaluation) that was grounded in the original
human care literature (Maslach, 1982) was more appropriate for
rugby players.
Raedeke, Granzyk, and Warren (2000) examined coaching burn-
out from commitment perspective which links burnout with feel-
ings of entrapment. In theoretical perspective, entrapment occurs
when coach becomes less interested in coaching but still considers
it best to stick to coaching because (a) they perceive a lack of
attractive alternatives to coaching, (b) they believe they have
invested too much to quit, or (c) they think others expect them to
continue coaching. The study was conducted on 295 swimming
coaches and the results suggested significant differences between
the three on exhaustion and commitment. It was revealed that

coaches with characteristics of entrapment reported significantly
higher exhaustion than the other groups.
Another study was carried out by Bradford, Pugh, Heitman,
Kovaleski, and Keshock (2012) to determine if the relationship
between burnout, as measured by the MBI and years of coaching
experience was curvilinear. These results suggest that emotional
exhaustion and depersonalization, the two out of three categories
as measured by MBI, showed a curvilinear relation with coaching
experience. The results also revealed that coaches with less years
of experience suffered more emotional exhaustion and depersona-
lization than those with more years of experience.
The research by Curran, Appleton, Hill, and Hall (2012) suggests
that passion (obsessive and harmonious), through various mediat-
ing processes can explain variability in burnout. They tested a
model, in which the effects of passion for sport on athlete burnout
were mediated by psychological need satisfaction on 173 academy
soccer players. Psychological need satisfaction was found to mediate
the relationship between harmonious passion and burnout but not
obsessive passion and burnout. The literature of burnout in sports
literature has seen a steady growth over the last twenty years.
Burnout in Other Professions

Kickul and Posig (2001) tested the adequacy of Cordes and
Dougherty’s (1993) framework of employee burnout in nonservice
occupations. Their results supported the efficacy of this model. It
was seen that the relation between role conflict, role ambiguity,
quantitative role overload stressors, and emotional exhaustion as
well as the relation between emotional exhaustion and depersona-
lization was moderated by the presence of supervisory social sup-
port. Additionally, the existence of a negative association between
participation and depersonalization was observed.
Burke, Shearer, and Desza (1984) investigated the utility and
generalizability of Golembiewsky’s phase model of burnout in 426
men and women employed in the police force. They found a wor-
sening of both work and personal experiences with a progression
of burnout to the more advanced phases. Also, a significant rela-
tion was found between the progressive phases of burnout and
the measures of work setting, the stress experienced and emo-
tional and physical well-being. On the whole, the results sup-
ported Golembiewsky’s phase model.
In a Dutch study (Kop & Euwema, 1999) conducted on police
officers, an attempt was made to study the relation between reci-
procity (with civilian colleagues and police organization), burnout,
and interpersonal conflict management. The MBI scores revealed
average scores on depersonalization and personal accomplishment
with relatively low scores on emotional exhaustion. A strong rela-
tion was found between lack of reciprocity in the police officers
and high levels of burnout along with the existence of a negative
attitude towards conflict management in those officers who were
found to be burned out. While the use of more conventional strate-
gies during confrontations (involving less investment) with civi-
lians was seen in officers who were high on depersonalization, a
decrease in the use of these strategies (avoidance behavior) was
observed in those who were high on emotional exhaustion.
Slate, Johnson, and Wells (2000) after reviewing the various fac-
tors and remedies for probation officer stress suggested the exis-
tence of a direct correlation between occupational level and job
satisfaction. Those officers, who were at the entry level or were
better educated or were from a minority group, showed a higher
propensity to quit the job. Amongst the probation officers, unne-
cessary paperwork, lack of time to get a job accomplished, finan-
cial concerns, sense of uncertainty relating to retirement benefits,
and insufficient mileage reimbursement were some of the major
stress-inducing factors.
Fletcher and Hanton (2003) interviewed international sports per-
formers, both male and female, regarding the potential sources of
organizational stress. The factors that were found to be critical were
the personal issues of nutrition, injury, goals and expectations, envir-
onmental issues of selection, finances, training environment, accom-
modation, travel, and competition environment, leadership issues
of coaches and their coaching style, and finally the team issues of
team atmosphere, support network, roles, and communication.

In a study of stress and burnout among 163 male and 98 female
collegiate tennis coaches (Kelley, Eklund, & Ritter-Taylor, 1999), an
attempt was made to investigate the suitability of the three alterna-
tive models of stress-mediated relations between personal and situa-
tional variables like hardiness, coaching issues, competitive levels,
gender, trait anxiety, leadership styles, and burnout. The results
showed a pattern of the levels of burnout in the coaches similar to
that found in Maslach’s and Jackson’s study (1986) of helping profes-
sionals in the field of higher education. A significant main effect of
gender was observed in the study with coaching issues being more
stressful for the female coaches than the male coaches. The results
revealed the efficacy of the stress-mediation model in adequately
explaining the emergent relationships in the data.
In a comparative cross-cultural study of 198 students in India
and 344 students in Canada (Sinha, Willson, & Watson, 2000),
stress, coping, psychosocial variables like locus of control, self-
esteem, life orientation (optimism-pessimism), and social support
were investigated. It was hypothesized that the Indian students
would experience more stress, would use more of emotion-
focused coping strategies, and would have an external locus of
control, low self-esteem, pessimistic life orientation, and a higher
social support satisfaction. Contrary to the expectations, it was the
Canadian students who reported higher levels of stress, though
Indian students, as was expected, did make more use of the
emotion-focused coping strategies. Additionally, Indian students
had higher scores on chance control and showed lower satisfaction
with social support, though a similar pattern emerged for both the
groups of students on the factors of powerful others and internal
control.
In 2001, Thrope, Righthand, and Kubik developed Professional
Impact Questionnaire to investigate burnout potential in profes-
sionals working with sex offenders in clinical, forensic, and human
services settings. These professionals encounter negative experi-
ences that give way to burnout. Describing such experiences may
help in designing remedial measures. For establishing the psycho-
metric properties of the questionnaire, the study was initially
tested with 17 clinicians who provide sex offender evaluations.
The second study was carried out on 70 clinicians, jurists, and
frontline caseworkers and their supervisors. The result of the
study revealed that caseworkers reported significantly greater
emotional distress than others. All the participants, negative emo-
tions led to poor work performance.
Shepherd, Marchisio, Morrish, Deacon, and Miles (2010) by con-
ducting a survey of entrepreneurs in New Zealand, conceptually
and empirically explored the antecedents and consequences of
entrepreneurial burnout. Stress is a widely accepted part of the
entrepreneurial life (Boyd & Gumpert, 1983). Relentless stress may
lead to burnout (Boyd & Gumpert, 1983; Maslach, 1982) which is a
significant concern for entrepreneurs (Brigham, 2002; Duran-
Whitney, 2004; Wincent & Ortqvist, 2009; Wincent, Ortqvist, &
Drnovsek, 2008). However, the literature highlighting the phenom-
enon of burnout in the entrepreneurial context is scarce. The find-
ings suggest that role stress (role conflict, role ambiguity, and role
overload) are positively and significantly related to burnout.
Burnout was negatively related to organizational commitment,
organizational satisfaction, and relative perceived firm performance.
PART 2: MENTAL HEALTH PROFESSIONALS’

PERCEPTION OF EXECUTIVE BURNOUT
This chapter is based on an empirical research conducted by the
author (Sharma, 2005) on an Indian sample of mental health pro-
fessionals comprising psychiatrists/psychologists pertaining to
their perception of executive stress and burnout. With a view to
obtaining a holistic and comprehensive perspective on the phe-
nomenon of burnout, it was envisaged that professionals from the
field of mental health be invited to take part in the study. In effect,
the all-India survey and interview of mental health professionals
from the national capital region of Delhi, India, sought to garner
an extensive and intensive understanding of burnout from the rich
clinical experience that mental health professionals had based on
their continual interaction with executives and people from all
walks of life.

