Hrev_master Healthcare in Low-resource Settings 2024; volume 12(s2):12906 Professional satisfaction of practitioners in psychiatry departments Beata Strzelecka,1 Katarzyna Wiśniewska,1 Anna Pacian2 1Faculty of Health Sciences, Radom School of Higher Education, Radom; 2Department of Health Education, Medical University of Lublin, Lublin, Poland Abstract Assessing the professional satisfaction of psychiatrists is cru- cial given the unique demands and complexities of their work, which include managing patients’ mental and physical well-being, adhering to strict ethical standards, handling crises, and coping with significant emotional stress. The study’s aim was to deter- mine the indicators of job satisfaction of doctors working in psy- chiatry departments, to analyse the professional satisfaction of Polish, European, and world psychiatrists, and to identify ways to improve it. The applied methods include: secondary data analysis, thematic analysis, comparative analysis, synthesis. The study identified factors that influence the professional satisfaction of psychiatrists, compared it among psychiatrists in Poland, Europe, and the world, and developed a number of methods to improve this indicator. The results of the study showed that the level of pro- fessional satisfaction of psychiatric doctors is influenced by the following factors: salary level, working conditions, team relations, resource support of the work process, stress level, level of emo- tional burnout, sense of recognition and importance of their own work, work-life balance, and the degree of stigmatisation of men- tal disorders in society. In terms of the number of practicing psy- chiatrists in the country, the availability of psychiatric services, and the level of the average annual salary of psychiatrists in Poland, Europe, and the world, the highest rates of professional satisfaction are recorded in the Scandinavian countries and Austria. Poland and Eastern European countries have lower scores, but the gradual increase in funding for psychiatry in Poland is leading to a positive upward trend. Ways in which this increase can be achieved include: increasing the staff of psychi- atric units and optimising administrative work to reduce work- load; using cooperation and mentoring programs to achieve a comfortable team environment; and encouraging specialists to participate in training and mentoring programs to enhance their professional development. Introduction The specificity of the speciality of practitioners in psychiatric departments involves working with patients with mental problems of various types and severity. During diagnostics, treatment, and rehabilitation, a doctor is responsible not only for the quality of certain procedures but also for the mental and physical well-being of patients, which is achieved by adhering to ethical standards in working with them and correctly and timely resolving crises or dangerous situations for patients or staff. Despite maintaining emotional neutrality, this level of responsibility can cause emo- tional stress, which will require emotional commitment both in the professional sphere and outside of it. Therefore, given the com- plexity and peculiarities of the work of psychiatric doctors, as well as the length of training in this speciality, it is important to assess their professional satisfaction in order to take the necessary mea- sures to preserve the human resources of the industry. The main problem of the study is the lack of reliable and valid statistical information on the level of professional satisfaction of psychiatric doctors in Poland, Europe, and the world in general. The study addresses this gap in comprehensive data on the profes- sional satisfaction of psychiatric doctors, highlighting the impor- tance of addressing this issue to improve the mental health care system. The lack of robust data limits the ability to develop effec- tive strategies to support psychiatrists in managing the unique stresses and demands of their profession. By focusing on this problem, the study aims to contribute to a better understanding of the factors that influence job satisfaction in psychiatric practice, which is essential for retaining skilled professionals in this chal- lenging field. Addressing this issue is particularly significant in light of the increasing prevalence of mental health disorders worldwide, which places additional pressure on psychiatric ser- vices and emphasizes the need for a satisfied and motivated work- force to meet the growing demand for mental health care. Therefore, researchers who have dealt with this issue have focused on conducting surveys on certain indicators responsible for professional satisfaction among psychiatric doctors. Makara- Studzińska et al.1 analysed the prevalence of professional burnout Correspondence: Katarzyna Wiśniewska, Faculty of Health Sciences, Radom School of Higher Education, 26-600, 26/28 1905 Roku Str., Radom, Poland E-mail: wisniewska.kater@gmail.com Key words: emotional burnout, stress level, workload, salary, industry resources, stigmatisation. Funding: none. Ethics approval: The study was conducted without human/animal participation. Ethical approval is not required. Conflict of interest: the authors declare no potential conflict of interest. Availability of data and material: the data that support the findings of this study are available on request from the corresponding author. Received: 7 August 2024. Accepted: 18 September 2024. Early view: 10 October 2024. This work is licensed under a