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Tepper MC, Le Beau M, Clark G, Thorning H, Pope LG. Barriers and Facilitators to Staff Recruitment and Retention for ACT Teams: Perspectives of Staff and Participants. J Behav Health Serv Res 2024; 51:499-515. [PMID: 39134898 DOI: 10.1007/s11414-024-09898-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2024] [Indexed: 10/02/2024]
Abstract
The behavioral health workforce has been experiencing deepening problems with recruitment and retention, particularly in publicly funded settings serving individuals with serious mental illnesses. This quality improvement project gathered Assertive Community Treatment (ACT) participant (service user) and provider perspectives on workforce challenges. The authors conducted 8 interviews with ACT participants and 9 focus groups with ACT current staff, team leaders, and former staff. Interviewees discussed barriers to recruitment and retention, including inadequate compensation, work becoming more task-oriented during periods of short staffing, a lack of understanding of what ACT work entails, and elements of the team-based model of care; and facilitators of recruitment and retention, including other aspects of the team-based model of care, connections with colleagues and ACT participants, and flexibility. ACT participants had variable experiences regarding availability of their teams. Recommendations from focus groups and interviews include increasing flexibility, improving awareness of ACT work, optimizing team functioning, addressing staff wellness, and attending to risk. Findings include key insights that may help address the critical workforce shortages in public behavioral health settings.
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Affiliation(s)
- Miriam C Tepper
- New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, Pardes 1710, New York, NY, 10032, USA.
| | - Mariah Le Beau
- New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, Pardes 1710, New York, NY, 10032, USA
| | - Gary Clark
- New York State Office of Mental Health, New York City Field Office, New York, NY, USA
| | - Helle Thorning
- New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, Pardes 1710, New York, NY, 10032, USA
| | - Leah G Pope
- New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, Pardes 1710, New York, NY, 10032, USA
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Werkmeister B, Haase AM, Fleming T, Officer TN. Environmental Factors for Sustained Telehealth Use in Mental Health Services: A Mixed Methods Analysis. Int J Telemed Appl 2024; 2024:8835933. [PMID: 39314675 PMCID: PMC11419844 DOI: 10.1155/2024/8835933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 04/10/2024] [Accepted: 07/08/2024] [Indexed: 09/25/2024] Open
Abstract
Background: The mental health service delivery gap remains high globally. Appropriate telehealth use may increase capacity through flexible remote care provision. Despite the historical lack of telehealth integration into publicly funded mental health services, during COVID-19 lockdowns, services rapidly switched to telephone and audiovisual care provision. In Aotearoa New Zealand (NZ), this was abandoned when no longer required by COVID-19 restrictions. This study explores environmental factors associated with telehealth implementation and ongoing use or discontinuation across a multiregional outpatient mental health service. This work contributes to understanding system-level factors influencing telehealth use and thus informs policy and practice in postpandemic environments. Methods: This mixed methods study applied an interpretive description methodology. Semistructured interviews with 33 mental health clinicians were thematically analysed. Qualitative findings were reframed and evaluated using time series analyses of population-level quantitative data (prior to and throughout the pandemic). Findings were synthesised with qualitative themes to develop an understanding of environmental factors contributing to telehealth use. Results: Findings highlighted an increase in clients assessed by mental health services and declining clinician numbers, contributing to pressure placed on clinicians. There was a lack of culture supporting telehealth, including limited awareness, leadership, and champions to facilitate implementation. Some teams provided services suited to telehealth; other subspeciality teams had limited applications for telehealth. There was a general lack of policy and guidelines to support telehealth use and limited technical support for clinicians unfamiliar with audiovisual software. Conclusion: Disorganised telehealth adoption in the study regions provides insight into wider environmental drivers affecting telehealth uptake. For telehealth to become a workable service delivery mode following COVID-19, stewardship and culture shifts are required, including policy development, technical support, and resources to support clinical teams. Telehealth may address growing service demand by improving interfaces with primary care and providing timely access to specialist input.
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Affiliation(s)
- Benjamin Werkmeister
- School of HealthTe Herenga Waka-Victoria University of Wellington, Wellington, New Zealand
- Department of Psychological MedicineTe Whatu Ora-Health New Zealand, Wellington, New Zealand
- Department of Psychological MedicineUniversity of Otago-Wellington, Wellington, New Zealand
| | - Anne M. Haase
- School of HealthTe Herenga Waka-Victoria University of Wellington, Wellington, New Zealand
| | - Theresa Fleming
- School of HealthTe Herenga Waka-Victoria University of Wellington, Wellington, New Zealand
| | - Tara N. Officer
- School of NursingMidwiferyand Health PracticeTe Herenga Waka-Victoria University of Wellington, Wellington, New Zealand
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3
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Burgess J, Kim HM, Porath BR, Van T, Osatuke K, Boden M, Sripada RK, Wong ES, Zivin K. The Importance of Autonomy and Performance Goals in Perceived Workload Among Behavioral Health Providers. Psychiatr Serv 2024; 75:748-755. [PMID: 38532686 PMCID: PMC11406112 DOI: 10.1176/appi.ps.20230406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/28/2024]
Abstract
OBJECTIVE The authors sought to assess workplace characteristics associated with perceived reasonable workload among behavioral health care providers in the Veterans Health Administration. METHODS The authors evaluated perceived reasonable workload and workplace characteristics from the 2019 All Employee Survey (AES; N=14,824) and 2019 Mental Health Provider Survey (MHPS; N=10,490) and facility-level staffing ratios from Mental Health Onboard Clinical Dashboard data. Nine AES and 15 MHPS workplace predictors of perceived reasonable workload, 11 AES and six MHPS demographic predictors, and facility-level staffing ratios were included in mixed-effects logistic regression models. RESULTS In total, 8,874 (59.9%) AES respondents and 5,915 (56.4%) MHPS respondents reported having a reasonable workload. The characteristics most strongly associated with perceived reasonable workload were having attainable performance goals (average marginal effect [AME]=0.10) in the AES and ability to schedule patients as frequently as indicated (AME=0.09) in the MHPS. Other AES characteristics significantly associated with reasonable workload included having appropriate resources, support for personal life, skill building, performance recognition, concerns being addressed, and no supervisor favoritism. MHPS characteristics included not having collateral duties that reduce care time, staffing levels not affecting care, support staff taking over some responsibilities, having spirit of teamwork, primary care-mental health integration, participation in performance discussions, well-coordinated mental health care, effective veteran programs, working at the top of licensure, and feeling involved in improving access. Facility-level staffing ratios were not significantly associated with perceived reasonable workload. CONCLUSIONS Leadership may consider focusing resources on initiatives that support behavioral health providers' autonomy to schedule patients as clinically indicated and develop attainable performance goals.
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Affiliation(s)
- Jennifer Burgess
- Center for Clinical Management Research, U.S. Department of Veterans Affairs (VA) Ann Arbor Health Care System, Ann Arbor (Burgess, Kim, Porath, Van, Sripada, Zivin); Departments of Biostatistics (Kim) and Psychiatry (Sripada, Zivin), University of Michigan, Ann Arbor; Veterans Health Administration, National Center for Organization Development, Cincinnati (Osatuke); Program Evaluation and Resource Center and VA Office of Mental Health Operations, VA Palo Alto Health Care System, Palo Alto, California (Boden); Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, and Department of Health Systems and Population Health, Magnuson Health Sciences Center, University of Washington School of Public Health, Seattle (Wong)
| | - Hyungjin Myra Kim
- Center for Clinical Management Research, U.S. Department of Veterans Affairs (VA) Ann Arbor Health Care System, Ann Arbor (Burgess, Kim, Porath, Van, Sripada, Zivin); Departments of Biostatistics (Kim) and Psychiatry (Sripada, Zivin), University of Michigan, Ann Arbor; Veterans Health Administration, National Center for Organization Development, Cincinnati (Osatuke); Program Evaluation and Resource Center and VA Office of Mental Health Operations, VA Palo Alto Health Care System, Palo Alto, California (Boden); Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, and Department of Health Systems and Population Health, Magnuson Health Sciences Center, University of Washington School of Public Health, Seattle (Wong)
| | - Brittany R Porath
- Center for Clinical Management Research, U.S. Department of Veterans Affairs (VA) Ann Arbor Health Care System, Ann Arbor (Burgess, Kim, Porath, Van, Sripada, Zivin); Departments of Biostatistics (Kim) and Psychiatry (Sripada, Zivin), University of Michigan, Ann Arbor; Veterans Health Administration, National Center for Organization Development, Cincinnati (Osatuke); Program Evaluation and Resource Center and VA Office of Mental Health Operations, VA Palo Alto Health Care System, Palo Alto, California (Boden); Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, and Department of Health Systems and Population Health, Magnuson Health Sciences Center, University of Washington School of Public Health, Seattle (Wong)
| | - Tony Van
- Center for Clinical Management Research, U.S. Department of Veterans Affairs (VA) Ann Arbor Health Care System, Ann Arbor (Burgess, Kim, Porath, Van, Sripada, Zivin); Departments of Biostatistics (Kim) and Psychiatry (Sripada, Zivin), University of Michigan, Ann Arbor; Veterans Health Administration, National Center for Organization Development, Cincinnati (Osatuke); Program Evaluation and Resource Center and VA Office of Mental Health Operations, VA Palo Alto Health Care System, Palo Alto, California (Boden); Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, and Department of Health Systems and Population Health, Magnuson Health Sciences Center, University of Washington School of Public Health, Seattle (Wong)
| | - Katerine Osatuke
- Center for Clinical Management Research, U.S. Department of Veterans Affairs (VA) Ann Arbor Health Care System, Ann Arbor (Burgess, Kim, Porath, Van, Sripada, Zivin); Departments of Biostatistics (Kim) and Psychiatry (Sripada, Zivin), University of Michigan, Ann Arbor; Veterans Health Administration, National Center for Organization Development, Cincinnati (Osatuke); Program Evaluation and Resource Center and VA Office of Mental Health Operations, VA Palo Alto Health Care System, Palo Alto, California (Boden); Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, and Department of Health Systems and Population Health, Magnuson Health Sciences Center, University of Washington School of Public Health, Seattle (Wong)
| | - Matthew Boden
- Center for Clinical Management Research, U.S. Department of Veterans Affairs (VA) Ann Arbor Health Care System, Ann Arbor (Burgess, Kim, Porath, Van, Sripada, Zivin); Departments of Biostatistics (Kim) and Psychiatry (Sripada, Zivin), University of Michigan, Ann Arbor; Veterans Health Administration, National Center for Organization Development, Cincinnati (Osatuke); Program Evaluation and Resource Center and VA Office of Mental Health Operations, VA Palo Alto Health Care System, Palo Alto, California (Boden); Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, and Department of Health Systems and Population Health, Magnuson Health Sciences Center, University of Washington School of Public Health, Seattle (Wong)
