Burnout, depression and job satisfaction in acute psychiatric and secure mental health settings

Abstract

Chapter 1: Objective: The systematic review aimed to review the literature on burnout and its relationship to depression within the acute in-patient mental health services: psychiatric units and specifically, secure forensic mental health services. Methods: The review process included a systematic search across five databases (Medline, PsychINFO, Cinahl Plus, EMBASE and SCOPUS). Eligible studies included a cross-sectional design, using validated measures on burnout and depression. Results: A strong relationship between depression and emotional exhaustion was found. The relationship between depression and two other burnout dimensions (personal accomplishment, depersonalisation) was weaker and better explained in the context of other predicting (anxiety) and mediating (transformational leadership) variables. While depression severity across the studies was mostly mild with average burnout, service-specific variations were observed. Chapter 2: Objective: The empirical study aimed to explore any direct relationships of subjectively perceived understanding, predictability, control (job demands) with burnout and job satisfaction, and direct/in-direct effects of social support, psychological mindedness and psychological inflexibility (external and internal resources) on these relationships. Methods: Data was collected among Scottish National Health Service (NHS) employees (n=198) working in secure mental health services; forensic (58.65%) or intellectual disability (41.35%). Data gathered from the final sample of 141 nursing staff was analysed using t-tests, bi-variate correlations, hierarchical regressions and a series of mediation, moderation and moderated-mediation analyses. Results: The empirical study revealed that individual burnout dimensions were predicted by different job demands. Social support appeared as predictor rather than a moderator of job satisfaction and emotional exhaustion while psychological inflexibility was a mediator for job demands and burnout. Overall Conclusions: Concluding remarks for both, systematic review and empirical study, identify the need for further research, especially within the forensic mental health speciality. Both highlight that direct and in-direct effects may be important in explaining burnout while the empirical study makes further suggestion with regards to likely individualised pathways and two important resources of social support and psychological flexibility.