Quiz: Is Your Community-Based Team Burned Out?

For most of us, a job with more independence; enough time to support staff, clients, and patients; and less stress would be ideal. But having this kind of flexibility when so many people need help is challenging. In fact, when stressors stack up, it’s easy for community health workers and promotores (CHWs/Ps) to reach a breaking point.

[Register now for Supporting Mental Wellness in CHW Teams]

Stress on the Job

Stress is a natural response to challenging situations. Low levels of stress are not damaging or a serious threat. In fact, a little stress can be a helpful motivator.

CHWs/Ps, healthcare workers, and in fact workers in most industries regularly face countless stressors. These can pile on top of daily stressors (divorce, sickness, financial difficulties) and anxiety-inducing world events … like pandemics.

But what happens when stress leads to exhaustion, a bleak view of your work and organization, and the loss of drive and interest in daily tasks? Burnout.

Burnout in Healthcare Providers

Burnout is when someone has reached a breaking point, they’ve lost control of the stress, struggle to keep up with work, and feel growing frustration. The World Health Organization recognized workplace burnout as a real condition in 2019.

Burnout on the job happens when someone runs out of physical, emotional, mental, and spiritual energy. It happens when they’re dealing with emotionally demanding situations for a long time. People report feeling burned out when they feel tired, frustrated, and like they’re not meeting their personal or professional goals. Burnout can happen especially when CHWs/Ps are feeling stressed.

CHWs/Ps develop strong bonds with clients and report that they feel fulfilled by their jobs. However, CHWs/Ps are often called on to respond to mental health crises but may not have the training to handle these challenging situations.

Many CHWs/Ps and their teams are often overworked, which contributes to growing frustration. Taking on so many responsibilities ups their risk of depression, anxiety, burnout, and compassion fatigue.

Another common source of frustration and discouragement is when a relationship they build with a client ends. The emotional roller coaster that comes with getting involved in the lives of their community — the people in their care — makes it easy to get attached and struggle with feelings like guilt, sadness, and even anger.

When your CHWs/Ps’ mental wellness is at risk, so are their clients. And so is your program.

If you work in a close team, you might be able to easily tell if someone is feeling undue stress. In our behavioral health course, we flag these as some of the items to look for if you suspect someone needs help.

Signs of Burnout

  • Sleeping too much or not enough
  • Sudden weight loss or gain
  • Avoiding people and activities
  • Smoking or drinking more, or using drugs
  • Mood swings
  • Apathy and calling in sick to work

In general, you can consider any big changes in everyday life patterns and habits a red flag among your team unless there’s a clear cause for them.

Whether you feel overwhelmed by tasks, trying to balance work and home, or just looking for ways to make your job better, here’s a quiz

you can take—or give to your CHW/P staff—to help determine if you should address burnout.

Quiz: Is Your Community-Based Team Burned Out or Stressed?

Ask your team members to select the answers that best apply to them.

1. Lately have you felt exhausted and frustrated at work?

2. Have you worried that your work is making you feel cynical?

3. Have you often felt down, depressed, or hopeless?

4. Have you felt overwhelmed or like you can’t finish all your tasks?

5. Have you felt anxious, depressed, or irritable?

6. Has your physical health declined, or have you been ill more frequently?

7. Do you believe that your work is not important or appreciated?

8. Do you find yourself simply wanting to escape by reading fiction, watching TV, playing video games, using substances?

Are You Dealing with Burnout?

If responses are mostly As, that could be full-fledged burnout. Even a single yes answer can indicate signs of burnout.

As a leader, you can create healthy work conditions, build a toolbox for your team to manage stress properly, and spot red flags that may point to hidden issues before your CHWs/Ps hit a breaking point. Help your staff to recover from burnout. A healthy, motivated staff makes all the difference in performance, job happiness, and overall wellbeing for your team and the people in your care.

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10 Signs You Need to Make a Behavioral Health Referral

Life is full of stressful situations. Frontline health workers, such as community health workers or promotores, are used to supporting clients as they juggle health issues along with stressors like child care and work. That’s on a good day.

Now think about how clients and patients deal with the outbreak of a crisis like the coronavirus disease 2019 (COVID-19) on top of day-to-day anxieties. This means more people are worried about paying the water bill, eviction, varying family obligations, changes to daily routines, and job instability.