| | - Rebecca K Sripada
- Center for Clinical Management Research, U.S. Department of Veterans Affairs (VA) Ann Arbor Health Care System, Ann Arbor (Burgess, Kim, Porath, Van, Sripada, Zivin); Departments of Biostatistics (Kim) and Psychiatry (Sripada, Zivin), University of Michigan, Ann Arbor; Veterans Health Administration, National Center for Organization Development, Cincinnati (Osatuke); Program Evaluation and Resource Center and VA Office of Mental Health Operations, VA Palo Alto Health Care System, Palo Alto, California (Boden); Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, and Department of Health Systems and Population Health, Magnuson Health Sciences Center, University of Washington School of Public Health, Seattle (Wong)
| | - Edwin S Wong
- Center for Clinical Management Research, U.S. Department of Veterans Affairs (VA) Ann Arbor Health Care System, Ann Arbor (Burgess, Kim, Porath, Van, Sripada, Zivin); Departments of Biostatistics (Kim) and Psychiatry (Sripada, Zivin), University of Michigan, Ann Arbor; Veterans Health Administration, National Center for Organization Development, Cincinnati (Osatuke); Program Evaluation and Resource Center and VA Office of Mental Health Operations, VA Palo Alto Health Care System, Palo Alto, California (Boden); Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, and Department of Health Systems and Population Health, Magnuson Health Sciences Center, University of Washington School of Public Health, Seattle (Wong)
| | - Kara Zivin
- Center for Clinical Management Research, U.S. Department of Veterans Affairs (VA) Ann Arbor Health Care System, Ann Arbor (Burgess, Kim, Porath, Van, Sripada, Zivin); Departments of Biostatistics (Kim) and Psychiatry (Sripada, Zivin), University of Michigan, Ann Arbor; Veterans Health Administration, National Center for Organization Development, Cincinnati (Osatuke); Program Evaluation and Resource Center and VA Office of Mental Health Operations, VA Palo Alto Health Care System, Palo Alto, California (Boden); Center of Innovation for Veteran-Centered and Value-Driven Care, VA Puget Sound Health Care System, and Department of Health Systems and Population Health, Magnuson Health Sciences Center, University of Washington School of Public Health, Seattle (Wong)
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Childs TM, Iachini AL, Reitmeier M, Browne T, DeHart D, Bengel A, Haynesworth M. Exploring Social Work Practitioners' Perspectives on the Contributors to Burnout since the COVID-19 Pandemic. SOCIAL WORK 2024; 69:142-150. [PMID: 38366254 DOI: 10.1093/sw/swae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 10/30/2023] [Accepted: 11/09/2023] [Indexed: 02/18/2024]
Abstract
Burnout has a historic and disproportionate impact on social workers and is one important contributor to the ongoing health and behavioral health workforce crisis in the United States. Little is known, however, about social workers' experiences of burnout and their perceptions of factors that contribute to burnout since the COVID-19 pandemic. This study sought to explore this by answering the following research questions: (a) To what extent are social workers in South Carolina experiencing burnout? and (b) What do South Carolina social workers view as the top reasons for burnout in their professional role? Seventy social work practitioners and leaders from South Carolina completed an online survey during Fall 2022 that included the Copenhagen Burnout Inventory and an open-ended question focused on identifying their perceptions of the top three reasons for burnout in the profession. Findings suggest that social workers in this study are experiencing moderate levels of burnout since the COVID-19 pandemic and report primarily organizational (83 percent) contributors to burnout. They also identified individual (36 percent), systemic (29 percent), and interpersonal (27 percent) contributors to burnout. Implications are discussed related to policy and practice responses to prevent and address burnout among social workers.
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Affiliation(s)
- Tasha M Childs
- PhD, LMSW, is assistant professor, School of Social Work, University of Missouri-Columbia, 701 Fifth Street, 726 Clark Hall, Columbia, MO 65203, USA
| | - Aidyn L Iachini
- PhD, LSW, is professor and associate dean for research and faculty, College of Social Work, University of South Carolina, Columbia, SC, USA
| | - Melissa Reitmeier
- PhD, LMSW, is director of field education and clinical professor, College of Social Work, University of South Carolina, Columbia, SC, USA
| | - Teri Browne
- PhD, LMSW, is dean and professor, College of Social Work, University of South Carolina, Columbia, SC, USA
| | - Dana DeHart
- PhD, is professor emerita, College of Social Work, University of South Carolina, Columbia, SC, USA
| | - Ala Bengel
- MSW, is HOPE-WWR project coordinator, College of Social Work, University of South Carolina, Columbia, SC, USA
| | - My'Ashia Haynesworth
- is an MSW candidate, College of Social Work, University of South Carolina, Columbia, SC, USA
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5
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Yousefzadeh NK, Dehkordi MK, Vahedi M, Astaneh AN, Bateni FS. The effectiveness of Balint group work on the quality of work life, resilience, and nurse-patient communication skills among psychiatric nurses: a randomized controlled trial. Front Psychol 2024; 15:1212200. [PMID: 38328376 PMCID: PMC10847344 DOI: 10.3389/fpsyg.2024.1212200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 01/09/2024] [Indexed: 02/09/2024] Open
Abstract
Background Balint group training has gained popularity in medical practices as an intervention designed to enhance the quality of life, well-being, and communication skills of healthcare practitioners. Psychiatric nurses, in particular, encounter distinct challenges and stressors inherent in their profession, necessitating the development and implementation of effective interventions to assist them in coping with the difficulties they experience. In this vein, the current study aimed to investigate the effectiveness of Balint group training on quality of work life, resilience, and nurse-patient communication skills among psychiatric nurses. Methods Thirty psychiatric nurses from Razi Hospital in Tehran were recruited via the purposeful sampling method in 2022 and were randomly assigned to either the Balint group, consisting of eight weekly one-hour training sessions, or a control group. Participants completed the Walton Quality of Work Life Questionnaire, Connor-Davidson Resilience Scale, and Communication Skills Scale before and after the intervention. The data were analyzed using the Analysis of Covariance (ANCOVA). Results The study found no significant differences between the Balint group and the control group in terms of quality of work life, resilience, and nurse-patient communication skills. Conclusion Findings suggest that Balint group training was not an effective intervention for improving the well-being and communication skills of psychiatric nurses. However, the study highlights the need for further investigation into the potential factors that may explain the lack of significant gains and offers insights for future research in this area.
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Affiliation(s)
- Negar Kiani Yousefzadeh
- School of Behavioral Sciences and Mental Health, Razi Educational and Therapeutic Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mansoureh Kiani Dehkordi
- Fellowship of Psychotherapy, Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohsen Vahedi
- Department of Biostatistics and Epidemiology, Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ali Nazeri Astaneh
- Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fatemeh Sadat Bateni
- School of Behavioral Sciences and Mental Health, Razi Educational and Therapeutic Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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6
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Mori T, Nagata T, Odagami K, Adi NP, Mori K. Occupational health staff's involvement contributes to supervisor's perceived organizational support in Japanese workforce: a prospective cohort study. J Occup Health 2024; 66:uiae035. [PMID: 38981848 PMCID: PMC11360596 DOI: 10.1093/joccuh/uiae035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 06/21/2024] [Accepted: 07/02/2024] [Indexed: 07/11/2024] Open
Abstract
OBJECTIVES Enhancing employees' perceived organizational support (POS) is crucial for organizations, and one effective approach is enhancing supervisors' POS. However, there is limited research focusing specifically on enhancing supervisors' POS. We aimed to investigate the influence of occupational health staff's involvement for supervisors on their POS. METHODS A prospective cohort study was conducted using an online survey targeting supervisors in various industries across Japan. We assessed supervisors' POS using 8 effective items of the Japanese version of the Survey of Perceived Organizational Support. Data were collected on the involvement of occupational health staff in providing supervisors with training on workplace health management and guidance on addressing specific subordinates with health concerns. The association between this involvement and POS was assessed through multiple regression analyses. RESULTS The study involved 541 supervisors with occupational health staff at their workplace in the final analysis. Training from occupational health staff was significantly associated with an increase in POS at follow-up after adjustment for potential confounders, including demographic variables and POS at baseline. Similarly, guidance from occupational health staff was also significantly associated with increased POS. This effect was particularly notable in small workplaces. CONCLUSIONS Our study indicates that occupational health staff's involvement in supporting supervisors can contribute to enhancing supervisors' POS, especially in small workplaces. These findings suggest that by developing structured systems and establishing specific roles for occupational health staff, organizations may effectively enhance supervisors' POS.
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Affiliation(s)
- Takahiro Mori
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu 807-8555, Japan
| | - Tomohisa Nagata
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu 807-8555, Japan
| | - Kiminori Odagami
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu 807-8555, Japan
| | - Nuri Purwito Adi
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu 807-8555, Japan
- Department of Community Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta 10230, Indonesia
| | - Koji Mori
- Department of Occupational Health Practice and Management, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Japan, Kitakyushu 807-8555, Japan
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Hallett E, Simeon E, Amba V, Howington D, McConnell KJ, Zhu JM. Factors Influencing Turnover and Attrition in the Public Behavioral Health System Workforce: Qualitative Study. Psychiatr Serv 2024; 75:55-63. [PMID: 37386878 PMCID: PMC10756926 DOI: 10.1176/appi.ps.20220516] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Many states are experiencing a behavioral health workforce crisis, particularly in the public behavioral health system. An understanding of the factors influencing the workforce shortage is critical for informing public policies to improve workforce retention and access to care. The aim of this study was to assess factors contributing to behavioral health workforce turnover and attrition in Oregon. Semistructured qualitative interviews were conducted with 24 behavioral health providers, administrators, and policy experts with knowledge of Oregon's public behavioral health system. Interviews were transcribed and iteratively coded to reach consensus on emerging themes. Five key themes emerged that negatively affected the interviewees' workplace experience and longevity: low wages, documentation burden, poor physical and administrative infrastructure, lack of career development opportunities, and a chronically traumatic work environment. Large caseloads and patients' high symptom acuity contributed to worker stress. At the organizational and system levels, chronic underfunding and poor administrative infrastructure made frontline providers feel undervalued and unfulfilled, pushing them to leave the public behavioral health setting or behavioral health altogether. Behavioral health providers are negatively affected by systemic underinvestment. Policies to improve workforce shortages should target the effects of inadequate financial and workplace support on the daily work environment.
