Psychiatrists Under Pressure: Exploring Occupational Risks and Protective Strategies
,
Abstract
Objective: The aim of this study was to investigate the occupational hazards faced by psychiatrists and their protective strategies against these challenges.
Method: The research adopted a qualitative approach with a thematic analysis strategy. The study included 15 psychiatrists selected through purposive sampling until theoretical saturation was achieved. Data were collected using semi-structured interviews and analyzed with MAXQDA 2024 software. The analysis was conducted based on Attride-Stirling’s thematic network framework and involved systematic coding of meaning units and progressive abstraction into basic, organizing, and global themes.
Results: Based on the analysis of interview transcripts, 73 basic themes, 11 organizing themes, and 3 global themes were identified for occupational hazards, along with 8 organizing themes for protective strategies. The global and organizing themes for hazards included: intrapersonal hazards (psychological stress, burnout, and clients’ social and cultural issues), interpersonal hazards (distress from patient interactions, domestic erosion, and lack of collegial cooperation), and Transpersonal hazards (organizational constraints, lost professional status, repetitive exhaustion under outdated infrastructure, and financial discrimination). The organizing themes for protective strategies encompassed psychological flexibility, passion for service, spiritual coping, professional growth, professional collaboration, restorative activities, therapeutic communication, and optimization of the treatment environment.
Conclusion: This qualitative study identified psychiatrists’ occupational hazards across three dimensions -intrapersonal, interpersonal, and supra-personalwhile also highlighting critical protective strategies such as psychological flexibility and professional growth. The findings underscore the necessity for comprehensive support for psychiatrists’ mental health and the development of supportive resources. These results can serve as a foundation for future policy-making in the field of mental health. However, the findings should be interpreted in light of the study’s limited sample size and regional scope.
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3. Summers RF, Gorrindo T, Hwang S, Aggarwal R, Guille C. Well-Being, Burnout, and Depression Among North American Psychiatrists: The State of Our Profession. Am J Psychiatry. 2020;177(10):955-64.
4. Tipa RO, Tudose C, Pucarea VL. Measuring Burnout Among Psychiatric Residents Using the Oldenburg Burnout Inventory (OLBI) Instrument. J Med Life. 2019;12(4):354-60.
5. Maslach C, Leiter MP. Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry. 2016;15(2):103-11.
6. Kumar S. Burnout and psychiatrists: what do we know and where to from here? Epidemiol Psychiatr Sci. 2011;20(4):295-301.
7. Fothergill A, Edwards D, Burnard P. Stress, burnout, coping and stress management in psychiatrists: findings from a systematic review. Int J Soc Psychiatry. 2004;50(1):54-65.
8. Heponiemi T, Aalto AM, Puttonen S, Vänskä J, Elovainio M. Work-related stress, job resources, and well-being among psychiatrists and other medical specialists in Finland. Psychiatr Serv. 2014;65(6):796–801.
9. Reynolds CF, 3rd, Jeste DV, Sachdev PS, Blazer DG. Mental health care for older adults: recent advances and new directions in clinical practice and research. World Psychiatry. 2022;21(3):336-63.
10. Vogt EL, Mahmoud H, Elhaj O. Telepsychiatry: Implications for Psychiatrist Burnout and Well-Being. Psychiatr Serv. 2019;70(5):422-4.
11. Shore J. The evolution and history of telepsychiatry and its impact on psychiatric care: Current implications for psychiatrists and psychiatric organizations. Int Rev Psychiatry. 2015;27(6):469-75.
12. Rotstein S, Jenkins K. Career satisfaction and work stressors in psychiatrists and psychiatry trainees in Australia and New Zealand. Australas Psychiatry. 2017;25(2):172-4.
13. Pitanupong J, Anantapong K, Aunjitsakul W. Depression among psychiatrists and psychiatry trainees and its associated factors regarding work, social support, and loneliness. BMC Psychiatry. 2024;24(1):97.
14. Adib-Hajbaghery M, Lotfi MS, Hosseini FS. The effect of occupational stress on marital satisfaction and mental health in Iranian nurses. Work. 2021;68(3):771-8.
15. Beschoner P, von Wietersheim J, Jarczok MN, Braun M, Schönfeldt-Lecuona C, Viviani R, et al. Effort-Reward-Imbalance, Burnout, and Depression Among Psychiatrists 2006 and 2016-Changes After a Legislative Intervention. Front Psychiatry. 2021;12:641912.
