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
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.
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.||en