EAPs and death care workers.

My name is Sam Ore, I’m a lifelong Montanan, clinical social worker, and educator based out of Missoula, Montana. In the decade since I started my career as a trauma therapist, I’ve worked with many first responders. These are the folks doing more than their share of emotional labor, whose daily experiences include participating in the worst moments in the lives of strangers; police officers, nurses, firefighters, paramedics, and social workers. People with long hours and weird schedules, endless paperwork and frustrated spouses, low wages and the occasional life-threatening-situation.

They tend to show up in my office in various presentations of burn-out. Burnout is “a response to occupational stress characterized by exhaustion, cynicism, aloofness, and reduced performance capacity among workers”. It can be expressed psychologically in symptoms like depression, overuse of numbing behaviors, and withdrawal from relationships but it is rooted in the nervous system, and often shows like fatigue, disinterest, or a suppressed immune system. In advanced stages, it compromises a person’s ability to perform their jobs, attend to their relationships, and literally feel happy.

Burnout is not uncommon. Recent data estimate that it affects up to a third of healthcare workers and results in at least $500 billion in lost revenue to the US economy. That’s between $4,000 and $20,000 in lost productivity per worker, according to a 2025 study in the American Journal of Preventive Medicine.

It’s fair to rank burnout among the biggest occupational hazards of the helping professions. The factors that precipitate burnout tend to be complex and the result of cumulative stress at both an individual and organizational level. Individuals with pre-existing mental or physical health concerns, trauma histories, and stressors outside of work such as parenting are more likely to experience burnout symptoms. Organizations that rely on shift work, offer limited financial compensation, or where employees are faced with moral injury or a diminished sense of control have see much higher rates of burnout.

Perhaps this is starting to sound familiar? This article sprang a friendship with a mortician who let me into her world as a death care worker and even shared some research on the toll that this job can take. These studies confirmed my hunch that death care workers are challenged with the same stressors as other first responders. For example, the rates of Post-Traumatic Stress Disorder (PTSD) are three times higher in Funeral Directors than the general population. Striking to me was that many funeral directors, much like police officers, report an element of stigma to their jobs that can represent a barrier to care. And, as you might guess, stigma is a risk-factor for burnout.

So how should Funeral Directors think about burnout?

Because the factors associated with burnout are unique to each individual experience, a wide range of interventions may be appropriate. That said, I get a lot of mileage from the work of Andrew Laue, another Montana-based clinician and creator of the STAR-T resiliency model, who points out that resilience in the face of chronic stress is predicted by awareness and connection. This means that when you really boil it down, the most resilient individuals are those with the habit of noticing their emotional and physiological state (us therapists like to call this emotional intelligence) and connecting with other humans (and animals) in ways that help regulate their nervous systems. Likewise, the most resilient organizations tend to have teams that are mutually supportive and responsive to the needs and abilities of the individual workers.

Awareness means a team wide acknowledgement that there is an emotional toll on the worker who takes a child’s body from their parent’s arms at 3am on a Sunday, just as there is an emotional toll involved in compassionately serving a high-conflict family who is struggling to pay their loved one’s funeral costs. It means noticing when your co-worker stops cracking jokes and starts falling behind on their paperwork. Awareness is paying attention to your own increasing irritability, numbing behaviors, and strain in your interpersonal relationships and responding to these needs with the same diligence that you apply to your other professional duties. Ideally, awareness include a reflective process such as therapy, a spiritual practice, or maybe even just periodically testing yourself with a burnout screener like the Burnout Assessment Tool (BAT) or the Maslach Burnout Inventory (MBI).

Connection is the action stage and it takes energy, skill, and a strategy. It can be as simple as acknowledging a co-worker’s efforts on a particularly grueling case around the coffee maker, or as elaborate as a company-wide Christmas party. It means getting to know the humans beings behind the teammates, and making sure that you’ve got enough left in the tank to care for the families in your waiting room to a standard that you can be proud of. Crucially, connection is about making sure that nervous systems of the people around you know that you have their back. Notably, it’s something that often must be built into the culture deliberately, especially in working environments with unusually hours and stressors.

Often, people come into my care when the stress has turned to burnout and the burnout has turned to crises. Awareness has been blunted and the supportive connections have been frayed and recovery is long and laborious. But the biggest catalyst of both resilience and change is environment, and honestly, its frustrating as a therapist to be attending to helpers on the front line in isolation. So I’ve looked for ways to intervene upstream of crisis.

At my group practice, Redtail Mental Health, our Employee Assistance Program (EAP) is designed to offer preventative strategies as well ongoing mental health support. The program is tailored to each individual business but generally consists of conducting a needs assessment to learn about the unique qualities of the organization, staff training on managing secondary trauma and cultivating resilience, and ongoing availability to support the entire organization in times of crisis, in addition to prompt access to skillful outpatient psychotherapy. This models is well proven and the Department of Labor notes that EAP models saves employers between $5 and $16 per dollar invested by increasing retention and decreasing absenteeism.

Of course, Redtail also offers individual psychotherapy via Zoom to the entire state of Montana, regardless of EAP participation. We accept all major third party insurances and scheduling is just a few clicks on our website www.redtailmentalhealth.com. We’re familiar with grief, trauma, family therapy, and crises counseling as well as burnout and we collaborate closely with resources local to our clients to ensure that participants receive comprehensive care.

Thank you for your difficult and important work and the time you’ve taken to consider this occupational hazard. I’ll look forward to our eventual collaboration, in your office or mine.