16. Abu zied M, Fekry M, Mohsen N, Morsy M, El Serafy D, Salah M. Burnout syndrome among psychiatrists in Egyptian mental health hospital. Middle East Current Psychiatry. 2020;27(1):25.
17. Lim MH. Practice of psychiatry ethics in the clinical applications. Korean Journal of Medical Ethics. 2015;18(1):36–49.
18. Hassannia L, Taghizadeh F, Moosazadeh M, Zarghami M, Taghizadeh H, Dooki AF, et al. Anxiety and Depression in Health Workers and General Population During COVID-19 in IRAN: A Cross-Sectional Study. Neuropsychopharmacol Rep. 2021;41(1):40-9.
19. Bareeqa SB, Ahmed SI, Samar SS, Yasin W, Zehra S, Monese GM, et al. Prevalence of depression, anxiety and stress in china during COVID-19 pandemic: A systematic review with meta-analysis. Int J Psychiatry Med. 2021;56(4):210-27.
20. Iozzino L, Ferrari C, Large M, Nielssen O, de Girolamo G. Prevalence and Risk Factors of Violence by Psychiatric Acute Inpatients: A Systematic Review and Meta-Analysis. PLoS One. 2015;10(6):e0128536.
21. Weltens I, Bak M, Verhagen S, Vandenberk E, Domen P, van Amelsvoort T, et al. Aggression on the psychiatric ward: Prevalence and risk factors. A systematic review of the literature. PLoS One. 2021;16(10):e0258346.
22. Witt K, van Dorn R, Fazel S. Risk factors for violence in psychosis: systematic review and meta-regression analysis of 110 studies. PLoS One. 2013;8(2):e55942.
23. Dhumad S, Wijeratne A, Treasaden I. Violence against psychiatrists by patients: survey in a London mental health trust. Psychiatr Bull. 2007;31(10):371–4.
24. Ridenour M, Lanza M, Hendricks S, Hartley D, Rierdan J, Zeiss R, et al. Incidence and risk factors of workplace violence on psychiatric staff. Work. 2015;51(1):19-28.
25. Abstracts of 28th annual congress of Iranian psychiatric association: tehran, november 15-17, 2011. Iran J Psychiatry. 2011;6(4):164-96.
26. Chen Y, Wang P, Zhao L, He Y, Chen N, Liu H, et al. Workplace Violence and Turnover Intention Among Psychiatrists in a National Sample in China: The Mediating Effects of Mental Health. Front Psychiatry. 2022;13:855584.
27. Gibbons R, Brand F, Carbonnier A, Croft A, Lascelles K, Wolfart G, et al. Effects of patient suicide on psychiatrists: survey of experiences and support required. BJPsych Bulletin. 2019;43(5):236–41.
28. Bond FW, Hayes SC, Barnes-Holmes D. Psychological flexibility, ACT, and organizational behavior. Acceptance and mindfulness at work: Routledge; 2013. p. 25–54.
29. Kashdan TB, Rottenberg J. Psychological flexibility as a fundamental aspect of health. Clin Psychol Rev. 2010;30(7):865-78.
30. Prudenzi A, C DG, Flaxman PE, O'Connor DB. Wellbeing, burnout, and safe practice among healthcare professionals: predictive influences of mindfulness, values, and self-compassion. Psychol Health Med. 2022;27(5):1130-43.
31. Howard R, Kirkley C, Baylis N. Personal resilience in psychiatrists: systematic review. BJPsych Bull. 2019;43(5):209-15.
32. Richards KC, Campenni CE, Muse-Burke JL. Self-care and well-being in mental health professionals: The mediating effects of self-awareness and mindfulness. Journal of mental health counseling. 2010;32(3):247–64.
33. Gracia Gozalo RM, Ferrer Tarrés JM, Ayora Ayora A, Alonso Herrero M, Amutio Kareaga A, Ferrer Roca R. Application of a mindfulness program among healthcare professionals in an intensive care unit: Effect on burnout, empathy and self-compassion. Med Intensiva (Engl Ed). 2019;43(4):207-16.
34. Fox S, Lydon S, Byrne D, Madden C, Connolly F, O'Connor P. A systematic review of interventions to foster physician resilience. Postgrad Med J. 2018;94(1109):162-70.
35. Kotera Y, Maxwell-Jones R, Edwards AM, Knutton N. Burnout in Professional Psychotherapists: Relationships with Self-Compassion, Work-Life Balance, and Telepressure. Int J Environ Res Public Health. 2021;18(10):5308.