Creative Commons Attribution 4.0 License (by-nc 4.0). ©Copyright: the Author(s), 2024 Licensee PAGEPress, Italy Healthcare in Low-resource Settings 2024; 12(s2):12906 doi:10.4081/hls.2024.12906 Publisher's note: all claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organi- zations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher. [Healthcare in Low-resource Settings 2024;12(s2):12906] [page 111] Non -co mmerc ial us e o nly syndrome based on a survey of 57 psychiatrists. The results of the study revealed a high degree of burnout, which was recorded in 50% of the doctors surveyed. Wontorczyk et al.2 conducted a search for psychosocial predictors that influence the development of stress and professional burnout, based on a survey of 131 psy- chiatrists. The researchers recorded a significant level of profes- sional stress and burnout, the main predictors of which were psy- chophysical exhaustion and a lack of a sense of professional effec- tiveness. The inclusion of non-professional predictors in Wontorczyk et al.’s research adds a valuable dimension by recog- nizing the broader social influences on professional well-being. The study’s sample size is insufficient for scalability and projec- tion to the entire psychiatry field, but burnout as a factor affecting the professional satisfaction of practicing psychiatrists should be further studied. McLoughlin et al.3 and Sandvik et al.4 broaden the scope of the subject by looking at burnout and work satisfaction among psychi- atrists in Ireland and Norway. The survey was conducted by Mcloughlin et al. among 100 doctors and revealed burnout in 36% of them and a low assessment of personal well-being in 30%. The results of the study by Sandvik et al., encompassing a survey of 903 Norwegian doctors, showed job satisfaction in 56% of respon- dents, dissatisfaction in 16%, and a neutral attitude in 27%. The studies provide a comparative perspective on work satisfaction, enabling cross-regional research. Sandvik et al.’s focus on job sat- isfaction aspects is valuable for identifying improvement areas. However, these studies largely focus on the immediate profession- al environment without delving into the systemic and cultural fac- tors that might influence job satisfaction. This creates a gap in understanding how broader societal and policy contexts influence the professional experiences of psychiatrists, which is critical for developing comprehensive strategies to improve job satisfaction. Based on the results of a social media survey, Gruber et al.5 determined the indicators of performance and job satisfaction among psychiatrists who emigrated from Croatia to Scandinavian and Western European countries and psychiatrists who practiced directly in Croatia. The analysis of a questionnaire survey of 62 doctors, 44 of whom emigrated, revealed higher levels of profes- sional satisfaction among the emigrant group of psychiatrists com- pared to their colleagues working in their home country. Gruber et al. offer a unique perspective by examining the well-being of emi- grant psychiatrists from Croatia, yet their study does not fully address the comparative aspects of professional satisfaction between different healthcare systems and cultural contexts. Outside of Europe, surveys aimed at determining the profes- sional satisfaction of psychiatrists were conducted by Chambers and Frampton,6 Nimmawitt et al.,7 and Jackson et al.8 As in the pre- vious studies, the authors investigated the level of burnout, stress, and exhaustion and assessed the prevalence of post-traumatic stress disorders among doctors in psychiatric departments. Chambers and Frampton studied the results of a survey of 368 doc- tors from New Zealand and found burnout in 34.6% of respon- dents, and the level of significant work-related stress was recorded in 35.3% of respondents. An analysis of a survey of 227 Thai psy- chiatrists conducted by Nimmawitt et al. showed that 49.3% of respondents reported severe emotional exhaustion, and 26.4% reported high levels of depersonalization. Jackson et al. studied the results of a cross-sectional national survey of 2,216 practicing psy- chiatrists in the United States and determined that 14% of them had post-traumatic stress disorders, the development of which pro- voked emotional exhaustion and job dissatisfaction. These studies overlook the relationship between burnout, work satisfaction, and career longevity, as well as the impact of mental health stigma on both patients and professionals. This lack of awareness creates a gap in understanding how public views towards mental health influence psychiatrists’ job satisfaction and professional identity in various cultural situations. Given the different approaches to the methodology of the above studies (sample sizes, types of questionnaires, statistical analysis of the results), it is incorrect to use their data to compare the job satisfaction of psychiatrists in differing regions. Therefore, it is important to analyse those aspects that will allow more accu- rately determining the level of professional satisfaction of psychi- atrists by analysing the factors that form this indicator. The fact that the majority of psychiatrists’ job satisfaction surveys focus on determining the level of burnout, stress, and depersonalisation indicates the relevance and severity of this problem among practi- tioners. However, it is worth noting that these negative aspects of professional activity are the result of a combination of factors that affect the overall level of job