Battling Burnout: A Speech Pathologist’s Journey to Innovating Self-Care and Equity in Healthcare with Ed Johnson – The Entrepreneurial Clinician Podcast

Fatigue and being overtired are two of the most common symptoms of burnout. However there can be a much darker side which can have a significant impact on your mental health. In this episode, Jo is joined by Ed Johnson who openly and vulnerably shares his experience of burnout which culminated in a diagnosis of psychosis and PTSD. 

In this episode, Jo and Ed discuss:

• Ed’s journey from being a child interested in language to being the co-founder of a social enterprise designed to provide access for underserved communities to speech pathology and occupational therapy support.
• The struggle (and cost) of juggling multiple projects at the same time.
• The cycle of burnout and (partial) recovery Ed experienced throughout his career.
• The work-related circumstances that led Ed to be diagnosed with psychosis and PTSD.
• How burnout is often focused on the person, not the environment that contributed to it, and
• The importance of speaking up if you are struggling or if you notice behaviour changes in your colleagues.

About Ed Johnson: Ed Johnson is a social entrepreneur and academic with degrees in linguistic anthropology and speech pathology. He worked in rural and remote Australia (mainly in Wiradjuri, Kamilaroi, and Iningai communities) for over a decade as a speech pathologist before moving into academia. Ed completed his PhD in 2021 at the University of Sydney which focused on the phenomenologies of rural families of children with intellectual disabilities, and humanistic digital allied health support delivery and capacity-building with National Disability Insurance Scheme (NDIS) participants across rural and remote Australia. He co-founded his scale-up Umbo, based on the findings to support Australians in underserved communities and populations to access speech pathology and occupational therapy support. Umbo has saved NDIS participants over $8m since its inception and continues to invest 50% of profits into funding services for people who can’t afford to see a therapist.

Ed now lives on Dharug land and is the coordinator of the Remote and Rural Enterprise Program at the University of Sydney which aims to support indigenous and rural communities to create and consolidate sustainable social enterprises in the bush. He lives by the quote from his favourite existentialist, Franz Kafka: “Do what is right, not what is acceptable.”

You can find Ed on LinkedIn here.

Resources mentioned in this episode:

• Future Proofing Health Professional Facebook group 

 If you know you need more support, please visit my website at https://jomuirhead.com

Finally, if you loved this episode, please make sure you subscribe and leave us a review.

Transcript

Jo:

Well, today’s episode of the Entrepreneurial Clinician Podcast fills me with incredible joy because we are going to be speaking to somebody. I have a lot of admiration for whose LinkedIn profile happens to read like an amazing transferable skills analysis. So for all of the rehabilitation counsellors who are listening to this podcast, if you go and find today’s guest on LinkedIn and look at how he has built his career, it is quite phenomenal. And my guest today is Ed Johnson. I’m gonna let him introduce himself to you in a minute. But thank you so much for giving up your time with your new family to come and speak to us today. Ed, thank you.

Ed:

Thanks very much, Joe. It’s lovely to be here. Yeah, I’m on Darug land this morning. The traditional custodians here are the Darug people who have been here for thousands of years, so I understand you are on Darug land as well this morning.

Jo:

Darug lands. Yes, Just up the road in fact. So I think today’s topic is really relevant, to indigenous culture. It’s staying connected with family, it’s staying connected with community and culture. So I’d really like to acknowledge the direct people and, their continued custodianship, of the land where we are sitting today. And I so appreciate you taking that leadership role there for us who can get very busy and very task-focused and forget about where we’ve come from, where we’re standing and just helps us orient ourselves in time and place, which I think is something that the traditional custodians of our land can teach us.

So Ed I’ve given you a little bit of a wrap about your your career, but can you share with us what you studied at university, what your career’s been like, and what you do for work today?