36. Soleimani K, Sharifi V, Tehranidoust M. Occupational burnout in psychiatric staff at Roozbeh Hospital. Advances in cognitive science. 2006;7(4):36–42.
37. Tayebani T, Ebrahimi A, Samoei, R, Nassiri H. Job burnout for psychologists and psychiatrists city of Isfahan city of and its interrelation with individual and professional factors. Journal of Research in Behavioural Sciences. 2013;11(5):465–73.
38. Todd NJ, Jones SH, Lobban FA. "Recovery" in bipolar disorder: how can service users be supported through a self-management intervention? A qualitative focus group study. J Ment Health. 2012;21(2):114-26.
39. Attride-Stirling J. Thematic networks: an analytic tool for qualitative research. Qualitative research. 2001;1(3):385–405.
40. Lincoln YS, Guba EG. The roots of fourth generation evaluation. Evaluation roots: Tracing theorists' views and influences. 2004;1(1):225–41.
41. Lam CK, Van der Vegt GS, Walter F, Huang X. Harming high performers: a social comparison perspective on interpersonal harming in work teams. J Appl Psychol. 2011;96(3):588-601.
42. Sainz M, Moreno‐Bella E, Torres‐Vega LC. Perceived unequal and unfair workplaces trigger lower job satisfaction and lower workers’ dignity via organizational dehumanization and workers’ self‐objectification. Eur J Soc Psychol. 2023;53(5):921–38.
43. Singh V, Kumar A, Gupta S. Mental Health Prevention and Promotion-A Narrative Review. Front Psychiatry. 2022;13:898009.
44. Ahad AA, Sanchez-Gonzalez M, Junquera P. Understanding and Addressing Mental Health Stigma Across Cultures for Improving Psychiatric Care: A Narrative Review. Cureus. 2023;15(5):e39549.
45. Landers A, O'Brien S, Phelan D. Impact of patient suicide on consultant psychiatrists in Ireland. The Psychiatrist. 2010;34(4):136–40.
46. Leung T, Schmidt F, Mushquash C. A personal history of trauma and experience of secondary traumatic stress, vicarious trauma, and burnout in mental health workers: A systematic literature review. Psychol Trauma. 2023;15(Suppl 2):S213-s21.
47. Schaufeli WB, Leiter MP, Maslach C. Burnout: 35 years of research and practice. Career development international. 2009;14(3):204–20.
48. Corrigan PW, Druss BG, Perlick DA. The Impact of Mental Illness Stigma on Seeking and Participating in Mental Health Care. Psychol Sci Public Interest. 2014;15(2):37-70.
49. Taghva A, Hajebi A, Noorbala AA, Khademi M, Asadi A, Rahnejat AM, et al. Mental health stigma in Iran: A systematic review. Stigma and Health. 2024.
50. Grzywacz JG. Shift work and its implications for everyday work and family life: A foundation and summary. Social and family issues in shift work and non standard working hours. 2016:3–17.
51. Broetje S, Jenny GJ, Bauer GF. The Key Job Demands and Resources of Nursing Staff: An Integrative Review of Reviews. Front Psychol. 2020;11:84.
52. Lee YR, Enright RD. A meta-analysis of the association between forgiveness of others and physical health. Psychol Health. 2019;34(5):626-43.
53. Schnitker SA, Ro DB, Foster JD, Abernethy AD, Currier JM, vanOyen Witvliet C, et al. Patient patients: Increased patience associated with decreased depressive symptoms in psychiatric treatment. J Posit Psychol. 2020;15(3):300–13.
54. Ozcan O, Hoelterhoff M, Wylie E. Faith and spirituality as psychological coping mechanism among female aid workers: a qualitative study. Journal of International Humanitarian Action. 2021;6(1):15.
55. Pandey J, Singh M. Positive religious coping as a mechanism for enhancing job satisfaction and reducing work-family conflict: A moderated mediation analysis. Journal of Management, Spirituality & Religion. 2019;16(3):314–38.
56. Thirioux B, Birault F, Jaafari N. Empathy Is a Protective Factor of Burnout in Physicians: New Neuro-Phenomenological Hypotheses Regarding Empathy and Sympathy in Care Relationship. Front Psychol. 2016;7:763.
57. Scheepers RA, Boerebach BC, Arah OA, Heineman MJ, Lombarts KM. A Systematic Review of the Impact of Physicians' Occupational Well-Being on the Quality of Patient Care. Int J Behav Med. 2015;22(6):683-98.
