Table 1.

Summary of literature on burnout and leadership style

	Why?	Where?	Who?	When?
Authors (year published)	Study aim	Setting	Subjects/sample size	Year study conducted	Outcome	Leadership style	Key findings
(Webster & Hackett, 1999)	This study investigated whether specific components of burnout in clinical staff in community mental health agencies was related to aspects of leadership behavior and quality of supervision of clinical supervisors.	Community mental agencies	151 clinicians	Not specified	Staff burnout (all three dimensions)	None explicitly stated, but items in the Leadership Practices Inventory Scale (LPI) correspond to transformational leadership	(i) Leadership style and supervisor rating were inversely related to emotional exhaustion and depersonalization components of burnout, (ii) No relationship between personal accomplishment and leader behavior.
(Corrigan et al., 2002)	This study examines the relationship between transformational, transactional and laissez-faire leadership styles and measures of organizational culture and staff burnout in mental health services teams.	Mental health teams in state hospitals and community mental health programs	236 leaders; 630 subordinates	Not specified	Staff burnout (all three dimensions)	(i) Transformational leadership (ii) Transactional leadership (iii) Laissez-faire leadership	(i) Leaders who saw themselves as transformational also saw their organizational culture as cohesive and transformational. (ii) Subordinates who viewed their organizational culture as transformational also viewed their leaders as charismatic and transformational, but those who viewed their culture as transactional were less likely to rate their leaders as charismatic. (iii) Leader and subordinate responses showed that burnout was negatively associated with transformational and charismatic leadership.
(Kanste et al., 2007)	The purpose of this study was to explore the relationship between multidimensional leadership and burnout among nursing staff.	Health care organizations, including psychiatric hospitals	601 nurses	2001-2002	Staff burnout (all three dimensions)	(i) Transformational leadership (ii) Transactional leadership (iii) Laissez-faire leadership	(i) Rewarding transformational leadership was negatively correlated with emotional exhaustion and depersonalization (ii) Passive laissez-faire leadership negatively related to emotional exhaustion and depersonalization. (iii) Active management-by-exception positively correlated with personal accomplishment. (iv) Passive laissez-faire leadership associated with emotional exhaustion in temporary nurses, rewarding transformational leadership protects temporary nursing staff from emotional exhaustion.
(Broome et al., 2009)	This study explores counselor views and the impact of organizational context in outpatient drug-free treatment centers.	Outpatient drug-free treatment centers	550 counselors and directors	2004-2005	Counselor’s perceptions of burnout, leadership, and job satisfaction	None explicitly stated. Survey of organizational functioning (SOF) tool used in the study includes measures of transactional and transformational leader behaviors.	(i) Leadership was significantly negatively related to burnout. (ii) Director leadership was a protective factor in the relationship between counselor caseload and burnout.
(Crawford et al., 2010)	The purpose of this study is to examine levels of burnout among staff working in community-based services for people with personality disorder (PD) and to explore factors which add to or lower the risk of burnout among people working in such services	Community-based treatment centers for people with personality disorders.	89 workers from 11 centers	Not specified	Staff burnout (all three dimensions)	None explicitly stated	(i) Teamwork and leadership support are essential to maintain good working conditions and support for staff. (ii) The best leadership style was dependent on the nature and needs of client and staff groups. (iii) External supervision essential for the team success.
(Aarons et al., 2011)	This study examined leadership, organizational climate, staff turnover intentions, and voluntary turnover during a large-scale statewide behavioral health system reform	Behavioral health agencies under safety net institutions	190 participants from 14 agencies	2006-2007	Voluntary turnover	Transformational leadership	(i) There was a negative relationship between transformational leadership and demoralizing organizational climate in high stress organizations. (ii) Relationship between transformational leadership and turnover intentions were fully mediated by empowering climate. (iii) There was a positive relationship between turnover intentions and voluntary turnover.
(Green et al., 2013)	The purpose of this study was to examine the relationship between transformational leadership, emotional exhaustion, and turnover intentions among public sector mental health care providers	Public sector mental health programs for children, adolescents, and families	388 community mental health providers	Not specified	Emotional exhaustion, turnover intentions	Transformational leadership	(i) Emotional exhaustion was significantly associated with turnover intention. (ii) Controlling for emotional exhaustion, the relationship between transformational leadership and turnover intentions became non-significant. (iii) Transformational leadership moderated the relationship between emotional exhaustion and turnover intention.
(Green et al., 2014)	This study examines the influence of demographics, work characteristic, and organizational variables on levels of burnout among child and adolescent mental health service providers operating within a public sector mental health service system	Public sector mental health programs	322 clinical and case management providers	Not specified	Staff burnout	Transformational leadership	(i) Leadership and organizational variables had significant moderate to large correlations with burnout. (ii) Higher levels of transformational leadership was associated with greater personal accomplishment.
(Madathil et al., 2014)	This study examined the relationships between leadership style of psychiatric nurse supervisors, work role autonomy, and psychological distress in relation to psychiatric nurse burnout	Hospitals in the New York State Office for Mental Health and one psychiatric hospital in a different state	89 nurses	2009-2010	Staff burnout	Transformational leadership	(i) Autonomy and transformational leadership were significantly negatively associated with emotional exhaustion and depersonalization, and significantly positively associated with personal accomplishment. (ii) Transformational leadership is a significant mediator of the relationship between depressive symptoms and personal accomplishment. (iii) Moderating relationship of workload on transformational leadership and autonomy, and burnout was not statistically significant.
(Bijari & Abassi, 2016)	The aim of this study is to determine the prevalence of burnout and associated factors among rural health workers in the health centers of Iran	Public Health Centers (PHCs) providing a range of primary care services, including mental health and occupational health services	423 rural health workers	2012-2013	Staff burnout	None explicitly stated	(i) High stress and dissatisfaction from poor supervisor oversight were associated with burnout. (ii) Burnout was more prevalent in this study than in prior studies conducted in the region.
(Yanchus et al., 2017)	This study examined predictors of turnover intention or an employee’s cognitive withdrawal from their job, in a large sample of direct care mental health professionals	Veteran’s Administration	10,997 mental health employees	2013	Emotional exhaustion, turnover intentions, turnover plans	None explicitly stated	(i) Supervisory support and job satisfaction were negatively related to emotional exhaustion. (ii) Job satisfaction and supervisory support negatively related to turnover plans. (iii) Emotional exhaustion significantly positively associated with turnover intentions.