The Mental Health Professionals deal with a wide range of dis-
orders such as acute stress disorder (ASD), post traumatic stress
disorder (PTSD), adjustment disorders, and anxiety disorders, etc.
Though a separate disorder caused by stress and burnout is not
present in the classification of disorders in the DSM-IV, it is clearly
stated that psychosocial and environmental problems such as
stress may have a strong impact on the diagnosis, treatment, and
prognosis of mental disorders. Furthermore, psychosocial stressors
can give rise to many clinically significant physical, emotional,
and behavioral symptoms.
Methodology
Based on an earlier research by Sharma (2002), review of
researches and inputs from some eminent and established psychia-
trists and psychologists of India, a questionnaire was developed to
tap various aspects of the phenomenon of burnout observed by
the mental health professionals in their patients during the course
of their clinical practice. While designing the questionnaire for eli-
citing the data from the mental health professionals, care was
taken to seek information not only about the antecedents, causes,
development, and the pattern of the onset of burnout, but also
about the nature of interventions that could be adopted in order to
reduce the incidence of this problem. The expert opinion of a
group of psychiatrists/clinical psychologists was sought on each
item of the questionnaire during test construction. Unanimity of
experts was taken as a criterion for inclusion of item in the final
questionnaire. The questionnaire was pilot tested and later admi-
nistered to the sample of mental health professionals. It was
ensured that the questionnaire is comprehensive and exhaustive
enough to capture various aspects of the scourge of Burnout, from
the vantage of the mental health professionals, which is gradually
gaining epidemic proportions with its debilitating impact on all
the walks of human life. It was believed that it is only after an inci-
sive understanding of this phenomenon that the preventive-
curative-remedial aspects could be studied.
The questionnaire covered broadly the following issues relating
to burnout. The mental health professionals were identified from a
directory of mental health professionals in India on random sam-
pling basis. Sharma sent the questionnaire to 200 mental health
professionals 50 per region, to four broad regions in India:
North, South, East, and West.
1. Incidence of Burnout in the population

a) Incidence of ASD, PTSD, adjustment disorder with
depressed mood, adjustment disorder with anxiety and burn-
out in their patients
b) Increase in the incidence of Burnout during the past
5 10 years
2. Stress as a major cause of psychoneurosis/psychosis among the
executives
3. Type of Interventions made to facilitate improvement in the
individuals’ coping abilities which will help them fight
distress:
a) Counseling
b) Biofeedback
c) Muscle relaxation technique
d) Yoga/meditation/physical exercises
e) Time management
f) Holistic wellness
g) Cognitive restructuring
h) Any other
4. Benefit of early intervention in preventing/reducing the inci-
dence of psychoneurosis/psychosis
5. Pattern of the onset of burnout
a) Phases: Depersonalization, Reduced Personal accomplish-
ment, and Emotional Exhaustion

b) Stages: Honeymoon, Fuel Shortage, Chronic Exhaustion,
Crisis, and Hitting the Wall Stage
c) Any other pattern through which stress leads to burnout.
6. Proneness to Burnout: Who is more prone to burnout?: A
number of options were given to choose from: Type A per-
sonality, males more than females, highly educated than less
educated, high achievers as compared to average or low
achievers, private sector employees as compared to public
sector employees, people within the age group of 21 30, or
31 40 or 41 50 or 51 60 years, those working in the metro
cities, working in a demanding job, job with long working
hours, jobs with stretched weeks, jobs with consistent dead-
lines, jobs with performance-based wages, jobs involving
excessive travel, working couples, high income groups, low
income groups, person being a single child, person being the
eldest child, individual from nuclear families, individual
from broken homes, unhappy married life, traumatic perso-
nal experiences, loss of job/income/business, accidents/
physical trauma/prolonged disease, natural calamities, case
of divorce, or death of a spouse.
7. Symptoms of Burnout: A range of symptoms were identified
which could be classified as physical, emotional, and beha-
vioral. Symptoms: Inadequacy, job dissatisfaction, feeling of
powerlessness, ambiguity, depersonalization, interpersonal
problems, physical and emotional exhaustion, sleeplessness
or difficulty in falling asleep, writers’ cramps, forgetfulness,
loss of concentration, verbal aggression, anger outbursts,
irritability, increased smoking, hyper-acidity, psychosexual
problems, headaches, frequent urination, feeling of dejection,
sense of worthlessness, high anxiety levels, depression, ima-
ginary fear, and transient psychosis.
8. Behavioral Effects of Burnout: Absenteeism, hopelessness,
secretiveness, malpractices, sabotage, low productivity, non-
compliance, falling short of deadlines, interpersonal and
group conflicts, sensitiveness, back stabbing, confusion
about goals, lack of teamwork, disruption in work, need to
work overtime, insecurity, violent behavior, alcoholism,
drug addiction, financial debt, drug addiction, inability to
cope with changes and attempting suicide.
9. Frequency of Visits in cases of Mild/Moderate/High Burnout
10. Nature of Patients’ visit to the Psychiatrist/Psychologist:
a) voluntarily
b) referred by their organization
c) by NGOs/Social workers
d) by family members/relatives
e) any other way
11. Prevention of Burnout: Recommendations for

a) Organizations
b) Employees
c) Health organizations
d) Government
e) Society
In addition, they were requested to give their inputs, they might

consider important, in understanding, diagnosing, treating/pre-
venting/reducing the incidence of burnout (Figure 3.1).
Though there were a large number of practicing Psychiatrist/
Psychologists, only those mental health professionals were
approached who were actively involved in the diagnosis and
treatment of cases of stress/burnout and related ailments as the
focus of the study was on executive burnout. The data collection
from mental health professionals was constrained by social stigma
attached to mental illness and visits to psychiatrist/psychologist
in India, consequently the number of cases of executive burnout
seen by the mental health professionals were low. Also, those
who consulted such patients were reluctant to respond and had to

be approached repeatedly and persuaded to respond to the ques-
tionnaire. In fact, the sample outside Delhi was sent several e-mail
reminders to return the filled up questionnaire. Some of the out-
station mental health professionals regretted that they did not see
many cases of executive burnout in their clinical practice; hence,
they would not like to be a part of the study.
From a survey of 200 mental health professionals only 56 (28%)
questionnaires were usable. The following presents regional distri-
bution of the responses from mental health professionals (Table 3.1).
Table 3.1: Regional Distribution of the Responses from Mental

Health Professionals.
Nationwide Distribution Number of Questionnaires Percentage

of the Data Received
North 26 46.43
South 16 28.57
West 7 12.5
East 7 12.5
East
13%
West
13% North
45%
South
29%
Figure 3.1: Nationwide Distribution of Sample of Mental Health

Professionals.
The data collected through the e-mail survey and interviews
were analyzed for the sample of mental health professionals and
the results are presented in the following paragraphs.
Analysis of Data
Data were subsequently analyzed at three levels:
I) National level covering the entire sample of psychiatrists/

psychologists
II) Regional level — North, South, East, and West
III) Government Hospitals and Private Hospitals/Clinics level
Prevalence of Executive Burnout in the Population

Table 3.2 presents the perspective of the mental health profes-
sionals about the incidence of executive burnout in the Indian
population. About 32% of the total sample of mental health profes-
sionals felt that around 10% of the population is affected by the
problem of burnout, followed by almost 20% stating that about
20% people suffer from burnout in both government and private
sectors. It is noteworthy that only less than 4% of the sample felt
that burnout is present in less than 10% of the population.
It is noteworthy that professionals from both government hos-
pitals (36%) and private hospitals/clinics (25%) have reported
the incidence of burnout to be among 10% of the population.
There is a consistent pattern across North, South, East, and West
about the incidence of burnout to be 10% in the population.
Similarly, nearly 20% of the sample from both government and
private sector has reported incidence of burnout to be in 20% of
the population; here again there is consistent pattern across the
regions except East. One may infer that the incidence of burnout is
on the increase as per mental health professionals. Despite the
stigma attached to mental health problems, people do seek psy-
chiatric/psychological help. There are some regional variations; as

92
Executive B urnout
Table 3.2: Prevalence of Burnout in the Population: Perception of Mental Health Professionals.
Incidence Response Distribution across Sample (in %)

Total Government Private East North South West
response total total
Less than 10% of the population 3.57 0 10.00 0.00 3.85 6.25 0.00
10% of the population 32.14 36.11 25.00 28.57 23.08 37.50 57.14
20% of the population 19.64 19.44 20.00 42.86 11.54 25.00 14.29
Source: (Sharma, 2005, unpublished Research Report on Determinants of Executive Burnout in India).
in some regions greater proportion of professionals perceives a
higher incidence of burnout in the population at large. Highest
response (57%) has been received from the West where mental
health professionals have reported incidence of burnout to be in
10% of the population followed by East where 43% of the profes-
sionals consider it to be in 20% of the population. The perception of
high incidence of burnout in the population as perceived by the
country’s mental health professionals is an issue of great concern
and needs attention to mitigate it.
Prevalence of Various Stress-Related Disorders: Experience of

Mental Health Professionals
Views of mental health professionals were sought with regard to
the prevalence of stress-related disorders seen by them in hospital/
clinics, viz.,
a) ASD,
b) PTSD,
c) Adjustment disorder-with Depressed Mood,
d) Adjustment disorder with Anxiety, and
e) Burnout.
As can be gleaned from Table 3.3 that the majority of the profes-
sionals report that the incidence of the above-mentioned disorders
seen by them falls below 10% which should not be dismissed as
this figure is based on cases seen by these professionals during a
month. Hence, considering the vast spectrum of psychological dis-
orders, such a record is noteworthy. One may note that with
regard to ASD, PTSD, and Burnout, almost all the mental health
professionals appear to have consensus regarding their perception
of the incidence of these disorders to be about 10% based on their
experience. A closer look at the table 3.3 reveals that about half
the mental health professionals find that of these Adjustment dis-
order with Depression and adjustment disorder with Anxiety