58. MacDonald J, Ellis PM. Supervision in psychiatry: terra incognita? Curr Opin Psychiatry. 2012;25(4):322-6.
59. Olfson M, Marcus SC, Wilk J, West JC. Awareness of illness and nonadherence to antipsychotic medications among persons with schizophrenia. Psychiatr Serv. 2006;57(2):205-11.
60. Slemon A, Jenkins E, Bungay V. Safety in psychiatric inpatient care: The impact of risk management culture on mental health nursing practice. Nurs Inq. 2017;24(4):e12199.
61. Bayramzadeh S. An Assessment of Levels of Safety in Psychiatric Units. Herd. 2017;10(2):66-80.
2. Trivedi JK, Tripathi A, Dhanasekaran S, Moussaoui D. Preventive psychiatry: Concept appraisal and future directions. Int J Soc Psychiatry. 2014;60(4):321-9.
3. Summers RF, Gorrindo T, Hwang S, Aggarwal R, Guille C. Well-Being, Burnout, and Depression Among North American Psychiatrists: The State of Our Profession. Am J Psychiatry. 2020;177(10):955-64.
4. Tipa RO, Tudose C, Pucarea VL. Measuring Burnout Among Psychiatric Residents Using the Oldenburg Burnout Inventory (OLBI) Instrument. J Med Life. 2019;12(4):354-60.
5. Maslach C, Leiter MP. Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry. 2016;15(2):103-11.
6. Kumar S. Burnout and psychiatrists: what do we know and where to from here? Epidemiol Psychiatr Sci. 2011;20(4):295-301.
7. Fothergill A, Edwards D, Burnard P. Stress, burnout, coping and stress management in psychiatrists: findings from a systematic review. Int J Soc Psychiatry. 2004;50(1):54-65.
8. Heponiemi T, Aalto AM, Puttonen S, Vänskä J, Elovainio M. Work-related stress, job resources, and well-being among psychiatrists and other medical specialists in Finland. Psychiatr Serv. 2014;65(6):796–801.
9. Reynolds CF, 3rd, Jeste DV, Sachdev PS, Blazer DG. Mental health care for older adults: recent advances and new directions in clinical practice and research. World Psychiatry. 2022;21(3):336-63.
10. Vogt EL, Mahmoud H, Elhaj O. Telepsychiatry: Implications for Psychiatrist Burnout and Well-Being. Psychiatr Serv. 2019;70(5):422-4.
11. Shore J. The evolution and history of telepsychiatry and its impact on psychiatric care: Current implications for psychiatrists and psychiatric organizations. Int Rev Psychiatry. 2015;27(6):469-75.
12. Rotstein S, Jenkins K. Career satisfaction and work stressors in psychiatrists and psychiatry trainees in Australia and New Zealand. Australas Psychiatry. 2017;25(2):172-4.
13. Pitanupong J, Anantapong K, Aunjitsakul W. Depression among psychiatrists and psychiatry trainees and its associated factors regarding work, social support, and loneliness. BMC Psychiatry. 2024;24(1):97.
14. Adib-Hajbaghery M, Lotfi MS, Hosseini FS. The effect of occupational stress on marital satisfaction and mental health in Iranian nurses. Work. 2021;68(3):771-8.
15. Beschoner P, von Wietersheim J, Jarczok MN, Braun M, Schönfeldt-Lecuona C, Viviani R, et al. Effort-Reward-Imbalance, Burnout, and Depression Among Psychiatrists 2006 and 2016-Changes After a Legislative Intervention. Front Psychiatry. 2021;12:641912.
16. Abu zied M, Fekry M, Mohsen N, Morsy M, El Serafy D, Salah M. Burnout syndrome among psychiatrists in Egyptian mental health hospital. Middle East Current Psychiatry. 2020;27(1):25.
17. Lim MH. Practice of psychiatry ethics in the clinical applications. Korean Journal of Medical Ethics. 2015;18(1):36–49.
18. Hassannia L, Taghizadeh F, Moosazadeh M, Zarghami M, Taghizadeh H, Dooki AF, et al. Anxiety and Depression in Health Workers and General Population During COVID-19 in IRAN: A Cross-Sectional Study. Neuropsychopharmacol Rep. 2021;41(1):40-9.
19. Bareeqa SB, Ahmed SI, Samar SS, Yasin W, Zehra S, Monese GM, et al. Prevalence of depression, anxiety and stress in china during COVID-19 pandemic: A systematic review with meta-analysis. Int J Psychiatry Med. 2021;56(4):210-27.