Ed:

Yeah, so I’ve taken sort of a little bit of a roundabout route to where I am today. I started off studying anthropology and linguistics and absolutely have always loved learning about culture and learning about languages since I was a little boy growing up around a dad who, is a bit of a polyglot and speaks lots of languages. So I was always looking at books about languages, but also looking at books about biology and anatomy and all those sorts of things. And at the end of my degree, I really wanted to go into the helping professions. I wanted to apply the knowledge that I had in anthropology and linguistics to help people make their lives better. And so I studied speech pathology and after that I spent a number of years working in rural and remote Australia across a range of different rural and remote communities where people really don’t have a lot of health services, a lot of community services, a lot of social services.

And that brought me a lot of joy. A few years into that journey, I saw that there were these really stark inequities between what people in metropolitan areas were getting in terms of these services and the services available to people in the bush. So I went to study for a PhD and I looked at the experiences of families, of children with intellectual disabilities and what made a good life for them and how we could help to improve that further to see what they wanted and how they wanted that to be. So that sort of looked at different service delivery models for allied health but also in the context of the policy of a really big shift in social policy in Australia, which was the National National Disability Insurance Scheme which in a sense privatised the disability and social services sector in Australia, moving from sort of government administered services for people with disabilities to a market-based system where each person or family would have a certain amount of money allocated to them, and then they would spend that as they wanted. But the issue with that is that in a remote community, you don’t necessarily have a service there to be able to spend it on. So the market-based system, and this is probably a topic for another chat <laugh>, and I think you’ve probably chatted about it a little bit before on the podcast, but it means that there’s this big sort of vacuum and a lot of difficulty with a market-based system that works for metro areas and doesn’t work in the bush necessarily as well.

So off the back of that PhD I was approached by my co-founders who were really interested in similar sorts of work and community development and said, would you like to start a social enterprise, a telepractice social enterprise where we can sort of fill the gaps for people in these remote areas where they don’t have in-person services to sort of capacity build in those communities. And six and a half years later, where we are now sort of servicing people all over Australia and, who knows, maybe overseas in future as well where they can’t get occupational therapy and speech pathology services otherwise, or whether or where that creates convenience for them or allows them to sort of get services more quickly than they would otherwise.

So I learned a lot about social enterprise in those six years. And I dabbled in academia throughout my speech pathology career teaching in speech pathology. Late last year, I took the jump out of sort of allied health and went into lecturing about social enterprise and now work at the University of Sydney as my day job lecturing in social enterprise. And I run a program called the Remote and Rural Enterprise Program where we partner with organisations and communities in rural and remote areas and indigenous enterprises and we help them to work on social issues that they have or elements of a social enterprise that they have to help create more sustainable and prosperous futures for those communities and individuals and enterprises. And it’s really fulfilling and I feel like it’s not too far away really from where I started in terms of trying to work directly with the community to figure out what they want, what’s important to them, and try to help them to get towards that goal.

Jo:

Wow. So I’m just listening to it going, so we’ve got this young kid who grew up in regional New South Wales, where there’s lots of bush around, lots of <laugh> paddocks, maybe some wind turbines, who knows? And you became fascinated with language and people and communities. And then you went, how do I help people? So you studied speech pathology and you started helping people, and then you went, how do we make this more equitable? How come there are people in the bush who don’t get the same services as people in the cities? That’s not okay. So you built some co-founders, and then you built a whole social enterprise out of that, which I know at times was heartbreaking. <Laugh>, I went on that journey a little bit with you guys. And then you went, ah, we actually need to start to let people know that there’s a model out there that can work, and let’s go back to the people of the land and ask them what they want, rather than the adage of health professionals, which is, do what I say. ‘Cause I’m the expert <laugh>.

So that’s marvellous. I always wanted to be a speech pathologist but I didn’t quite get that ATAR marks back in the day, and the thought of going and doing a degree just made me feel really ill. So I’m a rehab counselor instead. So I have this incredible obsession for speech pathologists and everything that you can offer the world, but you’ve had a lot going on there. And you were doing more than one thing at a time, right? You didn’t kind of stop your speech pathology, clinical job and then go to an academic job and then go to a founding job. You were kind of blending these things together. Would that be an accurate way to describe that?