satisfaction. The existing literature on the challenges faced by psychiatrists is limited, with significant research gaps. These include a need for a comprehensive exploration of factors influencing job satisfaction beyond burnout and stress, a deeper analysis of systemic and cul- tural influences, and a comparative examination of healthcare sys- tems’ impact on professional satisfaction. This study aims to address these gaps by examining a wider range of factors con- tributing to job satisfaction, situating them within the context of mental health systems and societal attitudes, and providing strate- gies for improving work environments and job satisfaction. The goal of the research was to identify and analyse the factors that determine the professional satisfaction of psychiatric doctors. The tasks of the study included comparing the job satisfaction of psy- chiatrists in Poland, Europe, and the world in general and finding the best ways to improve this indicator. The factors influencing the professional satisfaction of psychi- atrists were determined by analysing materials from scientific sources in psychiatry, psychology, and sociology. The search for publications was conducted among materials in the PubMed, Google Scholar, and Scopus databases. The query was formed using the keywords: “satisfaction with the work of psychiatrists”, “indicators of psychological satisfaction of doctors in psychiatric departments”, “level of professional satisfaction of psychiatrists”. According to this request, 26 articles were selected. In this research such methods as secondary data analysis, thematic analy- sis, comparative analysis, synthesis were used. A comparative analysis of the job satisfaction of practicing psychiatrists in Poland, Europe, and the world was carried out. For this purpose, the available materials containing descriptive or sta- tistical information on each of the previously identified factors in the respective regions were used. In addition to these databases, information was searched for among the materials available on the Internet that contained data on the resource provision of the health- care sector in these regions. The following keywords were used for the search: “level of remuneration/salary of psychiatrists in Poland/Europe/world”, “working conditions of psychiatrists in Poland/Europe/world”, “provision of the field of psychiatry in Poland/Europe/world”, “social status/recognition of psychiatrists in Poland/Europe/world”, “stigmatisation of mental illness in Poland/Europe/world”. A total of 33 relevant sources were select- ed. Given the results and the author’s conclusions, the researcher searched for effective methods to increase the level of professional satisfaction of practicing psychiatrists. Social and political factors affecting public health [page 112] [Healthcare in Low-resource Settings 2024;12(s2):12906] Non -co mmerc ial us e o nly Determination of indicators of professional satis- faction of psychiatric doctors, taking into account the specifics of the speciality In addition to psychiatrists, psychiatry departments may employ neurologists and general practitioners, as well as special- ists in related fields such as psychologists, psychotherapists, art therapists, occupational therapists, ergotherapists, and other spe- cialists, depending on the profile of the department, the needs of patients, and the resources of the healthcare facility. Given that these doctors, regardless of their specialities, work with people with suspected or confirmed mental disorders, it is important to identify factors specific to the field of psychiatry in addition to general satisfaction factors when determining their professional satisfaction. The level of remuneration, working conditions, micro- climate in the team (relationships with colleagues), resource sup- port for the work process and career development opportunities are important for any specialist and have a significant impact on the assessment of professional satisfaction. Stress level, burnout level, sense of importance of own activity, work-life balance, sense of pride in the profession can be attributed to factors inherent in the medical profession, taking into account the level of responsibility, psychological impact and working time regulation. The most spe- cific factor of professional satisfaction for psychiatric doctors is the stigma of mental illness in society. The level of remuneration, i.e. the salary of psychiatric doctors, generally corresponds to the salary of doctors of other specialities.9 However, there is an opin- ion among a certain number of psychiatrists that the level of mate- rial remuneration is insufficient, given the specifics of their profes- sion and the stressful nature of their work.10 The working conditions of psychiatrists depend on the number of staff involved in the work and the quality of communication between them, the standardization of working hours, the comfort of the psychosocial environment of the healthcare facility and the sufficiency of professional equipment and materials for profes- sional activities. The number of staff involved affects the optimal distribution of working time and helps to avoid overload, while maintaining the efficiency of doctors during the work shift.11 Interaction between staff creates a healthy atmosphere in the team and provides an opportunity to share experiences, consult and receive assistance in crisis situations.12 The environment of a healthcare facility affects the psychological and physical well- being of a