20. Iozzino L, Ferrari C, Large M, Nielssen O, de Girolamo G. Prevalence and Risk Factors of Violence by Psychiatric Acute Inpatients: A Systematic Review and Meta-Analysis. PLoS One. 2015;10(6):e0128536.
21. Weltens I, Bak M, Verhagen S, Vandenberk E, Domen P, van Amelsvoort T, et al. Aggression on the psychiatric ward: Prevalence and risk factors. A systematic review of the literature. PLoS One. 2021;16(10):e0258346.
22. Witt K, van Dorn R, Fazel S. Risk factors for violence in psychosis: systematic review and meta-regression analysis of 110 studies. PLoS One. 2013;8(2):e55942.
23. Dhumad S, Wijeratne A, Treasaden I. Violence against psychiatrists by patients: survey in a London mental health trust. Psychiatr Bull. 2007;31(10):371–4.
24. Ridenour M, Lanza M, Hendricks S, Hartley D, Rierdan J, Zeiss R, et al. Incidence and risk factors of workplace violence on psychiatric staff. Work. 2015;51(1):19-28.
25. Abstracts of 28th annual congress of Iranian psychiatric association: tehran, november 15-17, 2011. Iran J Psychiatry. 2011;6(4):164-96.
26. Chen Y, Wang P, Zhao L, He Y, Chen N, Liu H, et al. Workplace Violence and Turnover Intention Among Psychiatrists in a National Sample in China: The Mediating Effects of Mental Health. Front Psychiatry. 2022;13:855584.
27. Gibbons R, Brand F, Carbonnier A, Croft A, Lascelles K, Wolfart G, et al. Effects of patient suicide on psychiatrists: survey of experiences and support required. BJPsych Bulletin. 2019;43(5):236–41.
28. Bond FW, Hayes SC, Barnes-Holmes D. Psychological flexibility, ACT, and organizational behavior. Acceptance and mindfulness at work: Routledge; 2013. p. 25–54.
29. Kashdan TB, Rottenberg J. Psychological flexibility as a fundamental aspect of health. Clin Psychol Rev. 2010;30(7):865-78.
30. Prudenzi A, C DG, Flaxman PE, O'Connor DB. Wellbeing, burnout, and safe practice among healthcare professionals: predictive influences of mindfulness, values, and self-compassion. Psychol Health Med. 2022;27(5):1130-43.
31. Howard R, Kirkley C, Baylis N. Personal resilience in psychiatrists: systematic review. BJPsych Bull. 2019;43(5):209-15.
32. Richards KC, Campenni CE, Muse-Burke JL. Self-care and well-being in mental health professionals: The mediating effects of self-awareness and mindfulness. Journal of mental health counseling. 2010;32(3):247–64.
33. Gracia Gozalo RM, Ferrer Tarrés JM, Ayora Ayora A, Alonso Herrero M, Amutio Kareaga A, Ferrer Roca R. Application of a mindfulness program among healthcare professionals in an intensive care unit: Effect on burnout, empathy and self-compassion. Med Intensiva (Engl Ed). 2019;43(4):207-16.
34. Fox S, Lydon S, Byrne D, Madden C, Connolly F, O'Connor P. A systematic review of interventions to foster physician resilience. Postgrad Med J. 2018;94(1109):162-70.
35. Kotera Y, Maxwell-Jones R, Edwards AM, Knutton N. Burnout in Professional Psychotherapists: Relationships with Self-Compassion, Work-Life Balance, and Telepressure. Int J Environ Res Public Health. 2021;18(10):5308.
36. Soleimani K, Sharifi V, Tehranidoust M. Occupational burnout in psychiatric staff at Roozbeh Hospital. Advances in cognitive science. 2006;7(4):36–42.
37. Tayebani T, Ebrahimi A, Samoei, R, Nassiri H. Job burnout for psychologists and psychiatrists city of Isfahan city of and its interrelation with individual and professional factors. Journal of Research in Behavioural Sciences. 2013;11(5):465–73.
38. Todd NJ, Jones SH, Lobban FA. "Recovery" in bipolar disorder: how can service users be supported through a self-management intervention? A qualitative focus group study. J Ment Health. 2012;21(2):114-26.
39. Attride-Stirling J. Thematic networks: an analytic tool for qualitative research. Qualitative research. 2001;1(3):385–405.
40. Lincoln YS, Guba EG. The roots of fourth generation evaluation. Evaluation roots: Tracing theorists' views and influences. 2004;1(1):225–41.