[Download Now: Behavioral Health Resources]

Chronic stress can come from many sources such as poverty, long-term sickness, or domestic violence, in addition to a global pandemic. Stress has a serious effect on a person’s overall wellness. It can increase the risk of heart disease and strokes. It can increase depression, anxiety, and more serious mental illnesses—all associated with heart disease and a lower immune system. Stress can also lead people to unhealthy choices with food and substances.

“It’s now 455 days since my last sip of alcohol, and right now it feels harder than it has done, in over a year,” Yvette Mayer, a leadership coach, said on LinkedIn. “The idea of buffering with a bottle of red wine is appealing. I know I’m very unlikely to be alone in this ‘urge’.”

Supporting clients and patients in controlling stress is critical.

Managing Stress

10 Signs You Need to Make a Behavioral Health Referral

CHWs might feel helpless when they see clients have difficulty dealing with these anxieties, but they can still help. It’s always an important for CHWs to support clients’ behavioral health. They can do some things like be an active listener, give suggestions for telehealth, and coach healthy living. Here are two:

  1. Manage stress for health from the California Department of Public Health has some simple tips
  2. Free Online Sobriety Support During Covid-19 from the Sober Señorita is a great resource to share with clients with alcohol abuse issues

Supervisors of CHWs and program managers should look out for signs of stress and burnout among their staff. These resources are helpful with clients and also internally.

But there are some more serious signs that CHWs need to refer clients to a behavioral health provider who can give more support. Making a referral for a mental illness like depression or severe anxiety is an important step. Mental health disorders, like any chronic disease, can be managed or avoided with early intervention.

10 Signs Someone Needs a Behavioral Health Referral

  1. Suicidal thoughts
  2. Trouble concentrating
  3. Lack of interest
  4. Restlessness
  5. Constantly checking news outlets or social media
  6. Changed sleep patterns
  7. Fatigue
  8. Distant or withdrawn
  9. Mood swings
  10. Diet changes

These are 10 signs community health workers can look out for if you suspect someone in your community is struggling and needs help:

1. Suicidal thoughts

If someone talks about killing or harming themselves, make a referral right away. Call the 24-hour Suicide Prevention Lifeline at
1-800-273-8255 or text 838255. Not everyone who has suicidal thoughts shows them, but you can certainly notice subtle remarks that may point to trouble.

2. Trouble concentrating

When someone has difficulty concentrating on daily activities, are confused, forget things, has trouble getting anything done, this can be a sign of depression, anxiety, or substance use.

3. Lack of interest

Another warning sign is a lack of interest in things that used to cause joy, and even personal care. This can show up as the person not bathing or eating, stopping their hobbies, neglecting their job or responsibilities, and disengaging from their daily routine.

4. Restlessness

Someone might not be able to sit still. They might constantly shake their leg, shift between their feet when standing up, or fiddle with things in their hand.

5. Constantly checks news outlets or social media

Panic-scrolling is a sign of anxiety. This is the constant need to refresh social media channels, even knowing that nothing has changed since the last time they checked.

6. Changed sleep patterns

Someone might complain of sleeping more than usual or not sleeping at all. Significant changes in sleeping patterns can be a sign of a mental health issue—and can in some cases make it worse.

7. Fatigue

Feelings of fatigue might have nothing to do with sleep patterns. Even with normal sleeping, someone can feel constant fatigue. Even without realizing it, someone might feel this way because of irregular sleep, waking up in the middle of the night, or not being able to enter a deep state of sleep.

8. Distant or withdrawn

People who are clinically depressed often feel like withdrawing from social activities. Being isolated is not only a sign of mental illness but it can also be a cause of mental illness. This is especially challenging when so many people are required to self-isolate to stop spreading the virus.

9. Mood swings

Even though it’s fairly normal to go between moods in a week or even a day, someone who’s struggling with anxiety, depression, substance use, or other serious mental illnesses may experience wild changes in their mood quickly.

10. Diet changes

Whether someone is overeating or restricting food intake, any drastic changes to their daily food habits are often a red flag. This is another symptom that could be a cause. A healthy diet, such as the Mediterranean diet or DASH diet, can help with mental health as well as a variety of other conditions—including virus immunity.