Ed:

Yeah, absolutely. And at times became obsessive and it was a core part of my identity that I needed to help. I needed to help as many people as I could, and I needed to do that as efficiently and as effectively as I could. So I was not jumping from one thing to the next, but sort of transitioning slowly and not necessarily intentionally, but I would pick up a new project. You know, I was working full time and then I picked up the PhD on the side, and then I picked up volunteer jobs. Then I was taking leave from my job to go and volunteer at the hospital and then I was volunteering on boards. And it really sucked up a lot of my life. And it meant that I didn’t have time for the other good things in life as much like family, friends socialising, community sport, all those things that really bring people joy. And I think that that was something that I didn’t understand at the time but I understand a lot better now. I think about myself.

Jo:

Yeah. Great. What a thank you for sharing that so openly and vulnerably because I know my journey since 2020 has been all about ‘if I can’t do this thing called allied health anymore, who am I? What purpose do I serve?’ And it’s kind of been a little bit of an existential crisis, but then it’s gone right down into this whole sense of self and realising some insecurities that sit there. So I appreciate you bringing that up so quickly in our interview today. So I would like to ask, in amongst all of that you were doing, do you think you ever experienced something that you might now reflect on as burnout or a period of time when work was unhealthy? Can you describe that for us?

Ed:

Yeah, absolutely. Several times I would go through this cycle of burning out and then recovering a bit and then working up and up and up in terms of the capacity that I felt I had, but I didn’t really, and then sort of breaking down again and not knowing how to manage it all. Probably the best example was fairly early on in my career I was working as a sole practitioner. I was working within a large institution, a residential facility for people who had intellectual disability and mental illnesses, sort of chronic, longstanding mental illnesses and it was a really, really challenging environment to be in because it was in the middle of the countryside, there were really cold nights where I’d be sort of working late and tramping down down the road to the next building, to the ward. And you’d walk into the ward and it would smell. You’d walk past the kitchen and it just had that horrible sort of odour that those kitchens do sometimes in an aged care facility or somewhere there was shouting and yelling from nurses. There was shouting and yelling from the residents living there. And my job as the only allied health person there was to try to work with these residents to try to get them back into living in the community. So supported living in the community because this institution was devolving and sort of going out of service really. And a lot of the nursing staff there have worked there for decades. And when, you know, a young, 24, 25year-old Ed walked in and asked them about their client and the bosses had said, we need to try to figure out how so and so can get back in the community and what that means in terms of communication and mealtimes. They were often very resentful. I would have people just refusing to talk to me, just looking me in the face and walking away, I’d have people yelling and screaming at me. I didn’t mind that when that was the residents because that was their way of communicating. But the nursing staff had different abilities that they should have been using to communicate in a more socially acceptable way. But that was a lot on my shoulders.

And I just kept working more and more and more to try to build connections, to try to help the residents. And because of the shift work that was involved with the nurses, a lot of them didn’t know who I was. So I’d turn up on the ward and they’d tell me to get out, or they didn’t know who I was, or they’d say, get away from so and so when I had spent months with them trying to work on a particular way of communicating. And then it just completely destroys all that work because they’d get overwhelmed and meltdown and start growing and kicking and hitting things again. So it was tough and I felt very alone. And I thought the best way to get it better was to sort of try to do as much work as I could so I could get these people out into the community living in more supported settings.

And I saw a lot of mental illness in there. I saw a lot of people who had very longstanding schizophrenia, PTSD, and depression. A lot of complex trauma in there. And I was surprised, I suppose, or maybe I wasn’t so surprised when I started seeing some of these things in myself. And when I was at home, I wouldn’t know what to do with myself. I could just sit in the one spot. I needed everything to be clean. I needed everything to be tidy and in the same spot, otherwise I didn’t know what to do with myself. And even at the severe end, I started seeing things that really weren’t there. And probably the scariest thing was that I wasn’t scared of that because I just wanted to get through it. I just wanted to say, well you know, I’m seeing spiders on the walls, or I’m seeing a man following me around the house who I know is not there. And my pragmatic mind was thinking, well, I know I can see these things and I know they’re not real, but really that doesn’t help me get my work done. So it’s not useful to engage with it. And at one point started hearing voices and that’s probably the time when I called my parents because I was living alone at the time, and I said, I don’t think I’m coping. I don’t know what’s going on. But I think need help with this. And I saw a psychiatrist, I saw a psychologist for quite a while too. And I’d had anxiety and depression for a long time before that, but was well managed. But they gave me these diagnoses of psychosis, OCD and PTSD. And at the time it was just sort of well, okay, I’ve just got this, so I have to deal with it now, but I’ll just put it on the side until I can get my work done and be a success.