Table 3.3: Prevalence of Various Stress-Related Disorders Seen by the Mental Health Professionals in India
during a Month.
Percentage of Acute Stress Posttraumatic Stress Adjustment Adjustment Burnout % Increase of
Stress-Related Disorder (ASD) Disorder (PTSD) Disorder with Disorder with Burnout
Cases Seen in Depressed Mood Anxiety
a Month
Pvt. hospital/clinic
Govt. Hospital
Govt. hospital
Govt. hospital
Govt. hospital
Govt. hospital
Total sample
Total sample
Total sample
Total sample
Total sample
Total sample
Govt.
About 10 78.57 85 75 98.21 100 97.22 48.21 40 52.78 51.79 45 55.56 83.93 90 80.56 55.36 40 63.89
11 20 16.07 15 16.67 1.79 0 2.78 21.43 15 25 17.86 15 19.44 14.29 10 16.67 19.64 20 19.44
21 30 1.79 0 2.78 0 0 0 23.21 30 19.44 19.64 20 19.44 0 0 0 12.5 25 5.56
31 40 1.79 0 2.78 0 0 0 1.79 5 0 7.14 10 5.56 1.79 0 2.78 0 0 0
41 50 1.79 0 2.78 0 0 0 3.57 10 0 3.57 10 0 0 0 0 7.14 10 5.56
occur in about 10% of the cases. The remaining professionals
report seeing more of such cases in the range of 11 40% (in a
month) during the course of their monthly practice.
The classification of stress-related disorders seen by mental
health professionals is presented in Table 3.4.
A perusal of Table 3.4 revealed that the range of all the five
types of stress-related disorders seen by the mental health profes-
sionals was between 60.71 and 85.71 which is high. Among the
psychiatric disorders seen by mental health professionals, a major-
ity of them report seeing cases of Adjustment Disorder with
depressed mood. This century is said to be the age of anxiety,
therefore, it is not at all surprising to have adjustment Disorder
with Anxiety to be the next most important disorder followed by
ASD and Burnout. Burnout is said to be the consequence of stress
and anxiety; therefore, it is noteworthy that a considerably high
proportion of mental health professionals admitted seeing patients
afflicted with burnout both in government hospitals and the pri-
vate hospitals/clinics across the four regions of India.
The overall rank of these disorders based on data obtained on
the sample of 56 Indian mental health professionals was as
follows:
1. Adjustment Disorder with Depressed Mood (it ranked the

highest among all the four regions of India)
2. Adjustment Disorder with Anxiety
3. ASD
4. Burnout
5. PTSD
With regard to all the stress-related disorders stated above, a

higher incidence of cases was reported by professionals in the gov-
ernment hospitals. However, greater variation can be observed
with regard to Burnout, Adjustment Disorder with anxiety, PTSD,
and ASD. Considerably high proportion of mental health profes-
sionals admit seeing patients undergoing problems relating to

96
Table 3.4: Nature of Stress-Related Disorders seen by the Mental Health Professionals.
Executive B urnout
Nature of Disorder Distribution across Sample (in %)

Total sample Government Private East North South West
ASD 69.64 72.22 65.00 100.00 53.85 75.00 85.71
PTSD 60.71 63.89 55.00 85.71 50.00 62.50 71.43
Adjustment disorder 85.71 86.11 85.00 100.00 73.08 93.75 100.00
with depressed mood
Adjustment disorder 76.79 80.56 70.00 85.71 65.38 87.50 85.71
with anxiety
Burnout 66.07 72.22 55.00 85.71 57.69 68.75 71.43
Percent increase 71.43 66.67 80.00 71.43 65.38 68.75 100.00
burnout. It is noteworthy that 66% of the sample of mental health
professionals in the country deals with cases of burnout of which
72% represents government hospitals and 55% private hospitals/
clinics. It may be mentioned that the percentage of burnout cases
may actually be much higher in the population as many of them
do not seek psychiatric/psychological help due to social stigma.
The finding is of great significance as it was presumed that
stress-related disorders would generally be found among private
sector executives who, in turn, would seek help within the private
milieu. The executives were expected to seek more frequent help
from the private practitioners operating in clinics and private
hospitals as their medical expenses are reimbursed by their
organizations.
An attempt was made to ascertain from the mental health pro-
fessionals, whether there was an increase in the percentage of the
above-mentioned stress-related disorders, as seen by them during
the past 5 10 years (given in Table 3.4). The increase in burnout
cases during the past 5 10 years as perceived by the mental health
professionals is presented in Table 3.5.
It may be noted that more than half of the sample, that is,
55.36% of mental health professionals reported less than 10%
increase in the incidence of burnout. This was reported by
63.89% mental health professionals from government hospitals and
Table 3.5: Perception of Mental Health Professionals Regarding

Increase in Burnout Cases.
Percent Increase Response Obtained

in Burnout
Total sample Government Private
Less than 10% 55.36 63.89 40
10 40% 32.14 25 45
41 70% 7.14 5.56 10
71 100% 5.36 5.56 5
Source: Sharma (2005).

40% from private hospitals/clinics. However, 32% of the sample
reported the increase in stress-related disorders to be between 10%
and 40%. It might be inferred that stress-related problems are
emerging phenomena and are on the increase. From the results it is
also evident that treatment is sought in both government hospitals
and private hospitals/clinics. The results indicate that pressure on
government hospitals will increase with the reported increase in
stress-related disorders in general and burnout, in particular.
Stress as a Major Cause of Psychoneurosis/Psychosis

among the Executives
There has been a controversy whether burnout develops in
phases or stages. Considerable literature available that shows
that not being able to cope with the increasing pressures and
excessive demands, a state of exhaustion is reached; this has
been the Western perspective. The question is whether unma-
naged stress leads to a state of exhaustion characterized by low
energy levels, fatigue, and frustration resulting in a breakdown
in other cultures too. Sharma (2005) planned to test on Indian
sample empirically if unmanaged stress coupled with low coping
ability was linked with psychoneurosis/psychosis. This phenom-
enon could best be tested in two ways — through longitudinal
studies and through the psychiatrists/clinical psychologists who
have been engaged with the diagnosis and treatment of burnout
cases over the years. Keeping this in view, questions were
framed and data were collected with the help of questionnaire
and personal interview.
The data presented in Table 3.6 signify the perception of mental
health professionals in India, as to whether stress is the major
cause of psychoneurosis/psychosis among the executives.
• The results indicate overwhelming correspondence between

stress and psychoneurosis/psychosis. All the mental health
professionals (96.15%) who responded to the questions were
unanimous in their response that stress definitely is a cause of
psychoneurosis/psychosis.
Table 3.6: Stress as a Cause of Psychoneurosis/Psychosis among Executives.
Responses Response Distribution across Sample (in %)

Bu rn ou t in V ario us Pro fes sio ns
0 (no response) 5.36 5.56 5.00 0 3.85 12.5 0

1 (yes) 94.64 94.44 95.00 100 96.15 87.5 100
Grand total 100 100.00 100.00 100 100.00 100 100
99
• This was one of the most significant findings of the study
which ought to be utilized for preventing/reducing stress by
enhancing coping ability of the employees and improving
work-related factors.
• Further analysis revealed that barring the nonresponse the
same finding has been obtained across regions.
• From the foregoing it can be concluded that there is causal
relationship between stress psychoneurosis/psychosis.
Role of Early Intervention in Preventing/Reducing the

Incidence of Psychoneurosis/Psychosis
Table 3.7 presents the perception of mental health professionals
regarding the efficacy of early intervention to prevent/reduce the
incidence of psychoneurosis/psychosis. About 96.4% mental
health professionals agreed that if timely intervention was pro-
vided, it could reduce the incidence of psychological problems
relating to stress. However, a small percentage of professionals,
6.25%, did not agree with this viewpoint.
The findings point to the need for some structured preventive/
therapeutic/remedial measures that may be used to counteract
stress at its initial stage so as to prevent it from escalating to men-
tal disorders.
Table 3.7: Perception of Mental Health Professionals about

Benefits of Early Intervention.
Response Response Distribution across Sample (in %)

Total Government Private East North South West
sample
0 (No) 3.57 2.78 5.00 0 3.85 6.25 0
1 (Yes) 96.43 97.22 95.00 100 96.15 93.75 100
100 Exec ut ive B ur nout