doctor and can reduce his or her effectiveness. For example, studies have shown that: i) exposure to noise can lead to increased levels of stress, anxiety, and fatigue in doctors and neg- atively affect concentration and decision-making;13,14 ii) exposure to dim lighting provokes anxiety and depression;15 iii) exposure to bright artificial lighting disrupts doctors’ sleep, leading to over- work and reduced performance;16 iv) exposure to poor air quality leads to the development of respiratory diseases, allergies, headaches, dizziness, and nausea;17,18 v) exposure to unergonomic workplaces and places for rest causes musculoskeletal problems, increased fatigue, and reduced performance.19 The level of provision of professional equipment and materials for professional activities can affect the quality of doctors’ work, increase or decrease stress and burnout, and change the level of motivation, retention, or outflow of staff.20,21 Relationships with colleagues are one of the factors that influ- ence working conditions and depend on personal relationships between staff, the correct rules of subordination, and the level of professional solidarity in the community. Interpersonal relation- ships are determined by the level of communication between staff, the presence or absence of trust and respect, acceptance or rejec- tion of the character, behaviour, and values of colleagues, and the impact of personal successes or problems on mitigating or aggra- vating relationships in the team.22,23 The correct construction of subordination rules and their observance can ensure the effective- ness of solving existing professional, organisational, and interper- sonal problems, while incorrect subordination can lead to abuse of power, building a rigid hierarchy, deterioration of the microclimate in the team, and suppression of cooperation between doctors.24 Professional solidarity among psychiatric doctors is correlated with a sense of cohesion and unity and affects the level of support and protection in the team, promotes the effectiveness of peer-to- peer cooperation or mentoring, and creates a sense of belonging to a professional community.25 On the other hand, the lack of solidar- ity or its low level leads to isolation, conflicts, a lack of support, cooperation, and a sense of protection, which can significantly reduce professional satisfaction and provoke disillusionment with the profession. Resource provision of the workflow affects: work- ing conditions, as it determines the number of staff involved in the work and, accordingly, the distribution of working time; conve- nience of the healthcare facility environment for staff and patients; comfort and ergonomics of the workplace; places for doctors to rest and rooms for patients to stay; level of professional equipment, facilities, and materials; provision of a sufficient number of patient beds; necessary devices for diagnosis, treatment, and rehabilita- tion; instruments and medicines.26 There are several career paths in the field of psychiatry. Practitioners who focus on clinical work can, according to their specialisation, grow to the position of department head or use their clinical experience to conduct research while building a career as a researcher or teacher.27 Given that career advancement is perceived as professional recognition and is accompanied by an increase in salary, it has a significant impact on increasing the level of job satisfaction of psychiatric doctors. The level of stress experienced by psychiatrists is caused by contact with patients with mental disorders. Depending on the type and severity of such disorders, during their work, specialists find themselves in emotionally exhausting situations (exacerbation of psychosis, patient suicide) and face the risks of insults, threats, and physical violence.28 These factors contribute to the fact that the level of stress in psychiatric doctors is higher than in doctors of other specialities.29 Prolonged exposure to stress reduces profes- sional satisfaction and can cause emotional burnout. The character- istics of this condition include exhaustion, loss of enthusiasm, reduced empathy, and the development of cynicism. Studies have shown that, like stress levels, the level of emotional burnout in psy- chiatrists is higher than in doctors working in other specialities.30 The sense of importance in one’s own work is the perception of one’s work as beneficial to society – relieving suffering and improving the lives of patients with mental disorders. This percep- tion creates a sense of pride in one’s profession and can help to cope with stress and emotional burnout.31 The specifics of working in psychiatric wards can affect doctors’ personal lives and lead to rela- tionship problems. Exacerbation of the problem negatively affects moral well-being and may lead to thoughts about changing profes- sional activities.32 Maintaining a work-life balance determines the level of professional satisfaction of psychiatrists. The stigmatisation of mental illness is a factor that affects the decrease in the level of professional satisfaction of psychiatric doctors. Its causes are dis- crimination, prejudice, and devaluation by society, which can lead to a sense of isolation, reduced self-esteem, the development of feelings of guilt or shame, a loss of enthusiasm, and disappointment at work.33,34 Having examined the indicators of professional satis- faction of psychiatric doctors, a dependence was found between them, which can be direct – an increase in the level of one