Jo:

Oh, that’s interesting. I’m not saying this to be judgmental, of course, but they’re quite extreme symptoms. Like when most of us think of burning out, we think of being fatigued or overtired, or in my case, hoping I get hit by a bus or <laugh>. ’cause that turned up for me as well. It’s rare that we hear somebody talk about the fact that your mental health really started to deteriorate in such a significant way. It’s very easy in this day and age for us to go self-care and burnout is the responsibility of the person, right? We see a lot of language around, if you do these five things before 5:00 AM you won’t burn out. If you join the 4:00 AM club, you’ll be fine. Drink five litres of water. It’s all about the person, the person, the person. But I’m curious because you were in an environment that was considerably unhealthy, how do you now make sense of being a health professional in such an unhealthy environment? Do you have any insights there?

Ed:

Yeah, yeah. It was tough. And I’m very, very introverted. I don’t take the opportunity to go out and have a chat with people I don’t like. I’m very happy to sit in silence on a four-hour car trip with someone next to me. And I will not feel that pull or the weight of the silence at all. So I think people at work didn’t realize what effect it was having on me. So we had a small team of management and policy and project-type people. And when they saw me, they probably didn’t see that, and I can reflect on that now. I mean, they would’ve seen that I was seeming tired and not willing to have a joke that much.

But I very much had my work mask on and sort of felt that they’re getting through it, so I should be able to as well. But I think once I did bring it up with my boss, and she had worked there as a nurse before she had gone on and done other things and come back to this place. But, so she understood the culture that was in there, but she was a very supportive person. She was very supportive of me. And I’m very, very grateful for that. But I don’t think she saw that at the time. And when I did tell her this, she said, you’ve gotta take time off. You’ve gotta not work past this particular hour. There’s always going to be work here. And so I think it comes back to this. You’ve just gotta talk about it. You just have to force yourself to talk about this stuff. And that’s where you find the strategies then, because you talk to someone who has been through it, you might not see it on their face, or you might not know it before about this person, but everyone’s gone through tough times. Or if they haven’t, then they’ve done something amazing to not have to go through hard times. And they have a way of doing that. And so I think just those initial conversations that I had to force myself really hard to have with people to say, I’m feeling really terrible and I’m not fine. I would say that’s the number one piece of advice that I would give people in that situation. And each person is going to need different strategies to get better or to stay well. I don’t really subscribe too much, you know, there are five things you can do to stay well,

Jo:

<Laugh>. Oh, no, I don’t either. <Laugh>

Ed:

There may be five things that each person can do but they’re gonna be five different things for every single person in the world.

Jo:

Yeah, absolutely. I really appreciate those insights. I’m trying to imagine what it would’ve been like to be in your mid-twenties, incredibly introverted. Like you’ve described a male in a very female-dominated environment, having to go to your boss and say, despite how good my work is, and despite the fact that I’m here all the time, I feel really awful like that. That shows an incredible amount of courage. Can you remember what your heart was doing or your body was doing that day? Or were you just so flat that you were like, I’ve just gotta do this, I’ve just gotta function?

Ed:

Oh, no, I, I was shaking. I had a lot of the sort of physical symptoms of anxiety. You know, it felt like my heart was racing. My breath was shallow. I felt sweaty and jittery. And at that point in time, your brain doesn’t know how to use words, you know, you’re functioning on your limbic brain. You’re not using your forebrain. You don’t know what to say. So sometimes it’s best to write it down. I don’t think I did write it down then. I think I just sort of tried to sort of stumble my way through it. But she understood the basic message of what I was trying to get across in the end.