Interventions to Improve Coping Mechanisms to Fight Distress
Perspective of the mental health professionals was sought regard-
ing the interventions that can be used to improve coping mechan-
isms to fight distress. Results are presented in Table 3.8.
It may be observed from Table 3.8 that on the whole, yoga/
meditation/physical exercises have been reported to be the most
effective interventions for enhancing coping mechanisms to coun-
teract distress. This intervention had received the highest recom-
mendation across regions. It can be observed from the table that
the mental health professionals from government hospitals pro-
pose that other interventions namely, counseling, time manage-
ment, muscle relaxation, and cognitive restructuring were also
effective in that order. In private hospitals/clinics, however, the
most effective set of interventions suggested were counseling, time
management, and yoga/meditation which have received 95%
responses each followed by muscle relaxation, cognitive restructur-
ing, and holistic wellness receiving 90%, 80%, and 60% responses
from the mental health professionals.
A perusal of data in Table 3.8 across regions revealed that yoga/
meditation/physical exercises are considered by mental health profes-
sionals as the most effective intervention for countering stress. It
may be noted that in the East and the South, Counseling got the
highest rating. Time management and yoga received 100% rating
in the West. One may attribute it to high paced lifestyle and
accompanying stress.
Other Interventions
The mental health professionals were requested to share their
views with respect to other forms of interventions/therapy, that
they might consider valuable in their rich experience of dealing
with stress and burnout cases. These responses obtained were
grouped in broad categories (Table 3.9) to facilitate comparison.
Professionals in the government hospitals appeared to have
experimented with a plethora of therapeutic measures, which are
more generic in nature whereas the private hospitals/clinics exhib-
ited more reliance on medication as a speedy (quick fix) solution.
Bur no ut in Var ious P rof ess ion s 101

102
Table 3.8: Interventions Suggested by Mental Health Professionals for Coping.

Exec ut ive B ur nout
Nature of Intervention Response Distribution across Sample (in %)

Counseling 89.29 86.11 95.00 100.00 92.31 87.50 71.43
Biofeedback 46.43 50.00 40.00 71.43 42.31 43.75 42.86
Muscle relaxations 78.57 72.22 90.00 85.71 84.62 75.00 57.14
Yoga/meditation/physical exercises 96.43 97.22 95.00 100.00 100.00 87.50 100.00
Time management 85.71 80.56 95.00 71.43 92.31 75.00 100.00
Holistic wellness 58.93 58.33 60.00 42.86 73.08 50.00 42.86
Cognitive restructuring 76.79 75.00 80.00 71.43 88.46 62.50 71.43
Any other 39.29 38.89 40.00 28.57 26.92 62.50 42.86
Table 3.9: Interventions Suggested by Mental Health Professionals
for Coping with Stress/Burnout.
Other Interventions Response Distribution

across Sample (in %)
Government Private
Physical interventions (exercises, etc.) 6.66 14.28
Psychological interventions 46.6 42.85
Lifestyle changes 33.3 14.28
Pharmacology 13.3 28.57
However, mental health professionals from both the govern-

ment and private hospitals suggested psychological interventions
over any other forms of interventions to fight distress. Table 3.10
summarizes some of the divergent therapeutic measures
that were considered effective by some of the mental health
professionals.
Patterns of Burnout
The following data indicate mental health professionals’ opinion
of whether occurrence of burnout follows a particular pattern (in a
phased manner or in stages or any other pattern). The profes-
sionals were asked to choose from the given two patterns, or sug-
gest any other pattern of stress developing into burnout.
a) Phases: Depersonalization, Reduced Personal Accomplishment,

and Emotional Exhaustion
b) Stages: Honeymoon, Fuel Shortage, Chronic Exhaustion,
Crisis, and Hitting the Wall Stage
As can be observed from the Table 3.11, that about 54% of the
responses from the total sample suggest that burnout develops

104
Table 3.10: Variety of Interventions Suggested by Mental Health Professionals.
Physical Intervention Psychological Intervention Lifestyle Changes Pharmacology

Breathing exercises Aggression control Lifestyle modification Antidepressant drugs
Pranayam (yoga) Thought distraction/ Reduction in work hours Pharmacological

diversion management
Aroma therapy/ Problem solving Leisure activities Medication in select cases
massage
Acupressure Skill training Regular breaks Medicines
Psychiatric evaluation/ Change in work
diagnosis environment
Interpersonal therapy Forced holiday
Personality development Periods of rest
Self-help groups
Crisis intervention
Group therapy
Table 3.11: Pattern of Burnout as Perceived by Mental Health Professionals.
Pattern of Burnout Response Distribution across Sample (in %)

Total sample Govt. hospitals Pvt. hospital/ East North South West
Bur no ut in Var ious P rof ess ion s
clinics
In a phased manner 55.84 61.22 46.43 63.64 55.88 57.14 45.45
(43) (30) (13) (7) (19) (12) (5)
In stages 44.16 38.78 53.78 36.36 44.12 42.86 54.55
(34) (19) (15) (4) (15) (9) (6)
Note: No. of responses have been given in the bracket.
105
in a phased manner whereas 44% responses suggest that burn-
out occurs in stages. It can be observed that many respondents
have given more than one response which indicates that in their
experience, they have seen both the patterns, that is, burnout
occurring in phased manner as also in stage manner. A compari-
son of data from total sample of mental health professionals
from government hospitals and private hospitals/clinics revealed
a significant difference. While majority of professionals from
government hospitals reported burnout to manifest in a phased
manner, private practitioners/professionals report a higher per-
centage for the stage pattern. To elaborate, professionals in govern-
ment hospitals perceive higher incidence of occurrence of burnout in a
phased manner while in the private hospitals/clinics more weight has
been assigned to burnout as a stage pattern. The regional data mir-
rors the overall pattern; prominent expression of burnout in a
phased manner across the three regions namely the East, North,
and South. In contrast, the western region portrays a higher inci-
dence of burnout in a stage manner. As the sample size from the
region is small; it would be desirable to base the analysis on the
data from the total sample, though trend could be observed at
the regional level.
The mental health professionals were also requested to share
their views regarding any other pattern of stress developing
into burnout seen by them apart from the above two patterns.
Varied kinds of responses were obtained, indicating various
forms of development of stress into burnout. Many responses
indicated breakdown of individual resources, use of drugs,
deterioration of life, strained work, and interpersonal relations.
The impact of burnout on employees is seen as avoiding work,
absenteeism, negative attitudes to work, and ultimately leaving
work.
Views of Metal Health Professionals on “How Stress Turns into

Burnout?”
The various patterns suggested by the mental health professionals
have been presented in two parts below (Figure 3.2).

Pattern I: Phases of Burnout
Stress Use of resources Exhaustion Burnout
(diminished interest & (loss of physical/mental
activity) strength)
Gradual development of Somatic Symptoms not responding to medical treatment Burnout
Coping: first mature Failure in coping— Visits to health Burnout (avoiding work, absenteeism,
(if it fails) then immature development of psychosomatic professionals negative attitudes to work, ultimately
problems leaving work)
Acute changing constant internal autonomic arousal imbalance in Mind body clinical formation
Stress/Chronic perception dialogue sympathetic and dissociation of physical and
Stress parasympathetic emotional
systems disturbances
Figure 3.2: Pattern I. Source: Sharma (2005).
Pattern II: Stages of Burnout

• Sudden breakdown into depression or psychosis or acute
substance abuse;
• Depression, strained relations at work and at home, involve-
ment with alcoholism and drugs;
• Marital disharmony, conduct disorder along with maladap-
tive behaviors with others.
Other Responses
• Substance abuse — occupational and domestic aggression;
• Such persons may use psychotropic and/or narcotic sub-
stances to reduce their symptoms;
• Frequent job hopping, slow deterioration in work perfor-
mance, family-related problems, etc.;
• Stagnation in government service, stress of work/finance;
• Stress is not a cause; it is a result of one’s relative disabilities
or insufficient coping skills — over ambitious persons with
distorted self-image tend to be over confident and take up
executive professions;
• Burnout is a western concept of a competitive society where
achievement is based on acquisition. The Indian concept of

“Burnout” is influenced by spiritual and cultural values and
people mostly blame their “fate” or past “Karma.”
Proneness to Burnout
An extensive list of predisposing factors to burnout was prepared
based on review of literature, discussions with mental health profes-
sionals, and an earlier study by Sharma (2005). The mental health
professionals were requested to give their considered opinion about
the predisposing factors. They were requested to identify factors
from (the checklist provided to them in the questionnaire) which, in
their opinion, contributed to proneness to burnout. It can be
observed from Table 3.12 that a large number of mental health pro-
fessionals felt that work-related factors such as: working in a highly
demanding job, working for long hours, working in jobs with
stretched weeks, jobs with consistent deadlines, and working in pri-
vate sector are likely to make individuals prone to burnout. Among
sociocultural variables, individuals with unhappy married life and
individuals from broken home are more prone to burnout.
A perusal of Table 3.12 reveals that factors contributing to pro-
neness to burnout as perceived by the mental health professionals
can be classified into four categories: biographic, job-related, per-
sonal, and social factors. Important findings are that executives
between 31 and 40 years and Type A personality are more prone
to burnout. Job-related factors contributing to proneness are
demanding job, job involving meeting deadlines, long hours,
stretched weeks, private sector jobs, performance-based jobs, jobs
involving excessive traveling, and loss of jobs as seen by the men-
tal health professionals from private hospitals/clinics. Among
social factors unhappy married life, metro life, and broken homes
are significant factors contributing to proneness. From the data it
can be gathered that though the contributing factors to burnout
perceived by mental health professionals from government and
private hospitals/clinics are the same but their magnitude is less
than 50% reported by mental health professionals from govern-
ment hospitals in case of almost all the factors. There is similar