indicator Social and political factors affecting public health [Healthcare in Low-resource Settings 2024;12(s2):12906] [page 113] Non -co mmerc ial us e o nly will lead to an increase in another (an increase in the level of provi- sion of the industry will lead to improved working conditions), or the opposite – an increase in the impact of one indicator will pro- voke a decrease in the impact of another (a sense of the importance of one’s own work will reduce the level of stress and professional burnout). This pattern is important to take into account when analysing ways to increase the level of professional satisfaction. Analysis of professional satisfaction of psychiatric doctors in Poland, Europe, and the world Since there are currently no clear statistics on the level of pro- fessional satisfaction of psychiatrists globally and by region, a comparative analysis of this indicator was conducted based on sur- veys of psychiatrists on certain factors of job satisfaction and sta- tistical data on the resource provision of psychiatric departments in the regions studied. The human resource provision corresponds to the number of practising psychiatrists in psychiatry departments. Although it does not reflect a general understanding of profession- al satisfaction, it can influence the level of working conditions and reveal a trend towards development, stability, or decline in the industry. According to data from 2021, the number of psychiatrists employed in Poland was 4914. Compared to 2020, it increased by 5.56% and became the highest since 2007.35 It is worth paying attention to the fact that in 2018, this number was estimated at 3277 doctors, and in 2019 it was 4436. The sharp increase in the number of employed psychiatrists by 26.13% indicates the pres- ence of a number of factors that provoked it. The main ones were: an increase in mental health funding in 2018; an increase in the number of mental illnesses due to increased stress, anxiety, drug, and alcohol addiction; and demographic changes provoked by pop- ulation ageing.36-38 Thus, the trend towards an increase in the num- ber of practicing psychiatrists indicates the development of the psychiatric field and has a positive impact on increasing the level of professional satisfaction of doctors in this speciality, affecting the improvement of working conditions, as an increase in the staff makes it possible to optimise working hours and avoid overload. However, the number of practicing psychiatrists in Poland is still lower than in other European countries, taking into account the population of the countries (Figure 1). Statistics show that among the European countries mentioned, the United Kingdom, Denmark, Estonia, and Iceland have approx- imately the same level of population provision with psychiatrists; the highest rates are recorded in Switzerland and Norway, and the lowest are recorded in Poland. The general trend indicates that the number of psychiatrists in the studied countries is increasing every year, the greatest stability is observed in Denmark,40 a decrease in the number compared to 2020 is recorded in Estonia (272 doctors in 2020, 256 in 2021),41 and in Iceland, the highest rates were in 2016 (86 doctors, compared to 75 in 2021).42 Given that in 2020, the proportion of the European population that used professional help to address mental health problems was 21%, the approximate workload of psychiatric doctors in Britain, Estonia, Austria, Denmark, Iceland, and Norway will be about 1,000 patients per year, in Switzerland, about 400, and in Poland, up to 1,500.46 Although the data is approximate, the difference in workload between Polish and European doctors is obvious. A comparison of resource provision for psychiatry can be analysed by the level of government spending on the needs of the sector (Figure 2). The highest level of provision in the psychiatric sector is observed in Switzerland, Denmark, Iceland, and Norway, which are almost at the same high level, a fairly high level is observed in Austria, and significantly lower resources are allocated to the sec- tor in the UK, Poland, and Estonia. Given that resource support affects working conditions, the quantity and quality of equipment and materials required to work with patients, and the comfort of the workplace, its limitations can affect the quality of medical care and professional satisfaction of psychiatric doctors. This analysis shows that the resource provision of psychiatry, as one of the indi- cators of influence on job satisfaction, is on average higher in European countries than in Poland. It is worth noting that the high- est indicators are in Scandinavian countries, which are approxi- mately 5 times higher than in Poland. The level of remuneration, which is an important factor in determining the professional satis- faction of psychiatric doctors, can be analysed by comparing their average annual salary (Figure 3). Social and political factors affecting public health Figure 1. Statistics on the level of provision of the population with psychiatric services in European countries. Notes: statistics on the number of people per practising psychiatrist in Denmark, in the absence of data, are taken for 2020. Source: compiled by the authors based on 35; 39-45. Figure 2. Statistics on per capita expenditures on mental health care in Europe. Notes: statistics on the level of psychiatry provi- sion per capita, in the absence of up-to-date data, are taken for 2020. Source: compiled by the authors based on 47-54. Figure 3. Statistics on