41. Lam CK, Van der Vegt GS, Walter F, Huang X. Harming high performers: a social comparison perspective on interpersonal harming in work teams. J Appl Psychol. 2011;96(3):588-601.
42. Sainz M, Moreno‐Bella E, Torres‐Vega LC. Perceived unequal and unfair workplaces trigger lower job satisfaction and lower workers’ dignity via organizational dehumanization and workers’ self‐objectification. Eur J Soc Psychol. 2023;53(5):921–38.
43. Singh V, Kumar A, Gupta S. Mental Health Prevention and Promotion-A Narrative Review. Front Psychiatry. 2022;13:898009.
44. Ahad AA, Sanchez-Gonzalez M, Junquera P. Understanding and Addressing Mental Health Stigma Across Cultures for Improving Psychiatric Care: A Narrative Review. Cureus. 2023;15(5):e39549.
45. Landers A, O'Brien S, Phelan D. Impact of patient suicide on consultant psychiatrists in Ireland. The Psychiatrist. 2010;34(4):136–40.
46. Leung T, Schmidt F, Mushquash C. A personal history of trauma and experience of secondary traumatic stress, vicarious trauma, and burnout in mental health workers: A systematic literature review. Psychol Trauma. 2023;15(Suppl 2):S213-s21.
47. Schaufeli WB, Leiter MP, Maslach C. Burnout: 35 years of research and practice. Career development international. 2009;14(3):204–20.
48. Corrigan PW, Druss BG, Perlick DA. The Impact of Mental Illness Stigma on Seeking and Participating in Mental Health Care. Psychol Sci Public Interest. 2014;15(2):37-70.
49. Taghva A, Hajebi A, Noorbala AA, Khademi M, Asadi A, Rahnejat AM, et al. Mental health stigma in Iran: A systematic review. Stigma and Health. 2024.
50. Grzywacz JG. Shift work and its implications for everyday work and family life: A foundation and summary. Social and family issues in shift work and non standard working hours. 2016:3–17.
51. Broetje S, Jenny GJ, Bauer GF. The Key Job Demands and Resources of Nursing Staff: An Integrative Review of Reviews. Front Psychol. 2020;11:84.
52. Lee YR, Enright RD. A meta-analysis of the association between forgiveness of others and physical health. Psychol Health. 2019;34(5):626-43.
53. Schnitker SA, Ro DB, Foster JD, Abernethy AD, Currier JM, vanOyen Witvliet C, et al. Patient patients: Increased patience associated with decreased depressive symptoms in psychiatric treatment. J Posit Psychol. 2020;15(3):300–13.
54. Ozcan O, Hoelterhoff M, Wylie E. Faith and spirituality as psychological coping mechanism among female aid workers: a qualitative study. Journal of International Humanitarian Action. 2021;6(1):15.
55. Pandey J, Singh M. Positive religious coping as a mechanism for enhancing job satisfaction and reducing work-family conflict: A moderated mediation analysis. Journal of Management, Spirituality & Religion. 2019;16(3):314–38.
56. Thirioux B, Birault F, Jaafari N. Empathy Is a Protective Factor of Burnout in Physicians: New Neuro-Phenomenological Hypotheses Regarding Empathy and Sympathy in Care Relationship. Front Psychol. 2016;7:763.
57. Scheepers RA, Boerebach BC, Arah OA, Heineman MJ, Lombarts KM. A Systematic Review of the Impact of Physicians' Occupational Well-Being on the Quality of Patient Care. Int J Behav Med. 2015;22(6):683-98.
58. MacDonald J, Ellis PM. Supervision in psychiatry: terra incognita? Curr Opin Psychiatry. 2012;25(4):322-6.
59. Olfson M, Marcus SC, Wilk J, West JC. Awareness of illness and nonadherence to antipsychotic medications among persons with schizophrenia. Psychiatr Serv. 2006;57(2):205-11.
60. Slemon A, Jenkins E, Bungay V. Safety in psychiatric inpatient care: The impact of risk management culture on mental health nursing practice. Nurs Inq. 2017;24(4):e12199.
61. Bayramzadeh S. An Assessment of Levels of Safety in Psychiatric Units. Herd. 2017;10(2):66-80.
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How to Cite
1.
Salehi R, Ardeshiri Z, Mohammadi MR. Psychiatrists Under Pressure: Exploring Occupational Risks and Protective Strategies. Iran J Psychiatry. 2026;:1-15.