Table 3.12: Response Distribution across All Factors that Contribute Towards Proneness to Burnout.
Classification of Factors Response Distribution across Sample (in %)

Predisposing factors Total Government Private East North South West
sample
Biographic
Highly educated than less 53.57 27.78 60.00 71.43 57.69 43.75 42.86
educated
Males more than females 46.43 22.22 65.00 57.14 34.62 62.50 42.86
In case of the person being a 33.93 19.44 40.00 28.57 38.46 31.25 28.57
single child
In case of the person being 23.21 8.33 25.00 0.00 30.77 25.00 14.29
the eldest child
People between the ages of 26.79 13.89 40.00 28.57 15.38 37.50 42.86
21 and 30 years
31 and 40 years
41 and 50 years
109
51 and 60 years
110
Table 3.12: (Continued)

sample
Job-related factors
Working in a very 89.29 44.44 95.00 85.71 92.31 87.50 85.71
demanding job
Jobs which require meeting 87.50 41.67 95.00 71.43 92.31 87.50 85.71
deadlines consistently
People with long working 83.93 41.67 95.00 85.71 84.62 81.25 85.71
hours
Working in stretched weeks 78.57 41.67 85.00 71.43 76.92 87.50 71.43
Employees in private sector 71.43 30.56 95.00 85.71 73.08 62.50 71.43
than in public sector
Jobs in which wages are 66.07 33.33 75.00 71.43 73.08 68.75 28.57
dependent on performance
Jobs involving excessive 62.50 36.11 65.00 57.14 65.38 62.50 57.14
traveling
Loss of job/income/ 58.93 33.33 65.00 57.14 61.54 56.25 57.14
business
Personal
Type A personality 71.43 27.78 80.00 57.14 88.46 50.00 71.43
High achievers than average 67.86 25.00 85.00 71.43 76.92 56.25 57.14
or lower achievers
Social
Unhappy married life 89.29 44.44 100.00 71.43 92.31 87.50 100.00
People working in metro 78.57 38.89 85.00 71.43 84.62 68.75 85.71
cities
People belonging to broken 76.79 38.89 85.00 42.86 84.62 75.00 85.71
homes
In case of divorce/death of 71.43 33.33 85.00 57.14 76.92 62.50 85.71
spouse
Traumatic personal 71.43 41.67 80.00 71.43 69.23 75.00 71.43
experiences
Among working couples 58.93 27.78 75.00 42.86 57.69 56.25 85.71
111
112

sample
People living in nuclear 50.00 27.78 65.00 42.86 46.15 56.25 57.14
families
Among high income groups 42.86 16.67 60.00 28.57 53.85 43.75 14.29
Natural calamities 28.57 13.89 35.00 28.57 26.92 25.00 42.86
(earthquake/flood, etc.)
Among low income groups 21.43 13.89 20.00 14.29 19.23 31.25 14.29
In case of accidents/ 42.86 27.78 40.00 57.14 42.31 31.25 57.14
physical trauma/prolonged
disease
pattern in all the four regions of India, namely, East, North, South,
and West with the exceptions of East having low incidence of
broken homes and divorces as contributing factors. West has the
highest percentage (86%) reporting working couple as a proneness
factor. North and West have high job-related factors contributing
to burnout. This can be attributed to materialistic culture and high
paced lifestyle in these regions.
Symptoms of Burnout
A list of all possible symptoms that were frequently seen in cases of
burnout was prepared through extensive literature review and discus-
sions with mental health professionals. The mental health profes-
sionals were asked to identify symptoms of burnout based on their
experience of clinical practice over the years. Their responses were ana-
lyzed and data have been presented in Table 3.13 in descending order.
It can also be observed from Table 3.13 that the main symptoms
of burnout, as endorsed by the mental health professionals, are
emotional, cognitive, physical, and behavioral in nature. The
symptoms are generally common across regions. A comparison
between perception of mental health professionals from govern-
ment and private sector reveals that the intensity of symptoms
among executives from private sector is much higher as perceived
by mental health professionals from private hospitals and clinics.
The symptoms of burnout have been classified as emotional, phy-
sical, behavioral, and cognitive and presented in Table 3.14.
Behavioral Effects of Burnout

A list of behavioral patterns among executives with burnout was
prepared. The mental health professionals were requested to indi-
cate the behavioral symptoms representing the effects of burnout.
It was observed that overall a high proportion of mental health
professionals suggested that hopelessness, interpersonal, and
group conflicts, insecurity, disruption in work, falling short of
deadlines, and inability to cope with changes constitute as the
main behavioral effects of burnout among the burnout executives.

Table 3.13: Symptoms of Burnout as Perceived by the Mental
Health Professionals.
Symptoms of Burnout Overall Distribution of Responses
Headaches 91.07
Physical and emotional exhaustion 91.07
Depression 91.07
Irritability 91.07
Anger outbursts 87.50
High anxiety levels 87.50
Loss of concentration 85.71

Sleeplessness/difficulty in falling asleep 85.71
Interpersonal problems 85.71
Sense of worthlessness 82.14
Feeling of powerlessness 82.14

Job dissatisfaction 80.36
Increased smoking 76.79
Forgetfulness 75.00
Verbal aggression 75.00
Hyper-acidity 71.43
Inadequacy 69.64
Feeling of dejection 66.07
Psychosexual problems 66.07
Ambiguity 57.14
Imaginary fear 50.00
Depersonalization 41.07
Writers’ cramps 32.14

Transient psychosis 26.79
Frequent urination 21.43

Table 3.14: Classification of Symptoms of Burnout as Perceived by Mental Health Professionals.
Symptoms of Burnout Response Distribution across Sample (in %)
Overall Government Private East North South West
Emotional
Job dissatisfaction 80.36 47.22 80.00 85.71 84.62 81.25 57.14
Feeling of powerlessness 82.14 41.67 85.00 71.43 88.46 75.00 85.71
Interpersonal problems 85.71 47.22 85.00 85.71 92.31 87.50 57.14
Physical and emotional exhaustion 91.07 50.00 95.00 85.71 88.46 100.0 85.71
Verbal aggression 75.00 44.44 75.00 71.43 80.77 81.25 42.86

Anger outbursts 87.50 47.22 90.00 71.43 92.31 93.75 71.43
Irritability 91.07 52.78 100.00 100.00 84.62 93.75 100.0
Depression 91.07 47.22 95.00 85.71 96.15 87.50 85.71
High anxiety levels 87.50 44.44 90.00 71.43 92.31 93.75 71.43
Sense of worthlessness 82.14 44.44 85.00 71.43 84.62 81.25 85.71
Feeling of dejection 66.07 33.33 80.00 42.86 73.08 68.75 57.14
Imaginary fear 50.00 33.33 55.00 57.14 53.85 43.75 42.86
115
Transient psychosis 26.79 22.22 20.00 57.14 23.08 25.00 14.29

116
Symptoms of Burnout Response Distribution across Sample (in %)
Physical + Behavioral
Headaches 91.07 47.22 95.00 71.43 92.31 100.0 85.71
Sleeplessness/difficulty in falling asleep 85.71 47.22 95.00 100.00 84.62 87.50 71.43
Writers’ cramps 32.14 13.89 40.00 14.29 42.31 25.00 28.57
Frequent urination 21.43 13.89 15.00 14.29 23.08 25.00 14.29
Increased smoking 76.79 33.33 90.00 42.86 84.62 87.50 57.14
Psychosexual problems 66.07 33.33 75.00 57.14 73.08 75.00 28.57
Loss of concentration 85.71 44.44 95.00 100.00 84.62 81.25 85.71
Hyper-acidity 71.43 36.11 85.00 57.14 69.23 87.50 57.14
Cognitive
Forgetfulness 75.00 38.89 80.00 85.71 80.77 68.75 57.14
Inadequacy 69.64 41.67 65.00 85.71 73.08 62.50 57.14
Ambiguity 57.14 30.56 60.00 57.14 73.08 43.75 28.57
Depersonalization 41.07 22.22 60.00 71.43 30.77 50.00 28.57
The effects as perceived by the professionals have been pre-
sented in descending order in Table 3.15.
The details of behavioral effects of burnout from the entire sam-
ple of mental health professionals representing the country and
the four regions have been presented in Table 3.16.
Table 3.15: Behavioral Effect of Burnout as Perceived by the