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Affiliation(s)
- Eliza Hallett
- Center for Health Systems Effectiveness (Hallett, Simeon, Howington, McConnell) and Division of General Internal Medicine (Zhu), School of Medicine, Oregon Health & Science University, Portland; Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey (Amba)
| | - Erika Simeon
- Center for Health Systems Effectiveness (Hallett, Simeon, Howington, McConnell) and Division of General Internal Medicine (Zhu), School of Medicine, Oregon Health & Science University, Portland; Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey (Amba)
| | - Vineeth Amba
- Center for Health Systems Effectiveness (Hallett, Simeon, Howington, McConnell) and Division of General Internal Medicine (Zhu), School of Medicine, Oregon Health & Science University, Portland; Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey (Amba)
| | - Devin Howington
- Center for Health Systems Effectiveness (Hallett, Simeon, Howington, McConnell) and Division of General Internal Medicine (Zhu), School of Medicine, Oregon Health & Science University, Portland; Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey (Amba)
| | - K John McConnell
- Center for Health Systems Effectiveness (Hallett, Simeon, Howington, McConnell) and Division of General Internal Medicine (Zhu), School of Medicine, Oregon Health & Science University, Portland; Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey (Amba)
| | - Jane M Zhu
- Center for Health Systems Effectiveness (Hallett, Simeon, Howington, McConnell) and Division of General Internal Medicine (Zhu), School of Medicine, Oregon Health & Science University, Portland; Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey (Amba)
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Palmer Molina A, Palinkas L, Hernandez Y, Garcia I, Stuart S, Sosna T, Mennen FE. Implementation of the "Healthy Moms, Healthy Kids" Program in Head Start: An Application of the RE-AIM QuEST Framework Centering Equity. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024; 51:69-84. [PMID: 37898595 DOI: 10.1007/s10488-023-01312-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 10/30/2023]
Abstract
BACKGROUND Marginalized mothers are disproportionately impacted by depression and face barriers in accessing mental health treatment. Recent efforts have focused on building capacity to address maternal depression in Head Start; however, it is unclear if mental health inequities can be addressed by two-generation programs in Head Start settings. Therefore, this study examined the implementation outcomes and processes of a two-generation program called "Healthy Moms, Healthy Kids" (HMHK) that provided an evidence-based depression treatment to ethnic minority Head Start mothers. METHOD Quantitative and qualitative data were collected and merged in a convergent mixed method design in accordance with the RE-AIM Qualitative Evaluation for Systematic Translation (RE-AIM QuEST) framework. Qualitative data included interviews with 52 key stakeholders, including intervention participants and staff members, and 176 sets of meeting minutes from the implementation period. Quantitative data included intervention study data and administrative data. RESULTS It was difficult for HMHK to reach the target population, with only 16.8% of eligible mothers choosing to participate. However, mothers who participated experienced reductions in depressive symptoms and parenting stress and shared a variety of positive impacts in interviews. The program was also more successful in enrolling Latinx mothers who were Spanish-speaking or bilingual rather than English-speaking and Black/African American mothers, limiting its reach. CONCLUSION Providing IPT therapy groups was effective in reducing maternal depressive symptoms and stress for those who enrolled, but additional work should focus on reducing barriers to participation, considering other delivery models to meet participants' needs, and identifying culturally relevant ways to meet the needs of Black mothers.
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Affiliation(s)
| | - Lawrence Palinkas
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Yuliana Hernandez
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Iliana Garcia
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | | | - Todd Sosna
- Optimist Youth Homes, Los Angeles, CA, USA
| | - Ferol E Mennen
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
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9
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Flores MW, Sharp A, Carson NJ, Cook BL. Estimates of Major Depressive Disorder and Treatment Among Adolescents by Race and Ethnicity. JAMA Pediatr 2023; 177:1215-1223. [PMID: 37812424 PMCID: PMC10562990 DOI: 10.1001/jamapediatrics.2023.3996] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 08/08/2023] [Indexed: 10/10/2023]
Abstract
Importance The COVID-19 pandemic has contributed to poorer mental health and a greater need for treatment. Nationally representative estimates of major depressive disorder (MDD) and mental health treatment among US adolescents during the pandemic are needed. Objective To estimate MDD prevalence among adolescents, evaluate mental health treatment use among adolescents with MDD, and assess differences by race and ethnicity. Design, Setting, and Participants This cross-sectional analysis of the nationally representative 2021 National Survey on Drug Use and Health included noninstitutionalized US adolescents between the ages of 12 and 17 years (n = 10 743). Analytic weights were applied to all rates and model estimates to be nationally representative and account for sample design and survey nonresponse. Data were collected from January 14 to December 20, 2021, and analyzed from February 11 to April 3, 2023. Exposures Self-reported race and ethnicity. Main Outcomes and Measures Dichotomous outcomes of MDD as defined by the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition), MDD-specific mental health treatment, any type of mental health treatment, telehealth visits, and delays in mental health treatment. Results The sample included 10 743 adolescents (51.1% male). Self-reported race and ethnicity included 5.1% Asian, 14.1% Black, 23.3% Latinx, 51.2% White, and 6.3% more than 1 race. Ages were evenly distributed: 34.0% aged 12 to 13 years; 33.3% aged 14 to 15 years; and 32.7% aged 16 to 17 years. Adolescents of more than 1 race or ethnicity had the highest MDD rate (26.5%). Compared with White adolescents, the lowest rates of any MDD treatment overall were found among Latinx adolescents (29.2% [95% CI, 22.2%-36.2%]) and those of more than 1 race or ethnicity (21.1% [95% CI, 11.6%-30.7%]). Similar results were found for treatment by any clinician (Latinx, 25.6% [95% CI, 18.8%-32.4%]; >1 race or ethnicity, 19.1% [95% CI, 9.7%-28.6%]), treatment by a mental health specialist (Latinx, 22.9% [95% CI, 16.9%-28.9%]; >1 race or ethnicity, 16.7% [95% CI, 7.1%-26.3%]), treatment by a nonspecialist clinician (Latinx, 7.3% [95% CI, 3.3%-11.3%]; >1 race or ethnicity, 4.8% [95% CI, 1.9%-7.7%]), and use of any psychotropic medication prescription (Latinx, 11.6% [95% CI, 7.3%-15.9%]; >1 race or ethnicity, 8.3% [95% CI, 2.8%-13.7]). Compared with White adolescents, Black adolescents had lower rates of MDD treatment by any clinician (31.7% [95% CI, 23.7%-39.8%]) and by nonspecialist clinicians (8.4% [95% CI, 3.8%-13.2%]) and experienced lower prescription rates for any psychotropic medication (12.6 [95% CI, 4.6%-20.6%]). Asian (16.0% [95% CI, 5.0%-27.2%]) and Latinx (17.8% [95% CI, 12.6%-23.0%]) adolescents had lower rates of virtual mental health treatment compared with White adolescents. Black (19.1% [95% CI, 14.1%-24.2%]) and Latinx (17.9% [95% CI, 15.0%-21.1%]) adolescents had lower rates of appointments transition to telehealth, while Black adolescents (14.1% [95% CI, 10.7%-17.4%]) experienced delays getting their prescriptions. Conclusions and Relevance During the first full calendar year of the pandemic, approximately 1 in 5 adolescents had MDD, and less than half of adolescents who needed treatment had any mental health treatment. Adolescents in racial and ethnic minority groups, particularly Latinx, experienced the lowest treatment rates. Federal policy should target adolescents as a whole, and minority populations in particular, to ensure equitable treatment access. Efforts should consider the social, racial, ethnic, and cultural determinants of health.
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Affiliation(s)
- Michael William Flores
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Amanda Sharp
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, Massachusetts
| | - Nicholas J. Carson
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Benjamin L. Cook
- Health Equity Research Lab, Cambridge Health Alliance, Cambridge, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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Olson MG, Pyles KM, Nadorff DK. Give until It Hurts: An Exploratory Analysis of Mental Health Workers' Wellness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6925. [PMID: 37887663 PMCID: PMC10606168 DOI: 10.3390/ijerph20206925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND The well-being of mental health professionals has been of growing concern due to the increasing rates of reported stress and burnout. Previous research suggests that the quality of life for mental health workers (MHWs) is at an increased risk due to clinical load, salary concerns, and lack of time for self-care activities outside of work. There is a lack of research regarding the wellness of MHWs (i.e., psychology graduate students, academic faculty, psychiatrists, and mental health counselors) and its relation to the workplace environment. This study examined job-related factors that impacted participants' social, emotional, and professional well-being. METHODS Participants were recruited via professional organization listservs and answered questions about their psychological health (Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9), support systems (Multidimensional Scale of Perceived Social Support), and three qualitative questions about what they enjoy or find challenging about their work and any barriers to engaging in self-care activities. RESULTS An inductive qualitative analysis of the qualitative questions and descriptive statistics are presented to provide context for their qualitative responses. CONCLUSIONS Institutions can better support their workers by creating outlets to teach their staff self-care strategies and practice these strategies at work.
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Affiliation(s)
| | | | - Danielle Kristen Nadorff
- Department of Psychology, Mississippi State University, Starkville, MS 39762, USA; (M.G.O.); (K.M.P.)
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11
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Harrison JP, Deblinger E, Pollio E, Cooper B, Steer RA. TF-CBT Training Augmented with a Self-Care Focus: Understanding Facilitators and Barriers to Treatment Implementation. Community Ment Health J 2023; 59:1409-1421. [PMID: 37145337 PMCID: PMC10160727 DOI: 10.1007/s10597-023-01130-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 04/13/2023] [Indexed: 05/06/2023]
Abstract
Clinicians working with youth exposed to trauma may be at increased risk for experiencing elevated levels of stress and symptoms of secondary traumatic stress, which can negatively impact clinician wellbeing and ultimately contribute to reduced access to quality care for clients. An innovative Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) training incorporating self-care practices (i.e., Practice What You Preach; PWYP) was developed to help facilitate the implementation of TF-CBT and to enhance clinicians' coping and decrease stress. The primary purpose of this study was to determine whether the PWYP-augmented training met three Objectives: (1) increase clinicians' feelings of TF-CBT competency; (2) improve clinicians' coping abilities/reduce clinicians' stress; and (3) increase clinicians' insight into the benefits and/or challenges clients may experience in treatment. An exploratory aim was also developed to identify additional facilitators and barriers of TF-CBT implementation. The written reflections of 86 community-based clinicians who participated in the PWYP-augmented TF-CBT training were examined using qualitative methods. The majority of clinicians indicated increased feelings of competency and improved coping abilities and/or stress levels; almost half mentioned increased insight into clients' experiences. The most frequently mentioned additional facilitators were related to elements of the TF-CBT treatment model. Anxiety/self-doubt was the barrier most frequently mentioned, though all clinicians who mentioned this barrier indicated it lessened or resolved over the course of the training. Incorporating self-care strategies into trainings may serve as a facilitator for TF-CBT implementation by enhancing the competency and well-being of clinicians. The additional insights into barriers and facilitators can be used to further improve the PWYP initiative and future training and implementation efforts.
