WASHINGTON, DC—Mental healthcare providers in the military are not immune from developing compassion fatigue, experts said at the 2010 DoD/VA Suicide Prevention Conference held last month. “We are not immune from compassion fatigue by a long shot,” said Capt Joan Hunter, USPHS, RN, who is the director of psychological health for the National Guard Bureau.

Compassion fatigue has been defined by experts as the emotional residue or strain of exposure of working with patients recovering from traumatic events. Some warning signs of compassion fatigue can include irritability or anger, absenteeism, a decrease in performance, inattention to self-care, and conflicts with coworkers and peers, among other symptoms.

Compassion fatigue can lead to “burnout.” “It is a very, very complex situation when we are working with a servicemember and we are looking at the situation and saying, ‘you know what, you are having some post combat reaction, here are some things that you can do to take care of yourself.’ But, we don’t then do that for ourselves,” said J Elizabeth Perkins, PhD, director of Psychological Health for the Michigan National Guard.

Hunter said in the National Guard compassion fatigue has affected providers, chaplains, wing family program coordinators, and sexual assault and response coordinators, among others. It is an issue that is important to address to “protect” DoD and VA providers, she said. “Our counselors and our mental health providers are the best asset we have in DoD and in the VA, and I think it is our responsibility and our duty to protect them and provide them with the tools they need to get the job done,” she said.

The Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury is the perfect entity in DoD to help address compassion fatigue, said Hunter. “I would like to see DCoE research productivity formulas, I would like to see them develop guidelines--and I am talking about care for our providers. I’d like to see them look at best practices,” she said.

It is important that “downtime” is built into schedules for mental health care providers, according to Hunter, who noted that the literature emphasizes that, “supervisors and leaders have a responsibility to their workforce to make sure that they don’t overdo it,” she said.

Daily exercise, social support, healthy eating, sleep and relaxation habits are important in self care and building personal resiliency. In addition, strategies to combat compassion fatigue include meditation, journaling, deep breathing, “the importance of doing nothing,” and guided imagery, according to Perkins.

There are tools that can help providers measure how they are doing, such as the Professional Quality of Life Scale. Professional Quality of Life incorporates two aspects, the positive (compassion satisfaction) and the negative (compassion fatigue). “It consists of 30 questions related to characteristics experienced in the last 30 days,” said Perkins.

In addition, the Holmes-Rahe Life Stress Inventory can help measure stress experienced in the past year and the potential impact of that stress.

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