the average annual salary of psychiatrists in European countries. Source: compiled by the authors based on 55-62. [page 114] [Healthcare in Low-resource Settings 2024;12(s2):12906] Non -co mmerc ial us e o nly Switzerland has the highest average annual salary of psychia- trists among these European countries, with approximately the same level in Iceland, Denmark, Austria, and Norway, and a slight- ly lower level in the UK. Estonia and Poland have the same level of financial remuneration and are almost twice as low as other countries. These data correlate with indicators of the industry’s resource endowment and are an important indicator of psychia- trists’ job satisfaction. Despite belonging to the same region, the analysis of statistical data revealed significant differences between the number of practicing psychiatrists, the material support of the psychiatry sector, and the level of average salaries of specialists in different countries. The Scandinavian countries and Austria have an advantage in most of these indicators, while the lower level is recorded in Eastern European countries, including Poland. Thus, it can be concluded that the level of professional satisfaction of prac- tising Polish psychiatric doctors is currently lower than the European average. The low job satisfaction of psychiatrists in Poland is also con- firmed by the results of surveys that determine the level of stress and emotional burnout.63,64 Given the specifics of the work, these indicators are also high among physicians in other countries, which indicates that the problem of stress and burnout is common to European psychiatry specialists.65 The level of professional satis- faction of psychiatric doctors in different countries differs depend- ing on the healthcare system, the financing of the sector, and the social status of the profession. The tendency to increase the level of professional satisfaction of psychiatrists depending on the num- ber of patients per doctor, the level of resource provision in the industry, and the salary of a specialist, similar to in European coun- tries, remains for the world as a whole. The social status of the pro- fession of psychiatry is usually determined by the level of stigma- tisation of mental illness in society. Despite civilisational processes and an increase in the level of education, stigma is still a widespread problem in many countries. Prejudice, negative stereo- types, discrimination, and social isolation not only complicate the treatment process and further adaptation of the patient but are also projected onto the doctor who comes into contact with patients. Thus, a difficult treatment process and the associated stress lead to a decrease in job satisfaction and may influence thoughts about changing professions. Research has shown that the highest levels of mental illness stigma are found in countries with low incomes, collectivist cultures, and strict religious traditions. The high level of stigmatisation of mental illness in China is manifested through discrimination against patients and their fami- lies in professional and social life.66 In the collectivist culture of this country, mental illness often acquires signs of moral weakness, which distinguishes a person from the general community. In India, the collectivist culture, reinforced by the influence of reli- gious traditions, can lead to the isolation of the patient from the community and sometimes from the family. A similar trend is observed in Saudi Arabia, Nigeria, and Zimbabwe, where, depend- ing on a distorted interpretation of the causes of mental illness (witchcraft, obsession, karma), people with mental disorders may be subjected to isolation, abuse, or violence.67 The level of stigma- tisation of mental illness in Poland differs significantly from the level in the countries listed above, but it is still significant. Stigmatisation is expressed in the form of the perception of people with mental disorders as dangerous, unpredictable, and incapable of professional and social activities. This influence is determined by the level of public awareness. This trend is being reversed by introducing provisions in state legislation prohibiting discrimina- tion against people with mental disorders and introducing social programs to educate and inform the public about the specifics of mental disorders. The level of salary, resource provision in the psy- chiatric sector, and social status of the profession are important indicators of the professional satisfaction of doctors in psychiatric departments. The analysis showed that the highest level of these indicators is in countries with a high level of social and economic development. In Poland, they have lower values than in some Western European and Scandinavian countries, but the tendency to increase funding and government and public initiatives to improve the social status of the profession indicate a positive trend in improving the main factors of professional satisfaction of psychi- atric doctors. Ways to increase the level of professional satisfac- tion of doctors in psychiatry departments Improving the job satisfaction of psychiatric doctors is an important part of improving the state of the psychiatric sector and ensuring a decent level of mental health support for the population. Ways to improve the level of professional satisfaction of psychia- trists include reducing workload, improving working conditions, increasing opportunities for professional development, supporting the mental health of doctors themselves, and