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Affiliation(s)
- Julie P Harrison
- CARES Institute, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA.
| | - Esther Deblinger
- CARES Institute, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - Elisabeth Pollio
- CARES Institute, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - Beth Cooper
- CARES Institute, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - Robert A Steer
- Department of Psychiatry, Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
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12
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Reid R, Madhu A, Gonzalez S, Crosby H, Stjuste M, Dale SK. Burnout Among Service Providers for People Living with HIV: Factors Related to Coping and Resilience. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01784-2. [PMID: 37704906 DOI: 10.1007/s40615-023-01784-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/15/2023]
Abstract
Individuals who provide services for people living with HIV (PLWH) face numerous work-related challenges, including psychosocial and structural factors affecting the quality of care that they provide. Little is known about the factors that relate to burnout among service providers for PLWH. The current study seeks to examine the factors associated with burnout and the role of resilience and coping in the context of burnout. Via convenience sampling, data was collected from 28 professionals (e.g., peer counselors, HIV testers, case managers/case workers, group facilitators, or social workers) serving PLWH in the USA. Participants completed quantitative measures on sociodemographics, organizational factors, discrimination, trauma, depression, and burnout. A sub-sample of 19 participants provided in-depth qualitative data via semi-structured interviews on burnout, coping, and resilience as a buffer against the effects of burnout. Thematic content analysis revealed themes on the factors related to burnout (e.g., discrimination, limited financial and housing resources, and COVID-19), rejuvenating factors, coping with burnout, and intervention strategies. Additionally, Pearson's product moment correlations revealed significant associations between mental health variables such as depressive and posttraumatic stress disorder symptomology with (a) discrimination and microaggressions and (b) burnout. The current study highlights challenges to providing HIV care, including structural barriers and discrimination that are doubly impactful to the professionals in this sample who share identities with the PLWH whom they serve. These findings may inform the development of an intervention targeting burnout among individuals providing services to PLWH and motivate change to remove structural barriers and improve quality of care for PLWH.
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Affiliation(s)
- Rachelle Reid
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
| | - Aarti Madhu
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
| | - Stephanie Gonzalez
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
| | - Hannah Crosby
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
| | - Michelle Stjuste
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA
| | - Sannisha K Dale
- Department of Psychology, University of Miami, 5665 Ponce de Leon Blvd, Miami, FL, 33146, USA.
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13
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Viglione J, Childs KK, Peck JH, Chapman JE, Drazdowski TK, McCart MR, Sheidow AJ. Examining the measurement precision of behavior problems among a sample of primarily rural youth on juvenile probation and their parents. CHILDREN AND YOUTH SERVICES REVIEW 2023; 152:107039. [PMID: 38312220 PMCID: PMC10836716 DOI: 10.1016/j.childyouth.2023.107039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
Accurate and timely intervention in the justice system is particularly critical in rural communities, given documented barriers to accessible, evidence-based services for youth. As youth in the juvenile justice system have a high prevalence of behavioral health needs, accurate assessment of those needs is a critical first step in linking youth to appropriate care. The goal of the current study is to examine the reliability of a brief assessment (the Brief Problem Checklist [BPC]) among a sample of 222 justice-involved youth and their caregivers who primarily reside in rural communities in the United States. Using a series of reliability analyses and tests of agreement, we examined whether youth and caregiver BPC produces reliable scales, the strength of the convergence among each of the BPC scales, and youth and caregiver agreement on the BPC scales. Findings support the reliability of the BPC, but not inter-rater reliability. Poor agreement between youth and caregiver reports exists for both youth internalizing and externalizing problems. Additionally, the BPC was significantly related to several theoretically relevant constructs, including treatment, substance use disorder severity, and family history of substance use. These findings lend merit to discussions about the need for more research on the reliability and validity of assessment instruments before their widespread use in guiding youth- and agency case planning decisions, along with informing conclusions about program effectiveness.
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Affiliation(s)
- Jill Viglione
- Department of Criminal Justice, University of Central Florida, 12805 Pegasus Drive, Orlando, FL 8216, United States
| | - Kristina K. Childs
- Department of Criminal Justice, University of Central Florida, 12805 Pegasus Drive, Orlando, FL 8216, United States
| | - Jennifer H. Peck
- Department of Criminal Justice, University of Central Florida, 12805 Pegasus Drive, Orlando, FL 8216, United States
| | - Jason E. Chapman
- Oregon Social Learning Center (OSLC), 10 Shelton McMurphey Blvd., Eugene, OR 97401, United States
| | - Tess K. Drazdowski
- Oregon Social Learning Center (OSLC), 10 Shelton McMurphey Blvd., Eugene, OR 97401, United States
| | - Michael R. McCart
- Oregon Social Learning Center (OSLC), 10 Shelton McMurphey Blvd., Eugene, OR 97401, United States
| | - Ashli J. Sheidow
- Oregon Social Learning Center (OSLC), 10 Shelton McMurphey Blvd., Eugene, OR 97401, United States
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14
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Kopelovich SL, Blank J, McCain C, Hughes M, Strachan E. Applying the Project ECHO Model to Support Implementation and Sustainment of Cognitive Behavioral Therapy for Psychosis. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2023; 44:00005141-990000000-00086. [PMID: 37389485 PMCID: PMC11107895 DOI: 10.1097/ceh.0000000000000511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
INTRODUCTION Project Extension for Community Healthcare Outcomes (ECHO) is a teleconsultation model that leverages technology to sustain specialized interventions in underresourced settings. We present the application of the ECHO model to longitudinal training and consultation for community behavioral health providers learning to deliver cognitive behavioral therapy for psychosis, an evidence-based psychotherapy for individuals with psychotic disorders that has poorly penetrated the US mental health system. METHODS We analyzed within-group change over practitioners' 6-month ECHO participation cycle using the Expanded Outcomes Framework. We evaluated outcomes associated with participation, satisfaction, knowledge acquisition, performance, patient symptom severity, and functional impairment. RESULTS In the first 3 years, the cognitive behavioral therapy for psychosis ECHO Clinics supported 150 providers from 12 community agencies. Forty percent did not complete the 6-month ECHO calendar, most commonly due to separation from their agency. Participants reported high degrees of satisfaction. Declarative and procedural knowledge increased over the 6-month period. Of the 24 providers who received a fidelity review, 87.5% met or exceeded the competency benchmark within the 6-month period. Clinical outcomes reflected reductions in hallucinations, negative symptoms, depression, mania, and functional impairment, but no reductions were detected in delusions, disorganized speech, or abnormal psychomotor behavior. DISCUSSION ECHO Clinics offer a mode of providing continuous access to expert instruction, peer-to-peer consultation, and case-based learning that other workforce training models lack. Our evaluation suggests that the ECHO model supports continuous professional development for practitioners, most of whom had indicated inadequate preparation for their role. We observed improved learner and select patient outcomes.
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Affiliation(s)
- Sarah L. Kopelovich
- Department of Psychiatry and Behavioral Sciences University of Washington, Seattle, WA
| | - Jennifer Blank
- Department of Psychiatry and Behavioral Sciences University of Washington, Seattle, WA
| | - Chris McCain
- Department of Psychiatry and Behavioral Sciences University of Washington, Seattle, WA
| | - MacKenzie Hughes
- Department of Psychiatry and Behavioral Sciences University of Washington, Seattle, WA
| | - Eric Strachan
- Department of Psychiatry and Behavioral Sciences University of Washington, Seattle, WA
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15
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Woodward D, Wilens TE, Glantz M, Rao V, Burke C, Yule AM. A systematic review of substance use screening in outpatient behavioral health settings. Addict Sci Clin Pract 2023; 18:18. [PMID: 36967381 PMCID: PMC10041696 DOI: 10.1186/s13722-023-00376-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 03/15/2023] [Indexed: 03/29/2023] Open
Abstract
OBJECTIVE Despite the frequent comorbidity of substance use disorders (SUDs) and psychiatric disorders, it remains unclear if screening for substance use in behavioral health clinics is a common practice. The aim of this review is to examine what is known about systematic screening for substance use in outpatient behavioral health clinics. METHODS We conducted a PRISMA-based systematic literature search assessing substance use screening in outpatient adult and pediatric behavioral health settings in PubMed, Embase, and PsycINFO. Quantitative studies published in English before May 22, 2020 that reported the percentage of patients who completed screening were included. RESULTS Only eight articles met our inclusion and exclusion criteria. Reported prevalence of screening ranged from 48 to 100%, with half of the studies successfully screening more than 75% of their patient population. There were limited data on patient demographics for individuals who were and were not screened (e.g., gender, race) and screening practices (e.g., electronic versus paper/pencil administration). CONCLUSIONS The results of this systematic review suggest that successful screening for substance use in behavioral health settings is possible, yet it remains unclear how frequently screening occurs. Given the high rates of comorbid SUD and psychopathology, future research is necessary regarding patient and clinic-level variables that may impact the successful implementation of substance use screening. Trial registry A methodological protocol was registered with the PROSPERO systematic review protocol registry (ID: CRD42020188645).
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Affiliation(s)
- Diana Woodward
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Timothy E Wilens
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | | | - Vinod Rao
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Colin Burke
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02114, USA
| | - Amy M Yule
- Department of Psychiatry, Boston Medical Center, 850 Harrison Avenue, Boston, MA, 02118, USA.
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16
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Sonneveld D, Goverts Y, Duijn CCMA, Camps G, Bougie R, Mastenbroek NJJM. Dutch veterinary graduates leaving practice: A mixed-methods analysis of frequency and underlying reasons. Vet Rec 2023; 192:e2178. [PMID: 36056552 DOI: 10.1002/vetr.2178] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/26/2022] [Accepted: 08/08/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND This study aimed to evaluate the frequency of veterinarians graduated between 2009 and 2019 in the Netherlands leaving practice, their reasons for leaving and the relative importance of these reasons. METHODS Study 1 (focus group sessions, n = 14) of this project was aimed at defining the reasons Dutch veterinarians have for leaving veterinary practice within 10 years of graduation. In study 2, the frequency of veterinarians leaving veterinary practice and the relative importance of the reasons for leaving identified in study 1 were investigated through a cross-sectional digital survey. A career in veterinary practice was defined as working in first- or second-line veterinary practice. Leaving practice was defined as ending employment in veterinary practice. RESULTS The results of study 1 yielded 20 reasons given by veterinarians to leave veterinary practice within 10 years of graduation. One of the reasons obtained by this study was not mentioned in literature before: leaving veterinary practice as a pre-planned career path. Study 2 demonstrated that the mean percentage of respondents from graduation years 2009 to 2014 who left practice within 5 years of graduation was 16.8%. The most important reasons respondents gave for this career move were poor work-life balance, excessive workload, insufficient remuneration and perceived lack of employer support. CONCLUSION A substantial number of veterinarians leave veterinary practice within 5 years of graduation. The most important reasons for this decision are excessive job demands or insufficient job resources. Furthermore, these reasons are a result of negative experiences regarding organisation of work, management and remuneration.