Mental Health Professionals.
Interpersonal and group conflicts 89.29

Insecurity 89.29
Low productivity 87.50
Inability to cope with changes 83.93
Alcoholism 83.93
Absenteeism 80.36
Falling short of deadlines 80.36
Hopelessness 75.00
Disruption in work 73.21
Lack of teamwork 73.21
Noncompliance 71.43
Confusion about goals 67.86
Drug addiction 66.07
Sensitiveness 66.07
Attempting suicide 58.93
Violent behavior 42.86
Financial debt 39.29
Need to work overtime 35.71
Malpractices 35.71
Back stabbing 30.36

118
Table 3.16: Behavioral Effect of Burnout as Perceived by Mental Health Professionals.
Behavioral Effects of Burnout Response Distribution across Sample (in %)

Hopelessness 75.00 36.11 90.00 71.43 76.92 68.75 85.71

Interpersonal and group conflicts 89.29 50.00 95.00 100.00 88.46 93.75 71.43
Insecurity 89.29 47.22 90.00 100.0 92.31 87.50 71.43
Disruption in work 73.21 36.11 85.00 42.86 73.08 87.50 71.43
Falling short of deadlines 80.36 33.33 95.00 42.86 92.31 81.25 71.43
Confusion about goals 67.86 36.11 80.00 42.86 69.23 75.00 71.43
Inability to cope with changes 83.93 44.44 90.00 85.71 84.62 93.75 57.14
Alcoholism 83.93 47.22 85.00 85.71 88.46 87.50 57.14
Absenteeism 80.36 41.67 85.00 71.43 84.62 87.50 57.14
Noncompliance 71.43 33.33 75.00 28.57 84.62 75.00 57.14
Sensitiveness 66.07 27.78 85.00 28.57 73.08 75.00 57.14
Drug addiction 66.07 36.11 80.00 71.43 65.38 68.75 57.14
Lack of teamwork 73.21 44.44 80.00 71.43 73.08 87.50 42.86
Attempting suicide 58.93 41.67 70.00 85.71 42.31 81.25 42.86
Financial debt 39.29 25.00 50.00 28.57 26.92 62.50 42.86
Need to work overtime 35.71 19.44 50.00 14.29 30.77 50.00 42.86
Malpractices 35.71 19.44 50.00 28.57 30.77 43.75 42.86
Sabotage 28.57 22.22 35.00 42.86 23.08 37.50 14.29
Violent behavior 42.86 25.00 45.00 57.14 53.85 31.25 14.29
Secretiveness 25.00 19.44 25.00 42.86 19.23 31.25 14.29
Back stabbing 30.36 16.67 25.00 28.57 38.46 25.00 14.29

Low productivity 87.50 38.89 100.0 57.14 96.15 81.25 100.0
119
Frequency of Visits in Cases of Mild/Moderate/
High Burnout
Table 3.17 indicates the frequency of visits of mild, moderate and
high stress/burnout cases, seeking treatment from mental health
professionals.
a) Mild Burnout: It can be gleaned from Table 3.17 that 50% of

the cases suffering from mild burnout visited their mental
health professional for 1 3 sessions followed by 19.64%
cases coming for 3 6 consultations. A similar trend was
seen across the country with majority of the executives fre-
quenting professional help over a period of 1 3 sessions.
Specifically in the North, about 38% cases seek help during
1 3 and 3 6 sessions. A comparison of visits made by
executive burnout cases seeking treatment in government and
private hospital/clinic reveals that burnout cases visiting pri-
vate practitioners sought treatment over a longer period, that
is, 1 9 sessions as compared to such cases visiting govern-
ment hospitals for 1 6 sessions for treatment of mild cases.
b) Moderate Burnout: Looking at the Table 3.17, one may infer
that in case of executives suffering from moderate burnout,
their course of treatment spans a longer duration as com-
pared to mild burnout cases. To elaborate, a trend was
observed in clients with moderate burnout to seek help for
1 6 sessions on an average. Analysis of moderate cases visit-
ing government/private set up reveals some difference.
While 25% and 50% moderate cases visit government hospi-
tals 1 3 or 3 6 times respectively, in private hospitals/
clinics 35% visit 1 3 times, and an equal proportion of mod-
erate cases seek treatment for 3 6 times. It can be observed
that majority of executives visiting private clinics/hospitals
did not continue beyond 6 sessions. This might be due to the
intensity and effectiveness of sessions which might be help-
ing amelioration of their symptoms thereby reducing the
need for any kind of further help. On the whole, looking at

Table 3.17: Distribution of Consultation Visits to the Mental Health Professional in the Cases of Various
Degrees of Burnout.
Response Distribution across Sample (in %)
Visits to consultants Moderate
Moderate
Moderate
Moderate
Moderate
Moderate
Moderate
High
High
High
High
High
High
High
Mild
Mild
Mild
Mild
Mild
Mild
Mild
No answer 23.21 17.86 28.57 25 13.89 30.56 20 25 25 28.57 0 57.14 19.23 15.38 23.08 25 18.75 18.75 28.57 42.86 42.86
Visit 1 3 50 28.57 28.57 .78 25 25 45 35 35 57.14 0 14.29 38.46 38.46 30.77 62.50 37.50 43.75 57.14 0 0
Visit 3 6 19.64 44.64 14.29 22.22 50 11.11 15 35 20 14.29 71.43 14.29 34.62 38.46 11.54 0 43.75 18.75 14.29 42.86 14.29
Visit 6 9 5.36 5.36 19.64 0 5.56 22.22 15 5 15 0 28.57 14.29 7.69 3.85 23.08 6.25 0 12.5 0 0 28.57
Visit 10 & above 1.79 3.57 8.93 0 5.56 11.11 5 0 5 0 0 14.29 0 3.85 11.54 6.25 0 6.25 0 14.29 14.29
121
the regional distribution, one may note that the clients with
moderate burnout tended to seek treatment for 1 6 sessions.
c) High Burnout: A totally different trend emerged with respect
to high burnout. To elaborate, the overall trend indicated
that 28.57% of the cases sought help for 1 3 sessions fol-
lowed by 14.29% clients who sought help for 3 6 sessions,
followed by 19.64% who sought help for 6 9 sessions, and
8.93% who sought help for 10 and more sessions. When
comparing the government and private mental health pro-
fessionals’ response, it was observed that the percentage of
executives who sought initial help was higher in private sec-
tor; however, the cases of high burnout visited government
hospitals more frequently.
High burnout cases were more prevalent in the Western and

the Eastern regions. South has recorded the highest percentage
(62%) seeking help for mild burnout in 1 3 sessions; East has
recorded highest percentage of 71.43% of 3 6 visits, and of
28.57% of 6 9 visits for moderate cases at the time of the
study.
How Burnout Cases Approach Mental Health

Professionals
Data contained in Table 3.18 highlight the process through which
patients with burnout approached mental health professionals in
India.
Looking at the approach adopted by overall sample of burnout
cases for seeking some kind of therapeutic help for the first time,
they adopted two approaches — 92.86% of them came voluntarily
and 91.07% were brought by the family members or relatives. This
was followed by 51.79% cases through referrals by the organiza-
tions. A similar pattern can be observed in government and pri-
vate hospitals/clinics. A comparison of the four regions revealed
that in the East the most common pattern was that the patient was

Table 3.18: How Burnout Cases Approach Mental Health Professionals.
Method of Approaching the Response Distribution across Sample (in %)

Mental Health Professionals
Burnouts came voluntarily 92.86 88.89 100.00 71.43 92.31 100 100.00
Referred by organizations 51.79 50.00 55.00 71.43 42.31 56.25 57.14

Brought by NGOs/social 16.07 13.89 20.00 42.86 3.85 18.75 28.57
workers
Brought by family members/ 91.07 86.11 100.00 85.71 88.46 93.75 100.00
relatives
Any other way (please specify) 19.64 16.67 25.00 42.86 7.69 25 28.57
123
brought by family members whereas in West, North, and South,
they approached the mental health professionals voluntarily.
Prevention of Burnout
The mental health professionals were requested to give their
recommendations to the organizations, employees, government,
health organizations and society at large for prevention of burn-
out. The recommendations were content analyzed and grouped
under six broad categories viz., General Awareness and Early
Diagnosis, Relaxation Techniques, Lifestyle, HR Interventions,
Organizational Policies and Miscellaneous and have been pre-
sented along with other recommendations in Tables 3.19 3.23.
Table 3.21 presents recommendations by mental health profes-
sionals for health care organizations.
Recommendations for the government are presented in Table 3.22.
Summary: Various suggestions for reducing incidence of burnout/
executive burnout have been analyzed in order to study their
importance in the opinion of mental health professionals from
government and private hospitals/clinics. These suggestions have
been presented separately for organizations, employees, mental
health professionals, and society at large in Appendix.
Some general suggestions offered by mental health profes-
sionals are summarized below:
• There is need to bring down corruption; improve education

system; reduce unemployment; adopt family planning mea-
sure; reduce needs-demands; improve moral standards, cul-
tural values, and spirituality.
• Job satisfaction is very important in reducing burnout, as
overwork, low pay, less time for relaxation increase stress
levels. Finally, increased leisure activities, meditation, and
relaxation can mitigate burnout.

