title: Aspects of Sustainability: Cooperation, Job Satisfaction, and Burnout among Swiss Psychiatrists.
abstract: OBJECTIVE
  Greater sustainability in mental health services is frequently demanded but seldom analyzed. Levels of cooperation, job satisfaction, and burnout are indicators of social sustainability in this field and are of particular importance to medical staff. Because registered psychiatrists play a central role, we assessed the status quo and interactions between these three factors among registered psychiatrists in Switzerland.
  
  
  METHODS
  A postal survey with three standardized questionnaires about cooperation, job satisfaction, and burnout was conducted among all registered psychiatrists in the German-speaking part of Switzerland (n = 1485). Addresses were provided by the Swiss Medical Association.
  
  
  RESULTS
  Response rate was 23.7% (n = 352), yielding a largely male sample (62.8%; n = 218) aged 55.5 ± 8.7 years old. Quantity (47 ± 56.2 contacts over 3 months) and duration (91.1 ± 101.6 min per week) of cooperation was found to be diverse depending on the stakeholder. Quality of cooperation was greatest in general practitioners (81.5%) while it was worst in community mental health providers (54.9%). Overall job satisfaction was assessed rather high (3.7 ± 0.8), and burnout rates were below crucial values (Emotional Exhaustion, 2.9 ± 0.8; Depersonalization, 1.9 ± 0.5). Both were positively influenced by cooperation. The strongest correlation was found between job satisfaction and burnout, and both had significant inverse relationships in all dimensions.
  
  
  CONCLUSIONS
  To foster sustainability in outpatient mental health care regarding cooperation, job satisfaction, and burnout, personal aspects such and age or years of registration, organizational aspects, such as networking and practice setting, as wells as supportive aspects such as psychotherapy, and self-help groups, must be considered. Quality of cooperation should be reinforced in particular. Because Integrated and Managed Care models cover several of these factors, the models should be more strongly embedded in health care systems.
authors.affiliation: Competence Tandem Integrated Care, Leuphana University of Lueneburg , Lueneburg , Germany.
authors.forename: Johanna
authors.initials: J
authors.lastname: Baumgardt
authors.affiliation: Competence Tandem Integrated Care, Leuphana University of Lueneburg , Lueneburg , Germany.
authors.forename: Jörn
authors.initials: J
authors.lastname: Moock
authors.affiliation: Competence Tandem Integrated Care, Leuphana University of Lueneburg , Lueneburg , Germany ; Laboratory of Neuroscience (LIM 27), Institute of Psychiatry, University of São Paulo , São Paulo , Brazil ; University Hospital of Zurich , Zurich , Switzerland.
authors.forename: Wulf
authors.initials: W
authors.lastname: Rössler
authors.affiliation: Competence Tandem Integrated Care, Leuphana University of Lueneburg , Lueneburg , Germany ; Department for Psychiatry, Psychotherapy and Psychosomatics, Centre for Social Psychiatry, University Hospital of Psychiatry Zurich , Zurich , Switzerland.
authors.forename: Wolfram
authors.initials: W
authors.lastname: Kawohl
keywords: burnout; cooperation; job satisfaction; outpatient mental health care; psychiatrists; sustainability indicators