increasing recogni- tion and respect for the profession. The main condition for reducing the workload is, of course, an increase in staff, which requires additional funding for training and the remuneration of specialists. However, other less resource- intensive options can be considered to help relieve doctors of their workload. In this direction, it is worth paying attention to the study by Lai et al.,68 which highlights certain organisational aspects that can be revised to optimise the workload of a doctor. Based on sur- veys of psychiatry trainees in Australia, researchers studied the impact of changes in mental health legislation on the development of stress. The analysis of the questionnaire revealed that, in addition to long working hours, trainee psychiatrists named the intensity of the workload as a factor of fatigue, which leads to overtime and the need to take some responsibilities home. The stress factor is exac- erbated by a combination of a significant amount of administrative workload (increased volume and number of reports in accordance with the new legislation) and high emotional exhaustion due to the specifics of psychiatry (threats, aggression, and suicide of patients).69-71 Although this study focusses on the problems of trainees in psychiatry departments, due to the need to combine administrative and practical activities, they are also relevant for experienced doctors. Therefore, there are several ways to reduce the workload of doctors: differentiating both types of activities according to the doctor’s working hours; delegating administrative responsibilities to a part of the staff that is involved in providing psychiatric care to patients (clinic or department administrator, secretary); digitalizing and optimizing the reporting process. In addition, flexible work models, including part-time work, work from home, and the use of telemedicine, can be used to reduce workload. These models will help reduce the workload and main- tain a balance between the professional and personal lives of doc- tors. In addition, analysing the results of the Australian research, it is worth emphasising the conclusion drawn from the survey, which is that when changing the legislation on the provision of mental health services, the rights of doctors providing mental health ser- vices should be taken into account, in addition to the interests of patients. The imbalance between the interests of both parties can backfire and cause acute problems in the field of psychiatry. Ways to improve the working conditions of doctors in psychi- atric departments include providing comfortable workplaces and places for recreation and access to the technological and pharma- Social and political factors affecting public health [Healthcare in Low-resource Settings 2024;12(s2):12906] [page 115] Non -co mmerc ial us e o nly ceutical resources necessary for quality practice.72 In addition to the material support of the doctors’ environment, it is important to create a favourable emotional atmosphere in the team. One of the ways to achieve it can be through the use of cooperation and men- toring programs, which will help to adapt young specialists to the profession and form in them a positive perception of work in the acquired speciality at the beginning of their career. Individual or group mentoring and collaboration with experienced psychiatrists in the form of receiving feedback and advice while treating patients will be beneficial for developing professional skills and gaining valuable experience.73,74 Opportunities for professional development can be enhanced by introducing accessible training programs and conferences and encouraging psychiatrists to partic- ipate in them, expanding opportunities for research by conducting research in their field and publishing their results, creating and pro- moting mentoring programs to deepen knowledge and improve skills. In addition to professional aspects, it is important to intro- duce students to effective self-help methods and techniques for managing stress and preventing emotional burnout in psychiatric in-service training programs.75,76 It is important that these pro- grams are accessible to practicing psychiatrists and that the mate- rials are updated in accordance with changes in their relevance. Kilic et al.77 investigated the role of gender as a barrier to the professional development of psychiatrists. The authors conducted a survey among psychiatrists in 35 European countries and found that, compared to men, women were more likely to report gender discrimination that directly or indirectly affected their professional advancement. At the same time, it was noted that in the institutions where psychiatrists studied or worked, measures aimed at address- ing existing gender biases were not regularly and extremely rarely taken. Agreeing with the authors’ conclusions about the impor- tance of institutional support for states to eradicate prejudice, cre- ate equal conditions for professional development, and create a respectful environment for psychiatrists of all genders, we can add that creating safe and inclusive conditions for psychiatric doctors, regardless of their age, race, religious beliefs, and sexual orienta- tion, is important not only in terms of respect for human rights and freedoms in medical institutions but also for the development of the industry as a whole, as discrimination on certain grounds is a major threat to the health of the population. An important step to improve the professional satisfaction of doctors in