Table 3.19: Prevention of Burnout: Recommendations for Organizations.
Recommendation by Mental Health Professionals Recommendation by Mental Health Professionals

from Government Hospitals from Private Hospitals and Clinics
General awareness and early diagnosis General awareness and early diagnosis
• Creation of public awareness regarding the • Increasing awareness and insight about the
problem of executive burnout and its prevention existence of burnout as a problem of utmost
• Awareness of the problem and remedial importance.
measures/early identification • Then comes promoting awareness that these
• Regular evaluations or screening for burnout and problems are manageable with proper
psychological problems. Analyze early and treat intervention

fast • Efforts to identify employees with burnout and
provide help without delay
Relaxation technique Relaxation technique
• Group relaxation training • Organize relaxation programs
• Have regular workshops on coping skills • Conduct stress management workshops
• Organize stress management programs with the
help of professional and HR staff counselors
• Impart training in relaxation techniques
• Training programs for executives on
communication in order to facilitate improvement
125
in communication at all levels of organization

126

Lifestyle Lifestyle
• To plan a kind of work pattern which is less • Provide enough time for leisure
stressful
HR intervention HR intervention
• Active and developed HR departments and HRD • Encourage auto-suggestion
processes • Enhanced HR inputs and workshops
• Effective HR management • Effective management of HR practices and
• Increasing psychological security programs
• Close supervision of mental health and increased • Follow policy of equal opportunities for all the
interaction employees
• Provision for counseling/counseling cells • Frequent get together of employees
• Flexibility to be provided to employees • Group counseling measures
• Better interpersonal relations • Periodic counseling
• Realistic demand from employees adequate time • Organization of mental health programs
• Reduction of stressors in jobs • Realistic expectations depending upon the
• Should adopt various measures to address the capacity of person concerned
issue • Regular feedback from employees

• Should have an empathic view towards the • To employ industrial/social psychologists in
employees organizations
• Proper system development • To limit duty hours
• Provide training in yoga and meditation
Organizational policies Organizational policies
• Give employees breaks for leisure activities • Compulsory time out
• Time out • Compulsory vacation time for each employee

• Provide job security
Miscellaneous Miscellaneous
• Can discuss the matter of burnout with its victims • Providing primary care
and can refer the case to the health institutions • Psychodynamics for a stress-free environment
• NGOs can do a lot
127
128
Table 3.20: Prevention of Burnout: Recommendations for Employees.
Recommendation by Mental Health Recommendation by Mental Health Professionals from

Professionals from Government Hospitals Private Hospitals and Clinics
• Develop awareness of the problem of • For all employees increase awareness and insight
executive burnout about the existence and utmost importance of
• Adopt prevention measures burnout problem
• Adopt remedial measures • Sharing awareness that this problem is manageable
with proper intervention
Relaxation technique Relaxation technique
• Familiarize with self-help programs • Interactive group workshops
• Practice yoga, relaxation, meditation • Individualized approaches — alternative systems
• Enhancing coping mechanisms and • Learning stress management
assertiveness • Participate in mental health programs
• Learn stress busting/stress management • Practice auto-suggestion
techniques • Practice yoga/meditation/relaxation exercises
Lifestyle Lifestyle
• Improving social life/harmonious family life • Healthy food
• Time management • Balance work and leisure
• Hobby development

• Assertiveness • Give time for performing hobbies and involvement
• Overall fitness with family
• Positive attitude • Choosing the job/organization according to his/her
• Accepting failures endurance (coping skill)
• Should have healthy goals • Habit of regular exercise
• Should be regular and punctual • Time management
• Measures to increase coping skills • Introspection and planning

• Preparation and training before taking up a job • Must take rest/avoid long work hours
• Adjustment with other employees
• Recommendation of HR department • Planned work program
considered and implemented by the executives • Group counseling measures
• Have regular feedback (anonymously) from • Seek/receive regular counseling
executives • Self-assessment of stress level
• Seek counseling
• Inclusion of positive coping strategies in their
repertoire
129
• Develop problem solving skills

130

Organizational policies
• Availing periodic “off” given for relaxation
Miscellaneous
• Involve NGOs
Table 3.21: Prevention of Burnout: Recommendations for Health Care Organizations.
Recommendation by Mental Health Professionals from Recommendation by Mental Health Professionals

Government Hospitals from Private Hospitals and Clinics
• Generate public awareness regarding the health • Periodic physical and mental health camps/
hazards associated with burnout and teach people check ups
how to prevent them • Try to bring awareness among the masses
• Promoting good mental health • Increasing awareness and insight about the
• Raise awareness about stress in organizations and in existence of this problem is of utmost
public at large importance

• Conduct stress management workshops • Promoting awareness that these problems are
• Psychological health advice and programs manageable with proper intervention
• Assessment and management of problems • Have tie ups with the organization and conduct
• Identification of burnout at early stages regular check ups and intervention programs
• Treating/training target groups • Increasing social awareness
• Recognizing this as an important problem area • Periodic psychiatric evaluation
Relaxation training Relaxation training
• Seminars, train the trainers programs in relaxation • Impart training in relaxation exercises, auto-
• Arranging health educational programs for suggestion, yoga, and meditation
employers and employees • To arrange sensitization programs on
131
importance of stress relieving measures

• Stress management workshops on a large scale
132 Table 3.21: (Continued)
Recommendation by Mental Health Professionals from Recommendation by Mental Health Professionals

Government Hospitals from Private Hospitals and Clinics
Lifestyle
• Develop and promote work-life balance

programs
• Provide training to HR staff • Organize mental health programs periodically

• Tie up with organizations and have periodic • Group activities
evaluation • Group counseling measures
• Frequent health check ups Miscellaneous
• Training to HR staff to detect early signs of burnout
and act accordingly
• Involve NGOs
• Promote health concern among employer and
employees
• Productivity in hazardous situation for employees
• Encourage savings and financial planning

Table 3.22: Prevention of Burnout: Recommendations for Government.

Generating awareness Policies and generating awareness
• Supporting awareness campaigns • Implement policies and programs to safeguard
• More funds for mental health problems the interest of employees
• Provision of adequate health care facilities • Free health camps, screening measures at the
earliest
• Increasing awareness and insight about the
existence of burnout
• Promoting awareness that these problems are
manageable with proper intervention
• Highlighting public health campaigns on burnout
• Training facilities for relaxation, exercises, auto-
suggestion, yoga, and meditation
Lifestyle
• Encourage savings and financial planning by
providing incentives
HR interventions HR interventions
133
• Influencing employers by changing laws to protect • To create more jobs

the psychic and physical health of employees
134

• Regulation of work environment and facilities for • Employee-friendly HR policy and programs
relaxation provided by organizations mandatory for the organization
• Promote improved employer–employee • Demanding job should be less pressurizing
relationship • Make policies on the norms of work/person like
the European Union
• Should set up organizations where people can get
benefited without much hassle
• To form a regulatory authority which can
formulate realistic guidelines for both employee
and employer
Miscellaneous Miscellaneous
• Provision for unemployment insurance • Education should be more vocation oriented and
• Measures for checking corruption not just about getting degree
• Involve NGOs in promoting mental health
programs
Table 3.23: Prevention of Burnout: Recommendations for Society at Large.

