Autonomy in work location decision and burnout in behavioral health providers: Lessons learned from COVID-19.

Objective: The ability to choose one's work-location can influence burnout from employment. We sought to evaluate potential associations between autonomy in work-location decision and burnout. Methods: We used 2020 Veterans Health Administration Annual All Employee Survey data from behavioral health providers at 129 medical facilities. Based on responses to items in a COVID-19 module related to teleworking frequency and reasons for not teleworking both pre- and during COVID-19, we generated six groups representing potentially differing levels of work-location decision autonomy. We hypothesized that greater autonomy is associated with less burnout. Results: Psychologists reported highest burnout (40.1%, 1801/4494), followed by psychiatrists (35.6%, 703/1976) and social workers (31.0%, 3421/11,051). Adjusting for covariates including workload, providers newly approved for telework during COVID-19 showed 1.28 (95% CI=1.03-1.59), 1.71 (1.25-2.35), and 1.35 (0.86-2.12) times higher odds of burnout among social workers, psychologists, and psychiatrists, respectively, compared to providers chose not to telework during COVID-19. Conclusions: Providers who chose to keep coming into work in person reported less burnout than providers who previously could not telework and are teleworking during the pandemic. Greater autonomy in work-location decision might have greater importance in reducing burnout in behavioral health providers than having the ability to telework per se.