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Affiliation(s)
- Danse Sonneveld
- Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
- TIAS School for Business and Society, Tilburg, The Netherlands
| | | | | | - Guido Camps
- Department of Agrotechnology and Food Sciences, Wageningen University and Research, Wageningen, The Netherlands
| | - Roger Bougie
- TIAS School for Business and Society, Tilburg, The Netherlands
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17
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Sharp A, Carlson M, Vroom EB, Rigg K, Hills H, Harding C, Moore K, Schuman-Olivier Z. When a pandemic and epidemic collide: Lessons learned about how system barriers can interrupt implementation of addiction research. IMPLEMENTATION RESEARCH AND PRACTICE 2023; 4:26334895231205890. [PMID: 37936966 PMCID: PMC10572032 DOI: 10.1177/26334895231205890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023] Open
Abstract
Background Telehealth technologies are now featured more prominently in addiction treatment services than prior to the COVID-19 pandemic, but system barriers should be carefully considered for the successful implementation of innovative remote solutions for medication management and recovery coaching support for people with opioid use disorder (OUD). Method The Centers for Disease Control and Prevention funded a telehealth trial prior to the COVID-19 pandemic with a multi-institution team who attempted to implement an innovative protocol during the height of the pandemic in 2020 in Tampa, Florida. The study evaluated the effectiveness of a mobile device application, called MySafeRx, which integrated remote motivational recovery coaching with daily supervised dosing from secure pill dispensers via videoconference, on medication adherence during buprenorphine treatment. This paper provides a participant case example followed by a reflective evaluation of how the pandemic amplified both an existing research-to-practice gap and clinical system barriers during the implementation of telehealth clinical research intervention for patients with OUD. Findings Implementation challenges arose from academic institutional requirements, boundaries and role identity, clinical staff burnout and lack of buy-in, rigid clinical protocols, and limited clinical resources, which hampered recruitment and intervention engagement. Conclusions As the urgency for feasible and effective telehealth solutions continues to rise in response to the growing numbers of opioid-related deaths, the scientific community may use these lessons learned to re-envision the relationship between intervention implementation and the role of clinical research toward mitigating the opioid overdose epidemic.
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Affiliation(s)
- Amanda Sharp
- College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA
- Center for Mindfulness and Compassion, Cambridge Health Alliance, Cambridge, MA, USA
| | - Melissa Carlson
- College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA
| | - Enya B. Vroom
- School of Medicine, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Khary Rigg
- College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA
| | - Holly Hills
- College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA
| | - Cassandra Harding
- Center for Mindfulness and Compassion, Cambridge Health Alliance, Cambridge, MA, USA
| | - Kathleen Moore
- College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA
| | - Zev Schuman-Olivier
- Center for Mindfulness and Compassion, Cambridge Health Alliance, Cambridge, MA, USA
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18
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Silver SR, Li J, Marsh SM, Carbone EG. Prepandemic Mental Health and Well-being: Differences Within the Health Care Workforce and the Need for Targeted Resources. J Occup Environ Med 2022; 64:1025-1035. [PMID: 36472564 PMCID: PMC9722331 DOI: 10.1097/jom.0000000000002630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Occupational stress and diminished well-being among health care workers were concerning even before the coronavirus disease 2019 pandemic exacerbated existing stressors and created new challenges for this workforce. Research on the mental health of health care workers has focused on physicians and nurses, with less attention to other occupations. METHODS To assess pre-coronavirus disease mental health and well-being among workers in multiple health care occupations, we used 2017 to 2019 data from the Behavioral Risk Factor Surveillance System. RESULTS Across the health care workforce, insufficient sleep (41.0%) and diagnosed depression (18.9%) were the most common conditions reported. Counselors had the highest prevalence of diagnosed depression. Health care support workers had elevated prevalences for most adverse health conditions. CONCLUSIONS Ensuring a robust health care workforce necessitates identifying and implementing effective occupation-specific prevention, intervention, and mitigation strategies that address organizational and personal conditions adversely affecting mental health.
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Gravestock J. A scoping review of the literature pertaining to burnout and leadership in mental health clinicians. Leadersh Health Serv (Bradf Engl) 2022; ahead-of-print. [PMID: 36408980 DOI: 10.1108/lhs-04-2022-0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE This paper aims to explore what is known in the literature about leadership and burnout within mental health clinicians (MHC). DESIGN/METHODOLOGY/APPROACH The Arksey and O'Malley (2005) framework was used to conduct a systematised scoping review of three databases: PsycInfo, PubMed and CINAHL. To ensure a broad scope of the literature, Google, Google Scholar and three sources of grey literature were also searched. FINDINGS In total 1,087 articles were identified and 36 were included in the final review, 23 of which were cross-sectional and correlational studies. There is a lack of experimental studies, longitudinal research and qualitative approaches. The literature repeatedly demonstrated an association between leadership and burnout; transformational-leadership style, good quality supervision, supportive relationships, positive communication and fostering autonomy are areas of interest. RESEARCH LIMITATIONS/IMPLICATIONS Future research activity should aim to follow the recommendations made in the literature; more experimental and longitudinal approaches are needed to support practical application of the findings. ORIGINALITY/VALUE To the best of the author's knowledge there is no other review which maps out the research pertaining to leadership and burnout among MHC. These findings can be used to guide future research to ensure that efforts are directed toward original, meaningful and practical ventures that will add to the evidence base and benefit clinical practice.
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Affiliation(s)
- Jenny Gravestock
- Department of Health, Psychology and Social care, University of Derby, Derby, UK
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Server A, Suso-Ribera C, Pérez-Carrasco M, Medel J, Mesas Á, Ayora A, Gracia RM. Feasibility of a brief mindfulness-based program for burnout in pain healthcare professionals. Front Psychol 2022; 13:1009266. [DOI: 10.3389/fpsyg.2022.1009266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 10/18/2022] [Indexed: 11/09/2022] Open
Abstract
IntroductionStress inherent to health care, which is characterized by work overload and shortage of specialized staff, is associated with decreased quality of life and suboptimal patient care. Mindfulness-based programs have proved to be effective in reducing stress in healthcare providers. This study aims to assess the feasibility of an 8-week mindfulness program to reduce the burnout levels of the staff of a pain clinic in a tertiary public hospital.Materials and methodsA longitudinal study with a within subject pre/post-intervention design, consisting of daily face-to-face 10-min sessions and the creation of a virtual group using a social media platform. Variables measured: burnout, mindfulness, empathy, self-compassion, and demographic characteristics.ResultsProgram feasibility (i.e., reach, adherence, acceptability, and preliminary effectiveness) was evaluated in 10 participants (6 physicians, 2 nurse practitioners, 1 nursing assistant, and 1 administrative). The results revealed a high reach (i.e., participation rate of 90%), excellent adherence to the program (daily practice 95% of times), and very good acceptability of the group format and satisfaction with most treatment components. Regarding potential effectiveness, we report the results of the Wilcoxon signed-rank tests and its associated effect size (r). We observed improvements in mindfulness and all its subscales (−2.077 ≤ Z ≤ −2.703, 0.69 ≤ r ≤ 0.90, all p < 0.05) except for non-reactivity and all subcomponents of self-compassion (−2.501 ≤ Z ≤ −2.611, 0.83 ≤ r ≤ 0.87, all p < 0.05) but not on its global self-compassion score. Empathy and burnout did not change. In an exploratory manner, however, we found significant reductions in the burnout component of emotional exhaustion, but only in physicians (Z = −2.201, p = 0.028, r = 0.73).DiscussionWe believe that the 8-week mindfulness-based program described in the present investigation might be a feasible and potentially effective method that can be easily implemented to reduce burnout and promote mindfulness in specialized pain clinics.
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Woolford DD, Smout MF, Turnbull D, Gunn KM. Male Farmers' Perspectives on Psychological Wellbeing Self-Management Strategies That Work for Them and How Barriers to Seeking Professional Mental Health Assistance Could Be Overcome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912247. [PMID: 36231558 PMCID: PMC9564662 DOI: 10.3390/ijerph191912247] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 09/16/2022] [Accepted: 09/24/2022] [Indexed: 05/30/2023]
Abstract
This research aimed to explore the self-management strategies that Australian male farmers use to improve or maintain their psychological wellbeing and their views on what would assist them to overcome barriers to seeking professional mental health assistance. Individual semi-structured telephone interviews were audio-recorded with consent. Qualitative data were analysed inductively using thematic analysis. Fifteen male farmers participated, who were an average of thirty-nine years of age (23-74 years) with twenty years of farming experience (5-57 years). Seven themes relating to self-management strategies were identified: (1) interacting with a supportive network; (2) involvement in groups and teams; (3) physical activity; (4) proactively educating themselves; (5) self-prioritising and deliberately maintaining work-life balance; (6) being grateful; and (7) focusing on the controllable aspects of farming. Five themes were identified that related to mitigating barriers to seeking mental health assistance: (1) actively welcoming mental health professionals into the community; (2) normalising help-seeking; (3) making seeking mental health assistance a priority; (4) offering services that are culturally appropriate and accessible for male farmers; and (5) tailoring mental health information delivery to farming populations. Australian male farmers already use strategies to maintain and improve their mental health that are culturally and contextually appropriate. These proactive strategies could form the basis of interventions aiming to further promote male farmers' wellbeing. Barriers to seeking professional mental health assistance may be overcome by implementing solutions directly suggested by male farmers. Given the elevated risk of suicide in this group, investment in trialing promotion of these strategies is warranted.
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Affiliation(s)
- Dale D. Woolford
- Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, Australia
- Freemasons Centre for Male Health and Wellbeing, University of Adelaide, Adelaide, SA 5005, Australia
| | - Matthew F. Smout
- UniSA Justice and Society, University of South Australia, Adelaide, SA 5072, Australia
| | - Deborah Turnbull
- Freemasons Centre for Male Health and Wellbeing, University of Adelaide, Adelaide, SA 5005, Australia
- School of Psychology, University of Adelaide, Adelaide, SA 5005, Australia
| | - Kate M. Gunn
- Department of Rural Health, Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, Australia
- Freemasons Centre for Male Health and Wellbeing, University of Adelaide, Adelaide, SA 5005, Australia
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Abstract
OBJECTIVE One potential barrier to optimal healthcare may be provider burnout or occupational-related stress in the workplace. The objective of this study is to conduct a systematic review to identify the predictors of burnout among US. healthcare providers. DESIGN Systematic review using in-depth critical appraisal to assess risk of bias and present the quality of evidence in synthesised results from the prognostic studies. DATA SOURCES We searched 11 databases, registries, existing reviews and contacted experts through 4 October 2021. ELIGIBILITY CRITERIA FOR SELECTING STUDIES We included all studies evaluating potential predictors and documenting the presence and absence of associations with burnout assessed as a multidimensional construct. We excluded studies that relied solely on a single continuous subscale of burnout. Data were abstracted from eligible studies and checked for accuracy by a content expert and a methodologist. DATA EXTRACTION AND SYNTHESIS Two reviewers independently screened citations and full-text publications using predetermined eligibility criteria. RESULTS The 141 identified studies evaluated a range of burnout predictors. Findings for demographic characteristics were conflicting or show no association. Workplace factors, such as workload, work/life balance, job autonomy and perceived support from leadership, had stronger associations with risk for burnout. Mental health factors, such as anxiety, and physical health risks may increase the risk, although the direction of these associations is unclear as few prospective studies exist to address this question. Factors such as social support appear to have a protective effect. CONCLUSION We found the most evidence for workplace, mental health and psychosocial factors in predicting burnout but limited evidence for other potential predictors. However, more prospective studies are needed to improve our understanding about how to prevent provider burnout. PROSPERO REGISTRATION NUMBER CRD4202014836.