Does your team need training in behavioral health? Read about our Healthy Living learning track.

What Supervisors Can Do To Support Mental Wellness of CHW Teams

Anyone supervising a community health worker team knows how important it is to support clients with depression, anxiety or other behavioral health issues.

What they might not realize is that their own staff might be feeling the same as their clients.

We’re taking a closer look at the negative effects of feelings of depression, anxiety, burnout and compassion fatigue on CHW staff at the Unity Conference 2019, which I’m previewing on March 26 with co-presenter Jeanine Joy, Ph.D. We’ll offer some solutions and strategies managers and supervisors can share with their team.

Burnout and mental disorders in CHWs

Why CHWs Feel Overwhelmed

CHWs create strong bonds with clients and report that they feel fulfilled by their jobs. However, CHWs are often called on to respond to mental health crises, but they might not have the training to handle it. They could be overworked and become discouraged when a relationship they build with a client ends. When they take on too much, they run the risk of depression, anxiety, burnout and compassion fatigue. When their mental wellness is at risk, so is your program.

“CHWs are often lauded for their ability to develop trust with peers, yet this willingness and ability to create enduring emotional bonds could threaten programme delivery,” says a study published in BMC Health Services Research.

In fact, community-based health workers are more likely to have problems with depression and mental health issues than the other members of their health care team.

Supervisor Training Gaps

In the process of developing three new modules for CHWTraining’s catalog (Depression and Anxiety, Motivational Interviewing and Supervisor Training), we immediately noticed some troubling trends:

  • Supervisors lack general training for managing teams of CHWs.
  • Supervisors lack training for dealing with mental wellness issues among their staff.
  • Many programs have few resources for supporting either supervisors or their staff.

Clearly, there’s a training and support gap that needs to be addressed. We’ve added courses on this topic to our online community health worker certification program, and we’re taking a deeper dive in an upcoming presentation “Supporting Mental Wellness In CHW Teams” (March 26 at 10 a.m.).

Here are some quick highlights.

Burnout, Depression and Anxiety Warning Signs

If you work in a close team, you might be able to easily tell if someone is feeling undue stress. In our behavioral health course, we flag these as some of the items to look for if you suspect someone needs help:

  • Sleeping too much or not enough
  • Sudden weight loss or gain
  • Avoiding people and activities
  • Smoking or drinking more, or using drugs
  • Mood swings
  • Apathy and calling in sick to work

Support Strategies for Supervisors

Start Before Problems Begin

One of the best things you can do is look out for any warning signs. But it’s even more effective to help your team avoid these dangers in the first place. Not only will you prevent any problems, but problems are much harder to address when they’ve already happened. Be proactive about the mental health of your team.

Listen Up

If you’re not sure if one of your CHWs is starting to feel the pressure of their job, listen. Be the kind of manager who is willing to listen to work-related issues. This gives employees the sense that they can come to you when they need to share. If they don’t volunteer information, make a habit of asking.

Similarly, encourage teamwork and bonding among the team. If you’re not there to lend an ear, someone else who understands the unique nature of being a CHW can provide a sympathetic ear.

Burn off Stress

At the top of the list is burning off stress. Organize informal picnics or potlucks with your team, so you’re connecting with each other in a way that’s not all about work. Or suggest walking meetings to recharge, as they do at Berkeley County School District, Moncks Corner, S.C.

Some organizations provide a mindfulness space to encourage relaxation or meditation. See if you can assign a room as a place where your staff can stop feeling overwhelmed. If you don’t have space or have a workforce that isn’t in a room together, encourage them to sit at their desk quietly, noticing their body’s sensations as they sit.

Mental Health Days

Your program should also offer mental health days as part of a benefits package. However, you should also suggest your staff take advantage of them. This can help CHWs realize that you support their mental wellness and that they can feel comfortable asking for time when they need it. Same goes for vacation time.

So, would you like to learn more?

Join us as we discuss improving your team’s mental wellness, identify signs that an employee is at risk for depression, anxiety, or secondary trauma, and show you how you can help your team improve their personal and professional lives. Sign up for this free presentation now.