Jo:

Yeah. And I think that’s a really important point to bring up. We as employers or colleagues who care about each other, when we start to notice behaviour changes in our colleagues. So when I start to get overwhelmed and burnt out, I don’t cry my first, I get angry and I micromanage. So that’s really uncomfortable for people around me, right? Because they’re ugly behaviours. And I’ve been in enough organisations now to help people understand <laugh>, that guy over there that you all think is a horrible, horrible person is hurting badly. He turns up 10 minutes early to everything and then berates you for half an hour because he’s trying to assert some control ’cause he’s feeling so outta control, which is much harder behaviour to deal with than the I’m crying in the cupboard, or I’m going to the bathroom 25 times in an hour, or I’m just not turning up to work. So I think, you know, recognising that when people come to us to talk about some of this stuff, we’ve gotta let go of our functioning brain and go, wow, this person has done an incredibly courageous thing today. The best thing I can do is be present with them now.

So you’ve done something that I’ve never been able to do, and that is work in academia, but I’m curious to know in your career, have you seen changes in our workplace systems or our social systems or our expectations in the workplace that might be helpful to allow people to talk about that I’m not coping at work or harmful for people to be able to talk about. I’m just curious because you’ve been involved in some fairly big organizations. 

Ed:

Yeah, I don’t think I’ve ever been involved with a business that has said anything bad about mental health or even to the opposite end. They’ve all promoted social and emotional well-being at work from that organizational level. But I think the issue is with how that filters down and how the culture is created at the top of the organization and that manifests differently in different organisations. I think at my company, we do try very hard to get feedback on a regular basis from people about workloads, about wellbeing and make sure that people are seeing the leadership team working manageable workloads. We don’t always get that right.

But it’s difficult in a startup sort of context, but there’s a lot to be said for actually being open and honest about when you’re getting that right and when you’re not getting it right. And giving everyone in the organisation the same level of input into talking about what they need for social and emotional wellbeing. And we’ve got an employee assistance program that’s I think reasonably well used. We have different communities of practice and different interest groups within the organisation that focus on particular events or particular groups. So neurodiversity, Indigenous communities, LGBTQI plus communities and trying to just support and make it a safe space for everyone.

And that’s not directly talking about burnout, but what it does do is it allows those people to communicate in the way that they need to so that they can talk about things like burnout. And that’s why I think that that’s important from that burnout perspective. So in the larger institutions like universities, I think it’s very variable in terms of the team, in terms of the level of protection that your direct manager can give you. Because it’s a matter of sometimes the directions coming from on high to say, well, we need more work out of your team. And then the manager says, you know, well, you guys gotta do more work. But a really good manager is someone who is basically removing roadblocks along the way for you and letting you do your own work your own way.

And the really good managers that I’ve had in my time are people who have done that. They’re not telling you how to do things. They’ve hired you because you have a certain particular expertise in an area. And so what they need to do is to get things out of your way. And sometimes that might be unreasonable workload expectations. So I’ve had managers help me with that before, just basically saying to senior management, this is an unreasonable amount of work. And going into that and saying, well, these are the things that we need in terms of resourcing for the department and coming and reporting to me that you are to stop work at this time. You are only to work on these projects because I want your best work because that’s why we have you here for your best work. Not for you to do a really average job on too many projects.

Jo:

Oh, well, wow. I can’t wait for the transcription of that. You’ve just given so much great insight there. Number one, if you a manager or a leader inside of a business, creating a safe space for people to be able to come and talk to you. That doesn’t mean you need to be everybody’s counsellor by the way, but creating a way that people can come and talk to you ’cause it’s probably gonna look different to everywhere else. Nobody wants to be called into the principal’s office <laugh>. So it’s finding another way to be, especially for the really introverted people who are highly dedicated to their work and terrified that they’re gonna be told they’re doing a bad job. So how else can we create opportunities for people to have genuine conversations and feel safe enough to go, this workload is hard for me.