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Affiliation(s)
| | | | - Joan Chang
- Pardee RAND Graduate School, RAND Corporation, Santa Monica, California, USA
| | - Jody Larkin
- RAND Corporation, Santa Monica, California, USA
| | - Aneesa Motala
- RAND Corporation, Santa Monica, California, USA
- Southern California Evidence Review Center, University of Southern California, Los Angeles, California, USA
| | - Susanne Hempel
- RAND Corporation, Santa Monica, California, USA
- Southern California Evidence Review Center, University of Southern California, Los Angeles, California, USA
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Forman-Dolan J, Caggiano C, Anillo I, Kennedy TD. Burnout among Professionals Working in Corrections: A Two Stage Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9954. [PMID: 36011590 PMCID: PMC9408353 DOI: 10.3390/ijerph19169954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 07/23/2022] [Accepted: 07/24/2022] [Indexed: 06/15/2023]
Abstract
Burnout is a state of emotional, physical, and mental exhaustion often caused by excessive and prolonged stress. Given the emotionally and often physically demanding nature of the work of correctional professionals, they are at substantial risk of suffering the adverse consequences of burnout. We systematically reviewed (Stage 1) the influence of burnout amongst forensic psychologists, psychiatrists, case workers, nurses, and correction officers. Interventions were then reviewed (Stage 2) at the individual and collective level to examine the effectiveness or efficacy of treatments for burnout among professionals working in corrections.
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Last BS, Schriger SH, Becker-Haimes EM, Fernandez-Marcote S, Dallard N, Jones B, Beidas RS. Economic Precarity, Financial Strain, and Job-Related Stress Among Philadelphia's Public Mental Health Clinicians. Psychiatr Serv 2022; 73:774-786. [PMID: 34839673 DOI: 10.1176/appi.ps.202100276] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Efforts to improve mental health treatment delivery come at a time of rising inequality and cuts or insufficient increases to mental health funding. Public mental health clinicians face increased demands, experience economic stress, and treat underresourced patients disproportionately burdened by trauma. The authors sought to understand clinicians' current economic and psychological conditions and the relationship of these conditions to the delivery of an evidence-based intervention (EBI) designed to treat posttraumatic stress disorder among youths. METHODS In July 2020, 49 public mental health clinicians from 16 Philadelphia clinics who were trained in an EBI, trauma-focused cognitive-behavioral therapy (TF-CBT), were surveyed by e-mail. Respondents reported on their economic precarity, financial strain, burnout, secondary traumatic stress (i.e., the stress response associated with caring for people exposed to trauma), and TF-CBT use. Associations between clinicians' job-related stressors and their use of TF-CBT were examined with mixed models. Content coding was used to organize clinicians' open-ended responses to questions regarding financial strain related to the COVID-19 pandemic. RESULTS Clinicians' economic precarity, financial strain, and job-related stress were high; 37% of clinicians were independent contractors, 44% of whom wanted a salaried position. Of 37 clinicians with education debt, 38% reported owing ≥$100,000. In the past year, 29% of clinicians reported lack of personal mental health care because of cost, and 22% met the cutoff for experiencing secondary traumatic stress symptoms. Education debt was negatively associated with use of TF-CBT (p<0.001). CONCLUSIONS The stress of providing care in underresourced clinical settings may interfere with efforts to integrate scientific evidence into mental health care.
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Affiliation(s)
- Briana S Last
- Department of Psychology, University of Pennsylvania, Philadelphia (Last, Schriger);Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Becker-Haimes, Beidas);Hall Mercer Community Mental Health, University of Pennsylvania Health System, Philadelphia (Becker-Haimes); Community Behavioral Health, Philadelphia (Fernandez-Marcote, Dallard, Jones); Penn Implementation Science Center, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Beidas)
| | - Simone H Schriger
- Department of Psychology, University of Pennsylvania, Philadelphia (Last, Schriger);Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Becker-Haimes, Beidas);Hall Mercer Community Mental Health, University of Pennsylvania Health System, Philadelphia (Becker-Haimes); Community Behavioral Health, Philadelphia (Fernandez-Marcote, Dallard, Jones); Penn Implementation Science Center, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Beidas)
| | - Emily M Becker-Haimes
- Department of Psychology, University of Pennsylvania, Philadelphia (Last, Schriger);Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Becker-Haimes, Beidas);Hall Mercer Community Mental Health, University of Pennsylvania Health System, Philadelphia (Becker-Haimes); Community Behavioral Health, Philadelphia (Fernandez-Marcote, Dallard, Jones); Penn Implementation Science Center, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Beidas)
| | - Sara Fernandez-Marcote
- Department of Psychology, University of Pennsylvania, Philadelphia (Last, Schriger);Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Becker-Haimes, Beidas);Hall Mercer Community Mental Health, University of Pennsylvania Health System, Philadelphia (Becker-Haimes); Community Behavioral Health, Philadelphia (Fernandez-Marcote, Dallard, Jones); Penn Implementation Science Center, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Beidas)
| | - Natalie Dallard
- Department of Psychology, University of Pennsylvania, Philadelphia (Last, Schriger);Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Becker-Haimes, Beidas);Hall Mercer Community Mental Health, University of Pennsylvania Health System, Philadelphia (Becker-Haimes); Community Behavioral Health, Philadelphia (Fernandez-Marcote, Dallard, Jones); Penn Implementation Science Center, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Beidas)
| | - Bryanna Jones
- Department of Psychology, University of Pennsylvania, Philadelphia (Last, Schriger);Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Becker-Haimes, Beidas);Hall Mercer Community Mental Health, University of Pennsylvania Health System, Philadelphia (Becker-Haimes); Community Behavioral Health, Philadelphia (Fernandez-Marcote, Dallard, Jones); Penn Implementation Science Center, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Beidas)
| | - Rinad S Beidas
- Department of Psychology, University of Pennsylvania, Philadelphia (Last, Schriger);Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Becker-Haimes, Beidas);Hall Mercer Community Mental Health, University of Pennsylvania Health System, Philadelphia (Becker-Haimes); Community Behavioral Health, Philadelphia (Fernandez-Marcote, Dallard, Jones); Penn Implementation Science Center, Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Beidas)
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Dunn A, Dixon C, Thomson A, Cartwright-Hatton S. Workplace Support for Mental Health Workers Who Are Parents: A Feasibility Study. Front Psychol 2022; 13:854065. [PMID: 35814147 PMCID: PMC9262046 DOI: 10.3389/fpsyg.2022.854065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/04/2022] [Indexed: 11/25/2022] Open
Abstract
Background Mental health workers are subject to high levels of occupational stress which is associated with poorer health and wellbeing and impaired patient outcomes. For individuals operating in high stress environments, reducing challenge at home, in particular around parenting, has been found to generalize into improvements in the professional domain. The present study sought to investigate the effectiveness and feasibility of brief targeted workplace intervention to support workers in terms of their parental role. Design/Methodology An uncontrolled evaluation of a series of three-session parenting-focused courses delivered to employees of a large Mental Health Trust. A pre-post-follow-up design was used to investigate effects on outcomes including parenting practice and experience, wellbeing, stress, and occupational self-efficacy. Intervention feasibility and acceptably was also evaluated. Findings Data from 15 participants who completed measures pre-post indicates the courses were associated with improved parenting practice and experience at a p < 0.005 level. Improvements were reported at 6-month follow up. Participant satisfaction and course acceptability was highly rated by 100% of participants.
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Affiliation(s)
- Abby Dunn
- Department of Psychology, University of Sussex, Falmer, United Kingdom
- *Correspondence: Abby Dunn,
| | - Clare Dixon
- Sussex Partnership NHS Foundation Trust, Hove, United Kingdom
| | - Abi Thomson
- Department of Psychology, University of Sussex, Falmer, United Kingdom
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Salberg J, Ekselius L, Hursti T, Öster C. Staff experiences related to implementation of a recovery-oriented nursing programme in psychiatric inpatient care. Int J Ment Health Nurs 2022; 31:731-742. [PMID: 35315194 PMCID: PMC9311143 DOI: 10.1111/inm.12995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 02/28/2022] [Accepted: 03/11/2022] [Indexed: 11/28/2022]
Abstract
Nursing in psychiatric inpatient care is peripheral to a dominating biomedical model of care. Efforts are being made to implement nursing models based on core values and theories for nursing, such as recovery-oriented practices. The aim of the study was to explore experiences of a recovery-oriented nursing programme (Steps Towards Recovery, STR) among nursing staff in psychiatric inpatient care and their ratings of stress (Maslach Burnout Inventory scores), quality of care (Quality of Psychiatric Care - Inpatient staff scores) and satisfaction with nursing care (Satisfaction with Nursing Care and Work scale scores), before and after the implementation-and compare with ratings from reference wards. A quasi-experimental and prospective, pretest-post-test design was used. Specific questions about the nursing programme were answered by staff at the intervention wards. Staff reported predominantly positive experiences of the nursing programme. At follow-up, higher ratings were reported in two dimensions of quality of care in the STR group, and lower ratings in one dimension of stress were evident in the reference group. No differences in ratings between the STR and reference wards were found. Staff members' positive experiences of STR and higher ratings regarding participation and secure environment after implementation suggest that STR is a well-accepted and promising nursing programme. It is important to implement and evaluate recovery-oriented interventions in psychiatric inpatient care, where a focus on symptom relief still prevails. The results indicate that there is potential for further exploration of STR in this context.
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Affiliation(s)
- Johanna Salberg
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Lisa Ekselius
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Timo Hursti
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Caisa Öster
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
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27
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Galbraith C, Phillips-Hall CA, Merrill G. The effects of ethnic diversity and friendship ties on managers' emotional exhaustion: a network-based case study of Caribbean information technology firms. CROSS CULTURAL & STRATEGIC MANAGEMENT 2022. [DOI: 10.1108/ccsm-02-2021-0036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe purpose of this article is to empirically examine the relationship between managers' emotional exhaustion and the ethnic diversity, workload requirements, and friendship ties within their work-groups.Design/methodology/approachThe research employs a full-network sample of all managers from an indigenously owned ethnically diverse IT firm located in the Caribbean island nation of Trinidad and Tobago. Using a social network design within a regression model, the relationship between managerial power and operational workload and the burnout dimension of emotional exhaustion is initially examined as a baseline model. Work-group ethnicity and friendship ties are then examined as moderators to this relationship. The authors then examine the role of work-group ethnicity and friendship ties as a buffer mechanism using an efficient frontier analysis where managers act as decision-making units.FindingsThe study indicates that ethnic diversity acts more as a “negative moderator” to emotional exhaustion, while friendship ties act as both a “positive moderator” and “buffer” to work-related emotional exhaustion.Originality/valueThis is one of the few empirical studies that has examined the issues of ethnic diversity and burnout using social network and efficient frontier methodologies. This is also one of the first empirical studies to investigate these issues using an in-depth, full-sample case study of actual, real-work network relationships.