psychiatric wards is to support mental health.78 This can be done in several ways: i) developing and providing access to mental health improvement and recovery programs; ii) organising support groups where psychiatrists can share problems, find sup- port, and get useful advice from colleagues; iii) introducing inte- grative medicine methods such as yoga, meditation, acupuncture, and other methods for relaxation and stress reduction. Increasing recognition and respect for the profession can be achieved by raising awareness of the importance of psychiatrists’ work and their contribution to the mental health of the community, encouraging public recognition of achievements, lobbying for the interests of the psychiatric community through political, public, and professional organisations, increasing the authority of doctors through the introduction of projects and initiatives useful for pro- moting the work of psychiatrists, and combating the stigma of mental illness.79,80 Ran et al.81 conducted a systematic review of the level of mental illness stigma and factors that influence it in the Pacific region. According to the study, the level of public stigma in the region ranged from 25.4% to 85.2%. Among the factors that influenced the formation of a fairly high level of this indicator, sci- entists have identified collectivism, responsibility, and a sense of shame for certain differences perceived by the conservative com- munity as deviations, imposed values of “normality”, belief in the supernatural, and religious beliefs. Despite the differences between the cultural aspects of the Pacific and European regions, it is pos- sible to see overlaps between the factors that develop stigma in both regions. In Western and parts of Eastern Europe, Catholicism has long played an important role in shaping social norms and val- ues that contributed to the stigmatisation of mental disorders, emphasising the patient’s responsibility for their condition due to moral weakness, obsession, or a sinful lifestyle.82 However, given the civilisational changes that have also affected such a conserva- tive field as religion, the influence of the church can be used to combat the stigma of mental illness. The current level of education of the clergy makes it possible to properly understand the nature of mental disorders and spread awareness among believers, encour- aging them to abandon false stereotypes and to understand and treat people with mental problems appropriately.83 When looking for ways to increase the level of professional satisfaction of psychiatric doctors, it is important to understand that there is no one-size-fits-all approach to ensuring it. It is impor- tant to focus on the needs and priorities of different groups of psy- chiatrists, regularly communicating and collaborating with them. The job satisfaction and enthusiasm of psychiatrists are essential for maintaining and improving the mental health of the population, and therefore improving it is one of the most important tasks of the psychiatric field. Conclusions The study discovered that, while burnout and stress are sub- stantial challenges for psychiatrists, they are not the only factors determining job satisfaction. Significant factors such as profes- sional development opportunities, work-life balance, and institu- tional support were regarded as equally essential for job satisfac- tion. In areas with well-established mental health policies and strong social support for mental health, these variables strongly lead to better levels of work satisfaction and professional content- ment among psychiatrists. An analysis of the level of professional satisfaction of psychi- atrists in Poland, Europe, and the world has shown that in terms of salaries and human and material support of the psychiatry sector, the world’s countries with a high level of social and economic development are the most satisfied. Polish psychiatrists expressed lower levels of job satisfaction than their peers in Western European and Scandinavian nations. This inequality stems from disparities in funding allocation, professional recognition, and working conditions in psychiatric departments. The research demonstrates the need for a more comprehensive approach to resolving these imbalances, arguing for increased investment in mental health services, improved working conditions, and more opportunities for professional development and advancement. Several ways are proposed for increasing psychiatrists’ profes- sional satisfaction. These include increasing the number of staff, optimizing administrative tasks, improving working conditions, fostering a positive atmosphere through programs, increasing opportunities for professional development through training and mentoring, and promoting mental health recovery through support groups and integrative medicine. Social projects can also enhance recognition and respect for psychiatrists by raising public aware- ness of their role in preserving and improving society’s mental health. Since professional satisfaction is an indicator that can change Social and political factors affecting public health [page 116] [Healthcare in Low-resource Settings 2024;12(s2):12906] Non -co mmerc ial us e o nly depending on many factors, it is necessary to constantly update rel- evant information. The study’s limitation was the lack of statistical data on satisfaction indicators for psychiatrists in Poland, Europe, and the world, affecting the sample size and analysis depth. 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