And our initial response as the leader is not to go, why is it so hard for you when everyone else can cope with it? I just need the bills paid. But asking the question, what makes this hard for you? But then also being able to understand you are not gonna get it right all the time. I love the way you said that, Ed. It’s like, we often have conversations here at Ambo, we’re trying to get this stuff done, and we don’t always get it right. So I think as leaders and managers, we need to give ourselves some grace. To go, oops, I got it wrong. What could I have done better? What could I have done better? So wrapping this up, I’d like to ask you now, with all of this history, and you’ve been doing this work a long time and you’ve got some things under your belt, what makes work good for you, Ed?

Ed:

I think it’s one thing and that is the people. So having really supportive people around you, like, the manager who moves the roadblocks but also the people working in your team directly who have different perspectives, who you learn from, those inspiring people that you come across and you have a really interesting conversation with them in the tea room. And you think, wow, I never knew anything about that before. Never. That never even crossed my mind. So those really inspiring people who just bring warmth to the room and to the team, and I don’t mean that by those people who are out there, you know cracking the jokes necessarily. And, you know, bringing, bringing everyone together in that way.

There are definitely those people, but also the quieter people who have these amazing insights that just come from left field and just make your workday better. Sometimes they contribute directly to your work, sometimes not. But I think just being in that creative mood for me is really important. And I think also my career is about trying to connect the dots. It’s about looking at not just one sort of area or one project. It’s looking at how individuals, families, and communities are all connected and the different parts of the lives they live. So I really love looking at what’s one person’s experience and getting a rich understanding of that, but also what’s the community’s experience? What does that look like in policy? So looking at all how everything is connected and getting perspective from that is really interesting and really sort of drives me in my work and also collaboration. I think it’s going back again to that sense of learning and being inspired by new people. So collaborating on new projects and finding people who are really interested in doing the things that you are doing and potentially doing them in a different way. I think that’s something that will never stop being of interest to me.

Jo:

Fantastic. So I’m hearing building really good connections with the people around you, like work offers us that opportunity. And in this day and age where we have so much mental health from isolation work really does create an opportunity for people to socialise. So that puts a lot of responsibility on us as workplaces, right? To create those connections for people. Like you were saying before, your boss wanted you there to do your best work, not average work over a range of projects. I love that. I wish somebody had said that to me some time ago, but allowing that sense of connection and connectedness, which doesn’t always need to be in the same room with the same people. I mean, we’re getting better at being able to do that online as well. But there’s also this incredible sense of going back to something fundamental to you as a younger person, which was, I love people and I love to learn. I wanna see how people and learning function and joining the dots for people. I know for, for me, I come back to this sense of, I think people are amazing, and sometimes they just have a crappy understanding of how they turn up in the world, <laugh>. And I wanna help change that as well. That’s really cool. 

So, Ed, I wanna say a big thank you for this. I think it’s been incredibly insightful. We went to places I wasn’t expecting today. So again, thank you for your vulnerability and your willingness to share with us now, when we can make the massive divide between where we are, which is about 10 minutes down the road, and we meet each other in a cafe where hopefully I get to meet Lucas. What will I be ordering for you at the cafe?

Ed:

I’m a pretty cheap date Jo. Just a cappuccino for me. No sugar, no special milk, no special order. The barista usually asks me, no sugar, no milk, no nothing? I think they get surprised that my order’s so simple, but yeah, I’m easy to please.

Jo:

Yeah, you are ’cause you’re boy from the bush <laugh>, which in this episode, for people who may not understand means the outback, it means rural and regional Australia. So get your mind out of the gutters for the rest of you who weren’t thinking that at all. <Laugh> <laugh>. 

So this has been the Entrepreneurial Clinician Podcast. We look forward to welcoming you to our next episode, where we’re gonna delve deep into all things burnout, self-care, and what you can be doing to make your workplaces safer for your people. Until next time, go be your awesome self.