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28
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Zivin K, Chang MUM, Van T, Osatuke K, Boden M, Sripada RK, Abraham KM, Pfeiffer PN, Kim HM. Relationships between work-environment characteristics and behavioral health provider burnout in the Veterans Health Administration. Health Serv Res 2022; 57 Suppl 1:83-94. [PMID: 35230714 PMCID: PMC9108225 DOI: 10.1111/1475-6773.13964] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 11/28/2022] Open
Abstract
Objective To identify work–environment characteristics associated with Veterans Health Administration (VHA) behavioral health provider (BHP) burnout among psychiatrists, psychologists, and social workers. Data Sources The 2015–2018 data from Annual All Employee Survey (AES); Mental Health Provider Survey (MHPS); N = 57,397 respondents; facility‐level Mental Health Onboard Clinical (MHOC) staffing and productivity data, N = 140 facilities. Study Design For AES and MHPS separately, we used mixed‐effects logistic regression to predict BHP burnout using surveys from year pairs (2015–2016, 2016–2017, 2017–2018; six models). Within each year‐pair, we used the earlier year of data to train models and tested the model in the later year, with burnout (emotional exhaustion and/or depersonalization) as the outcome for each survey. We used potentially modifiable work–environment characteristics as predictors, controlling for employee demographic characteristics as covariates, and employment facility as random intercepts. Data Collection/Extraction Methods We included work–environment predictors that appeared in all 4 years (11 in AES; 17 in MHPS). Principal Findings In 2015–2018, 31.0%–38.0% of BHPs reported burnout in AES or MHPS. Work characteristics consistently associated with significantly lower burnout were included for AES: reasonable workload; having appropriate resources to perform a job well; supervisors address concerns; given an opportunity to improve skills. For MHPS, characteristics included: reasonable workload; work improves veterans' lives; mental health care provided is well‐coordinated; and three reverse‐coded items: staffing vacancies; daily work that clerical/support staff could complete; and collateral duties reduce availability for patient care. Facility‐level staffing ratios and productivity did not significantly predict individual‐level burnout. Workload represented the strongest predictor of burnout in both surveys. Conclusions This study demonstrated substantial, ongoing impacts that having appropriate resources including staff, workload, and supervisor support had on VHA BHP burnout. VHA may consider investing in approaches to mitigate the impact of BHP burnout on employees and their patients through providing staff supports, managing workload, and goal setting.
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Affiliation(s)
- Kara Zivin
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, United States.,Department of Psychiatry, Michigan Medicine, Ann Arbor, Michigan, United States
| | - Ming-Un Myron Chang
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, United States
| | - Tony Van
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, United States
| | - Katerine Osatuke
- VHA National Center for Organization Development, Cincinnati, Ohio, United States
| | - Matthew Boden
- Program Evaluation and Resource Center and VA Office of Mental Health Operations, VA Palo Alto Health Care System, Palo Alto, California
| | - Rebecca K Sripada
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, United States.,Department of Psychiatry, Michigan Medicine, Ann Arbor, Michigan, United States
| | - Kristen M Abraham
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, United States.,Department of Psychology, University of Detroit Mercy, Detroit, Michigan, United States
| | - Paul N Pfeiffer
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, United States.,Department of Psychiatry, Michigan Medicine, Ann Arbor, Michigan, United States
| | - Hyungjin Myra Kim
- Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, United States.,Consulting for Statistics, Computing and Analytics Research, University of Michigan, Ann Arbor, Michigan, United States
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Whitt-Woosley A, Sprang G, Eslinger J. Foster care during the COVID-19 pandemic: A qualitative analysis of caregiver and professional experiences. CHILD ABUSE & NEGLECT 2022; 124:105444. [PMID: 34972016 PMCID: PMC8669913 DOI: 10.1016/j.chiabu.2021.105444] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/04/2021] [Accepted: 12/07/2021] [Indexed: 05/17/2023]
Abstract
BACKGROUND Research is needed to facilitate better understanding of how different groups have been impacted by COVID-19, especially those in already strained service systems such as foster care. These inquiries will support further response, recovery and preparedness efforts. OBJECTIVE This qualitative study addressed how professionals and caregivers in foster care described being affected by COVID-19 in order to support future research and planning for foster care systems in this pandemic context. PARTICIPANTS AND SETTING A sample of foster parents and foster care professionals (N = 357) from a mostly rural, southeastern state in the U.S. participated in the study. METHODS Qualitative analysis was conducted of 357 open-ended responses regarding the impact of COVID-19 from a survey distributed in August 2020. RESULTS The coding process resulted in the identification of 15 distinct themes: Isolation & Loss of Social Support, Work Changes/Stressors, School Issues, Childcare Issues, No Impact/Positive Changes, Financial Problems, Fear of Contagion, Negative Child Welfare Impacts, Mental Health Problems/Stress, Loss of Faith/Trust & Societal Frustrations, Health & Mental Healthcare Access Issues, PPE & Testing Issues, Grief & Loss, and Marital Problems. Secondary impacts rather than direct physiologic effects of the virus were primarily reported. CONCLUSIONS This study underscores the various challenges facing foster care systems, and how the pandemic context is exacerbating many of these issues. Further research is needed to ensure the implementation of adequately complex and nuanced responses that target needs and avoid creating further problems for foster care.
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Affiliation(s)
- Adrienne Whitt-Woosley
- University of Kentucky, College of Medicine - Department of Psychiatry, United States of America.
| | - Ginny Sprang
- University of Kentucky, College of Medicine - Department of Psychiatry, United States of America
| | - Jessica Eslinger
- University of Kentucky, College of Medicine - Department of Psychiatry, United States of America
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Sharp A, Brown B, Shreve T, Moore K, Carlson M, Braughton D. Direct-Care Staff Perceptions of Patient Engagement and Treatment Planning in Detox. J Behav Health Serv Res 2021; 48:566-582. [PMID: 34590236 DOI: 10.1007/s11414-021-09757-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2021] [Indexed: 11/24/2022]
Abstract
As the prevalence of substance use disorders and drug-related deaths continue to rise, addiction treatment facilities are charged with providing effective and efficient services to curb the national substance use crisis. Direct-care staff in treatment service facilities play a crucial role in whether or not evidence-based practices are incorporated. Without their understanding and utilization of patient engagement best practices, an organization risks maintaining the status quo rather than actively pursuing improved outcomes through empirically supported approaches. Through in-depth interviews (N=13) with nurses, counselors, and behavioral health technicians in an inpatient detoxification facility, this study evaluates the perspectives and experiences of direct-care staff through a lens of patient engagement in treatment planning. The findings from these interviews elucidate how participants' personal characteristics and values, perspectives of patient engagement, understanding of treatment planning, and organizational culture and operations facilitate or inhibit the integration of patient engagement for treatment planning in detox.
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Affiliation(s)
- Amanda Sharp
- Department of Mental Health Law & Policy, University of South Florida, 13301 Bruce B. Down Blvd., Tampa, FL, 33612, USA.
| | - Bonnie Brown
- Department of Mental Health Law & Policy, University of South Florida, 13301 Bruce B. Down Blvd., Tampa, FL, 33612, USA
| | - Tayler Shreve
- Department of Justice, Law, and Criminology, American University, 4400 Massachusetts Ave NW, Washington, DC, 20016, USA
| | - Kathleen Moore
- Department of Mental Health Law & Policy, University of South Florida, 13301 Bruce B. Down Blvd., Tampa, FL, 33612, USA
| | - Melissa Carlson
- Department of Mental Health Law & Policy, University of South Florida, 13301 Bruce B. Down Blvd., Tampa, FL, 33612, USA
| | - David Braughton
- Agency for Community Treatment Services, Inc., 4612 N 56th St., Tampa, FL, 33610, USA
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31
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Kelly RJ, Hearld LR. Burnout and Leadership Style in Behavioral Health Care: a Literature Review. J Behav Health Serv Res 2021; 47:581-600. [PMID: 32189184 PMCID: PMC7223098 DOI: 10.1007/s11414-019-09679-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Burnout among behavioral health care providers and employees is associated with poor patient and provider outcomes. Leadership style has generally been identified as a means of reducing burnout, yet it is unclear whether some leadership styles are more effective than others at mitigating burnout. Additionally, behavioral health care is provided in a variety of contexts and a leadership style employed in one context may not be effective in another. The purpose of this paper was to review the literature on leadership style and burnout in behavioral health care contexts to identify the different leadership styles and contexts in which the relationship between the two constructs was studied. Studies were categorized based on the leadership style, study design, research methods, and study context. Findings of this review provide insights into potential approaches to prevent employee burnout and its attending costs, as well as ways to improve future research in this critical area.
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Affiliation(s)
- Reena Joseph Kelly
- Department of Health Services Administration, University of Alabama at Birmingham, 1716 9th Ave. S., SHPB 547, Birmingham, AL, 35233, USA.
| | - Larry R Hearld
- Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, USA
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32
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Rollins AL, Eliacin J, Russ-Jara AL, Monroe-Devita M, Wasmuth S, Flanagan ME, Morse GA, Leiter M, Salyers MP. Organizational conditions that influence work engagement and burnout: A qualitative study of mental health workers. Psychiatr Rehabil J 2021; 44:229-237. [PMID: 33793289 PMCID: PMC8440452 DOI: 10.1037/prj0000472] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Objective: Clinician burnout in healthcare is extensive and of growing concern. In mental health and rehabilitation settings, research on interventions to improve burnout and work engagement is limited and rarely addresses organizational drivers of burnout. This study sought to elaborate on the organizational influence of burnout and work engagement in mental health. Methods: We randomly selected 40 mental health clinicians and managers who were participating in a burnout intervention and conducted semi-structured interviews to understand their views of organizational conditions impacting burnout and work engagement. Data were analyzed using a thematic analytical approach. Results: Analyses yielded three major themes where organizational contexts might reduce burnout and increase work engagement: (a) a work culture that prioritizes person-centered care over productivity and other performance metrics, (b) robust management skills and practices to overcome bureaucracy, and (c) opportunities for employee professional development and self-care. Participants also referenced three levels of the organizational context that they believed influenced burnout and work engagement: front-line supervisors and program managers, organizational executive leadership, and the larger health system. Conclusions and Implications for Practice: Findings point to several possible targets of intervention at various organizational levels that could guide the field toward more effective ways to reduce burnout and improve work engagement. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Angela L Rollins
- VA HSR&D Center for Health Information and Communication, Veterans Health Indiana
| | - Johanne Eliacin
- VA HSR&D Center for Health Information and Communication, Veterans Health Indiana
| | - Alissa L Russ-Jara
- VA HSR&D Center for Health Information and Communication, Veterans Health Indiana
| | - Maria Monroe-Devita
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine
| | - Sally Wasmuth
- VA HSR&D Center for Health Information and Communication, Veterans Health Indiana
| | - Mindy E Flanagan
- VA HSR&D Center for Health Information and Communication, Veterans Health Indiana
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Weikel K, Fisher T. Burnout and Turnover Intention Among Peer Providers and Other Providers of Mental Health Services in a Rural Two-County Area. JOURNAL OF PSYCHOSOCIAL REHABILITATION AND MENTAL HEALTH 2021; 9:33-43. [PMID: 34458073 PMCID: PMC8383238 DOI: 10.1007/s40737-021-00232-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 08/12/2021] [Indexed: 06/13/2023]
Abstract
Peer providers in the mental health field, having their own lived experience with mental illness, use their personal experience to assist the consumers of their services. Given high burnout rates in the mental health field, there have been two prior investigations of burnout among peer providers. The present study extends those prior investigations to a sample of peer providers working in community mental health programs in a rural area of the United States. Consistent with the prior studies, there were no differences in burnout between peer providers and other providers employed by those programs, with particularly strong support for the null hypothesis regarding the emotional exhaustion component of burnout. There were also no differences in strength of turnover intentions. However, among the non-consumer providers emotional exhaustion was correlated with both types of turnover intention assessed in this study (intent to change job setting within the mental health field and intent to leave the mental health workforce), whereas among the peer providers emotional exhaustion was correlated only with intent to leave the mental health field. Workload dissatisfaction was the workplace variable most strongly associated with emotional exhaustion among both types of providers. Other moderately strong inverse predictors of emotional exhaustion among peer providers were workplace community and workplace control, and the correlation between emotional exhaustion and workplace control was significantly stronger among the peer providers than among the other providers.