• Developing awareness about burnout • Promotion of stress-free life, no addiction, healthy
• Promote freedom from addiction lifestyle
• Lower over-expectation and the rat race • To develop healthy coping skills and prepare people
• Provide for social networking for future needs
• Place low priority to materialism • To take responsibility towards healthy and happier
• Change of views and attitudes towards work, living
productivity, and problem of executive burnout • To be more responsive to the needs of the people
• Encourage savings and financial planning • Promote supportive outlook
• Efforts to improve employer–employee • Planned work schedule plus good relaxing week
relationship ends
• Conduct stress management programs • Develop understanding that stress of any type can
• Self-help groups for value training right from lead a person to problems like depression, anxiety,
the adolescent stage and the neurotic illnesses. So proper relaxation and
• Society can arrange group meetings and help rest is required, apart from coping strategies
people emotionally and financially • To take stress more seriously
• Group counseling measures
• Cultivation of humanistic approach
• Improved cultural and moral values
135
136

• Relaxation exercises, auto-suggestion, yoga, and

meditation
• Proper mental health programs
• NGOs can help society at large about mental health
awareness and promotion
APPENDIX
Suggestions by Mental Health Professionals for Organizations to Reduce
Incidence of Executive Burnout
Table 3.A1: Responses Obtained from Mental Health

Professionals.
Suggestions for Organizations Responses Obtained from Mental
Health Professionals from
Government Private hospitals/

hospitals (N = 25) clinics (N = 25)
Generating awareness 2 8% 1 4%
Timely identification of burnout/ 2 8% 1 4%
stress
Interventions (yoga, meditation, 4 16% 6 24%
relaxation, employee counseling,
etc.)
Changes in work environment 1 4% 1 4%
Provision for an Industrial 1 4%
psychologist
Introducing sound health-related 5 20% 4 16%
policies
Training programs/workshops 3 12% 3 12%
Vacations
Time out 2 8% 3 12%
Lowering the workload/ 3 12% 2 8%
introducing work flexibility
Improved employee interaction 2 8% 1 4%
NGOs/primary care giving 1 4% 2 8%

Table 3.A2: Suggestions by Mental Health Professionals for
Employees to Reduce Incidence of Executive Burnout.
Suggestions for Employees Responses Obtained from Mental
Government Private hospitals/

hospitals (N = 22) clinics (N = 22)
Develop awareness 1 4.5% 1 4.5%

Timely self-identification of 1 4.5%
burnout/stress
Awareness of self-competencies 1 4.5%
and then choice of work
Planning for intervention through 14 63.6% 7 31.8%
various techniques (yoga,
meditation, fitness regime, and
psychological measures like
relaxation, counseling, positive
coping strategies, self-help
programs, auto-suggestion
enhancing coping mechanisms,
time management, hobby, problem
solving, assertiveness, acceptance,
goal planning)
Healthy lifestyle like healthy food 1 4.5% 2 9%
and exercise
Feedback from colleagues 1 4.5%
Following recommendations of HR 1 4.5%
department
Training programs/workshops/ 1 4.5% 2 9%
mental health programs
Vacations, time out, leisure 3 13.6%
Work planning and punctuality 1 4.5% 2 9%
Improving social/family life 1 4.5% 1 4.5%
Employee interaction and 1 4.5% 1 4.5%
adjustment
NGOs/primary care giving 1 4.5%

Table 3.A3: Suggestions by Mental Health Professionals for
Health Care Organizations to Prevent/Reduce Incidence of
Executive Burnout.
Suggestions for Health Responses Obtained from Mental
Organizations Health Professionals from
Government (total Private (total

responses = 20) response = 19)
Awareness and health promotion 5 25% 4 21%

Periodic evaluation and early 5 25% 4 21%
identification by organizations to
take preventive steps
Stress management through 1 5% 3 15.78%
various techniques like group
counseling, relaxation, auto-
suggestion, yoga, meditation
Encourage proactive employees for 1 5%
prevention in hazardous situations
Planning timely intervention 6 30% 4 21%
through workshops and programs
for stress management and
education
Promoting healthy interaction and 1 5%
interpersonal relations at work
Encouraging financial planning 1 5%
Direct services to corporate and 1 5.26%
MNCs
Planned work program 1 5.26%
Involve NGOs 1 5.26%
Continuing medical education 1 5.26%

Table 3.A4: Suggestions by Mental Health Professionals for the
Government to Prevent/Reduce Incidence of Executive Burnout.
Suggestions for Government Responses Obtained from Mental
Government (total Private (total

responses = 12) response = 17)
Awareness 1 8.3% 1 5.8%

Acceptance of stress-related 1 5.8%
problems
Planning timely intervention 1 8.3% 4 23.52%
through workshops and programs,
health camps for stress
management, and education
Conduction of stress management 1 8.3% 1 5.8%
techniques like relaxation, yoga
Creation of new jobs or 1 8.3% 1 5.8%
unemployment insurance
Providing health care facilities in 1 8.3%
organizations
Protecting rights of employees 1 8.3% 4 23.52%
through legal measures/
guidelines/policies
Time bound promotion and 2 16.6%
financial planning and security
Change in work environment and 2 16.6% 1 5.8%
provision of facilities for stress-free
functioning
Corruption-free system 1 8.3%
Improvement in interpersonal 1 8.3%
relations at work
Mandatory HR policies and 1 5.8%
programs
Change in education system 1 5.8%
towards job orientation
Involvement of NGOs 1 5.8%
Creation of less demanding jobs 1 5.8%

Table 3.A5: Suggestions by Mental Health Professionals for the
Society at Large to Prevent/Reduce Incidence of Executive
Burnout.
Suggestions for Society at Responses Obtained (in Numbers)
Large
Government Private
(total responses = 12) (total response = 17)
Awareness 1 8.3% 3 17.64%

Promoting healthy lifestyle 1 8.3% 2 11.76%
Planning timely intervention 1 8.3% 4 23.52%
through workshops and
programs, self-help groups,
health camps, and meetings
for stress management and
education
Practicing stress management 1 8.3% 1 5.8%
techniques like relaxation,
yoga
Promotion of cultural and 1 5.8%
moral values
Change in attitude (towards 3 25% 1 5.8%
jobs, materialism, and
lowering expectations)
Change in parenting style 1 8.3%
Planned work schedules and 2 11.76%
enough leisure time
Increase in social interactions 2 16.6% 2 11.76%
and emotional support from
society at large
Saving and financial 1 8.3%
planning
Promoting good 1 8.3%
interpersonal relations at
work
Involvement of NGOs 1 5.8%

47 Burnout in Various Professions

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47 Burnout in Various Professions

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Burnout in Various

PART 1: BURNOUT IN VARIOUS PROFESSIONS

Stress and Burnout in Managers

Bu rn ou t in V ario us Pro fes sio ns 65

Bu rn ou t in V ario us Pro fes sio ns 67

Bu rn ou t in V ario us Pro fes sio ns 69

Burnout among Teachers

Bu rn ou t in V ario us Pro fes sio ns 71

Bu rn ou t in V ario us Pro fes sio ns 73

Burnout among Nurses, Doctors, and other

Bu rn ou t in V ario us Pro fes sio ns 75

Bu rn ou t in V ario us Pro fes sio ns 77

Bu rn ou t in V ario us Pro fes sio ns 79

Bu rn ou t in V ario us Pro fes sio ns 81

Burnout in Other Professions

Bu rn ou t in V ario us Pro fes sio ns 83

PART 2: MENTAL HEALTH PROFESSIONALS’

Bu rn ou t in V ario us Pro fes sio ns 85

1. Incidence of Burnout in the population

Bu rn ou t in V ario us Pro fes sio ns 87

11. Prevention of Burnout: Recommendations for

In addition, they were requested to give their inputs, they might

Bu rn ou t in V ario us Pro fes sio ns 89

Table 3.1: Regional Distribution of the Responses from Mental

Nationwide Distribution Number of Questionnaires Percentage

Figure 3.1: Nationwide Distribution of Sample of Mental Health

I) National level covering the entire sample of psychiatrists/

Prevalence of Executive Burnout in the Population

Bu rn ou t in V ario us Pro fes sio ns 91

Incidence Response Distribution across Sample (in %)

Prevalence of Various Stress-Related Disorders: Experience of

Bu rn ou t in V ario us Pro fes sio ns 93

1. Adjustment Disorder with Depressed Mood (it ranked the

With regard to all the stress-related disorders stated above, a

Bu rn ou t in V ario us Pro fes sio ns 95

Nature of Disorder Distribution across Sample (in %)

Table 3.5: Perception of Mental Health Professionals Regarding

Percent Increase Response Obtained

Bu rn ou t in V ario us Pro fes sio ns 97

Stress as a Major Cause of Psychoneurosis/Psychosis

• The results indicate overwhelming correspondence between

Responses Response Distribution across Sample (in %)

0 (no response) 5.36 5.56 5.00 0 3.85 12.5 0

Role of Early Intervention in Preventing/Reducing the

Table 3.7: Perception of Mental Health Professionals about

Response Response Distribution across Sample (in %)

100 Exec ut ive B ur nout

Bur no ut in Var ious P rof ess ion s 101

Table 3.8: Interventions Suggested by Mental Health Professionals for Coping.

Nature of Intervention Response Distribution across Sample (in %)

Other Interventions Response Distribution

However, mental health professionals from both the govern-

a) Phases: Depersonalization, Reduced Personal Accomplishment,

Bur no ut in Var ious P rof ess ion s 103

Physical Intervention Psychological Intervention Lifestyle Changes Pharmacology

Pranayam (yoga) Thought distraction/ Reduction in work hours Pharmacological

Pattern of Burnout Response Distribution across Sample (in %)

Views of Metal Health Professionals on “How Stress Turns into

106 Exec ut ive B ur nout

Gradual development of Somatic Symptoms not responding to medical treatment Burnout

Figure 3.2: Pattern I. Source: Sharma (2005).

Pattern II: Stages of Burnout

Bur no ut in Var ious P rof ess ion s 107