Coping, Mental Health, and Subjective Well-being among Mental Health Staff working in Secure Forensic Psychiatric Settings: Results from a Workplace Health Assessment

Abstract

Given raised rates of patient suicide and violence in secure psychiatric facilities, staff in such settings are arguably at increased risk for burnout and reduced mental health. The present paper responds to the recent UK National Institute for Health and Care Excellence (NICE) call to assess workforce well-being. This paper held the following aims: (1) to quantify existing levels of mental health (i.e., depression, anxiety, distress, and post-traumatic stress) and subjective well-being (i.e., job satisfaction, life satisfaction, and four domains of burnout), and (2) to evaluate Coping Self-Efficacy (CSE) and Need for Affect (NFA) as factors associated with staff mental health and subjective well-being. We conducted a voluntary cross-sectional health needs assessment of forensic mental health staff (N=170) between 2017 and 2018 from one National Health Service (NHS) Trust. Descriptive findings suggest staff possessed non-clinical average ranges of mental health symptoms. Subjective well-being findings showed burnout was relatively low, whereas job and life satisfaction were modest. Regression models demonstrated that: (a) thought/emotion stopping beliefs were negatively associated with psychological exhaustion; (b) social support beliefs were positively associated with life satisfaction and job enthusiasm; (c) NFA Avoidance was linked with poor mental health and burnout, and; (d) NFA Approach was positively associated with two health subjective well-being indicators. Overall, assessment results suggest NHS forensic mental health staff reported relatively good health. Cognitive- and emotion-focused coping beliefs demonstrate promise as content for prevention programming. Using Emotional Labour Theory, we offer psychological services-based recommendations for future prevention programming and research.