Building a robust workforce is essential for health care safety net organizations that aim to address gaps in access to care, improve health outcomes, and eliminate long-standing health inequities. A challenge, however, is that this dedicated workforce — including providers, support staff, and policymakers — is prone to burnout, which is especially prevalent among individuals with diverse identities and experiences who are tasked, either formally or informally, with leading equity efforts. This is due to the nature of challenging systemic work but is compounded by staffing shortages, the effects of second-hand trauma from patients and clients, and the impacts of the COVID-19 pandemic. Finding ways to prevent burnout and support career longevity is critical; however, there are obstacles to adequately sustaining individuals who apply an equity lens to their work at the individual and organizational levels. 

As part of the Equity Changemakers Institute, a leadership development program for public sector staff with significant oversight over efforts to advance health equity, the Center for Health Care Strategies spoke with Omar Reda, MD, a psychiatrist, trauma-informed care expert, and author of The Wounded Healer and Untangled. Dr. Reda shared advice for fostering more care and wellness among public sector staff who champion equity in the health and human services field.

How do people in health and human services roles with diverse identities and lived experience uniquely carry the weight of their work responsibilities to address health equity?

Health care safety net workers care about issues that impact not only the individual or the family, but our communities. We stretch ourselves thin trying to be everything for everybody all the time. When we see injustice in policies, procedures, and practices that are not healing, human centered, or trauma informed, there is a weight that our other colleagues may not similarly carry because of our own passion and the communities we identify with. It is very rewarding but emotionally exhausting work.

How can health and human services organizations respond to staff burnout?

Burnout is the worst outcome for many people in the field because the people we serve lose on our talent, skills, and expertise. Early prevention is more effective than late intervention, saving both money and human resources. This includes challenging and either rehabilitating or dismantling toxic systems, such as removing unnecessary policies that are not conducive for staff wellness. Diverse staff need to be valued for their expertise and invited to contribute, but when we are excluded, relational harm can occur. Healing relational wounds requires safety, truth-telling, justice, reconciliation, and deep healing work, all of which amount to additional time and energy for those already directly impacted.

Organizations can celebrate their staff by including them “at the table,” creating an environment where they feel safe voicing their opinion, including disagreement with leadership without the fear of retaliation, and reinforcing systems that maximize talents and contributions to create a win-win situation.

There also needs to be flexibility with “gold standards” that claim to be the solution for an issue. There is no one-size-fits-all, especially when it comes to diverse groups. It’s important to be open-minded and ensure that any intervention is one tool in a toolkit of many.

Lastly, leadership teams should prioritize opportunities for collaboration with frontline staff on organizational policies, such as: (1) lead through example, taking time to understand unique challenges frontline staff face; (2) invite staff input in planning meetings that include budget and policy discussions; and (3) create open channels of communication for staff to share their voice and talents.

How can an equity-minded public sector staff member promote their own self-care? What advice would you give to someone starting their journey?

Serving others is extremely rewarding, but be careful with your boundaries, abilities, and expectations or other people’s expectations. Being invited to the table can be joyful and exciting. Equity-minded practitioners with diverse identities and experiences come with unique viewpoints that are not always at the table. On the other hand, you might be invited to every single committee and task force, but don’t be the teacher for everybody in the organization. Understand your needs and voice them; assert your boundaries.

Mainstream self-care focuses on the individual, can you talk about the role and value of community care?

Mental health work can occur individually by prioritizing sleep hygiene, healthy meals, exercise, fresh air, or taking care of your mind by challenging negative thoughts and engaging in positive dialogue. But what I’ve found most effective is when there is a system that prioritizes staff wellness and builds a community of care. A community of care is any team that has each other’s best interest at heart. It can be made of all staff regardless of their background or hierarchical status. It can be built when we pay attention to one another, care deeply, and genuinely notice and respond when a teammate is in need.

What advice can you give to public sector equity champions to center joy and fulfillment?

I had my own post-traumatic stress disorder as a refugee from civil war, afraid my whole family was going to be killed in a genocide. These four things kept me safe, sane, and helped me heal — I share them in The Wounded Healer:

1. Whatever your definition of a higher power may be, connect to your religion, faith, or spirituality.
2. Separate your professional and personal life. When I stop my car in front of the garage at home, I make sure to pause and empty all the emotional trash that I bring from work. I don’t take issues from my work to my family and vice versa.
3. Take care of your soul, practice gratitude.
4. Engage in acts of service. Take care of your heart by having social interactions with people that you love and build support systems around you.

*Bryna Antonia Cortes, National Urban Fellow ’23, excelled during a nine-month residency at the Center for Health Care Strategies while simultaneously earning a master’s in policy management from Georgetown University McCourt School of Public Policy.