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Affiliation(s)
- Kim Weikel
- Psychology Department, Shippensburg University of Pennsylvania, Shippensburg, PA USA
| | - Thomas Fisher
- Psychology Department, Shippensburg University of Pennsylvania, Shippensburg, PA USA
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Furst MA, Salinas-Perez JA, Gutiérrez-Colosia MR, Salvador-Carulla L. A new bottom-up method for the standard analysis and comparison of workforce capacity in mental healthcare planning: Demonstration study in the Australian Capital Territory. PLoS One 2021; 16:e0255350. [PMID: 34314451 PMCID: PMC8315559 DOI: 10.1371/journal.pone.0255350] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 07/14/2021] [Indexed: 11/26/2022] Open
Abstract
The aims of this study are to evaluate and describe mental health workforce and capacity, and to describe the relationship between workforce capacity and patterns of care in local areas. We conducted a comparative demonstration study of the applicability of an internationally validated standardised service classification instrument—the Description and Evaluation of Services and Directories—DESDE-LTC) using the emerging mental health ecosystems research (MHESR) approach. Using DESDE-LTC as the framework, and drawing from international occupation classifications, the workforce was classified according to characteristics including the type of care provided and professional background. Our reference area was the Australian Capital Territory, which we compared with two other urban districts in Australia (Sydney and South East Sydney) and three benchmark international health districts (Helsinki-Uusima (Finland), Verona (Italy) and Gipuzkoa (Spain)). We also compared our data with national level data where available. The Australian and Finnish regions had a larger and more highly skilled workforce than the southern European regions. The pattern of workforce availability and profile varied, even within the same country, at the local level. We found significant differences between regional rates of identified rates of psychiatrists and psychologists, and national averages. Using a standardised classification instrument at the local level, and our occupational groupings, we were able to assess the available workforce and provide information relevant to planners about the actual capacity of the system. Data obtained at local level is critical to providing planners with reliable data to inform their decision making.
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Affiliation(s)
- Mary Anne Furst
- Centre for Mental Health Research, Australian National University, Canberra, Australian Capital Territory, Australia
- * E-mail:
| | | | | | - Luis Salvador-Carulla
- Centre for Mental Health Research, Australian National University, Canberra, Australian Capital Territory, Australia
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Cost Borne by the Counselor: Comparing Burnout Between Dialectical Behavior Therapy (DBT) Counselors and Non‐DBT Counselors. JOURNAL OF COUNSELING AND DEVELOPMENT 2021. [DOI: 10.1002/jcad.12376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Page J, Robertson N. Extent and predictors of work-related distress in community correction officers: a systematic review. PSYCHIATRY, PSYCHOLOGY, AND LAW : AN INTERDISCIPLINARY JOURNAL OF THE AUSTRALIAN AND NEW ZEALAND ASSOCIATION OF PSYCHIATRY, PSYCHOLOGY AND LAW 2021; 29:155-182. [PMID: 35755153 PMCID: PMC9225775 DOI: 10.1080/13218719.2021.1894259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Research indicates that indirect exposure to trauma can have a detrimental psychological impact on professionals working within, and interfacing with, law enforcement and the criminal justice system. This systematic review aimed to explore the extent and predictors of work-related distress amongst community corrections personnel. A search of five databases identified 19 papers eligible for inclusion; 16 addressed burnout, and the remainder investigated secondary trauma, vicarious trauma and compassion fatigue. Synthesis revealed that community corrections personnel reported burnout at levels akin to those of other professions working in forensic contexts, though reports of secondary trauma appeared higher. Predictive factors encompassed personal, role-based and organisational factors. Research reporting work-related distress in correctional officers is focused on burnout but uses divergent models of stress, reveals methodological weaknesses, and to date has little examined responses to indirect trauma. The limitations of this review are discussed, alongside clinical implications and areas for future research.
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Affiliation(s)
- Jessica Page
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Noelle Robertson
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
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Effectiveness of a stress management program in continuous care nursing professionals. HEALTH PSYCHOLOGY REPORT 2021. [DOI: 10.5114/hpr.2020.99970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Emotion Regulation Strategies, Workload Conditions, and Burnout in Healthcare Residents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217816. [PMID: 33114522 PMCID: PMC7663662 DOI: 10.3390/ijerph17217816] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/01/2020] [Accepted: 10/22/2020] [Indexed: 12/15/2022]
Abstract
Background: Burnout syndrome is very prevalent among healthcare residents. Initiatives addressing workload conditions have had limited impact on burnout. The present study aims to explore the contribution of two emotion regulation strategies, namely emotion suppression and cognitive reevaluation, to residents’ burnout, while accounting for workload factors. Methods: Participants were 105 residents (68.6% women; mean age = 27.5, SD = 3.0). They completed measures of workload, burnout, and emotion regulation. The study was cross-sectional. Results: Emotional suppression was associated with higher burnout (depersonalization scale; β = 0.20, p < 0.05, CI 0.15–2.48) and cognitive revaluation was linked to lower burnout (higher personal accomplishment; β = 0.35, p < 0.01, CI 0.16–2.56), even after controlling for demographic and workload factors. We found interaction effects between workload variables (supervisor support and number of patient hours) and emotion regulation (p < 0.05). Conclusions: The relationship between workload, emotion regulation, and burnout seems to be complex. That is, similar work conditions might generate different levels of burnout depending on the resident’s emotional regulation strategies. This might partly explain why existing initiatives based on workload changes have had a modest impact on burnout. Results also support including emotion regulation training in prevention and treatment programs targeting burnout during residency.
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Bruce M, Patel S, Stevens P. Psychologically informed practice (PIP) within the offender personality disorder pathway: Towards establishing an evidence base for approved premises. CRIMINAL BEHAVIOUR AND MENTAL HEALTH : CBMH 2020; 30:268-280. [PMID: 32754973 DOI: 10.1002/cbm.2165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 07/09/2020] [Indexed: 06/11/2023]
Abstract
The United Kingdom (UK) government has commissioned numerous interventions across all stages of the criminal justice pathway for managing offenders likely to have a personality disorder, with the intention to reduce reoffending, improve psychological wellbeing, and develop workforce capabilities. Psychologically Informed Practice (PIP) models underpin these. To evaluate a modified PIP model within the post-imprisonment community stage of the Offender Personality Disorder (OPD) pathway, specifically workforce development, within all London (UK) probation supervised hostels (approved premises), we used both non-equivalent control group and pre-post repeated measure designs to compare changes in staff and offender outcomes before and after introduction of a PIP model across all 12 London approved premises. Findings revealed statistically significant improvements in a number of workforce outcomes (measured using the Personality Disorder - Knowledge, Attitudes and Skills Questionnaire and Maslach Burnout Inventory) which were moderated by age and gender. Data did not support associated improvements in resident offender outcomes (progressive moves, rearrests/reoffences, or breaches leading to recalls). The modified PIP is an effective intervention model for improving some workforce outcomes among probation supervised hostel staff, particularly for women, but our findings suggest that intervention development may be required for significant improvements to be observed in resident offending outcomes. In addition, further research is necessary to determine the longer term effects of PIP on absenteeism, employee turnover, quality of resident-staff interactions, and overall culture change among staff working within the post-imprisonment community stage of the OPD pathway.
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Affiliation(s)
- Matthew Bruce
- Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Shivani Patel
- Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Peter Stevens
- Forensic and Prison Services, Oxleas NHS Foundation Trust, Dartford, UK
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Storm M, Fortuna KL, Gill EA, Pincus HA, Bruce ML, Bartels SJ. Coordination of services for people with serious mental illness and general medical conditions: Perspectives from rural northeastern United States. Psychiatr Rehabil J 2020; 43:234-243. [PMID: 31985242 PMCID: PMC7382986 DOI: 10.1037/prj0000404] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The objective of the study was to investigate providers' perspectives on how medical, mental health, and social services are coordinated for people with serious mental illnesses and general medical conditions in 2 predominantly rural states. METHOD To achieve multiple perspectives on service coordination, this study includes perspectives from providers employed in community mental health centers, social service agencies, and primary care settings in 2 northern rural New England states with contrasting approaches to financing and organizing services. We conducted 29 individual semistructured interviews and 1 focus group, which included administrative leaders, team leaders, primary care providers, social workers, and case managers who provide services for people with serious mental illness. Data were analyzed using qualitative thematic content analysis. RESULTS We identified key themes at 3 levels: (a) provider-level coordination: bridging across services; managing interprofessional communications; and contrasting perspectives on the locus of responsibility for coordination; (b) individual-level coordination: support for self-management and care navigation; trusting and continuous relationships; and the right to individual choice and autonomy; (c) system-level coordination: linking appropriate residential and care provision services, funding, recruiting and retaining staff, policy enablers, and integration solutions. CONCLUSIONS Three levels of provider-reported coordination themes are described for the 2 states, reflecting efforts to coordinate and integrate service delivery across medical, mental health, and social services. IMPLICATIONS Improvements in patient outcomes will need additional actions that target key social determinants of health. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Marianne Storm
- Faculty of Health Sciences, Department of Public Health, University of Stavanger
| | | | - Emily A Gill
- General Practice and Primary Healthcare, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland
| | - Harold A Pincus
- Department of Psychiatry and Irving Institute for Clinical and Translational Research, Columbia University
| | | | - Stephen J Bartels
- Mongan Institute, Massachusetts General Hospital, Harvard Medical School
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Adams DR, Williams NJ, Becker-Haimes EM, Skriner L, Shaffer L, DeWitt K, Neimark G, Jones DT, Beidas RS. Therapist Financial Strain and Turnover: Interactions with System-Level Implementation of Evidence-Based Practices. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2020; 46:713-723. [PMID: 31203492 DOI: 10.1007/s10488-019-00949-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Therapist turnover is a major problem in community mental health. Financial strain, which is composed of cognitive, emotional, and behavioral responses to the experience of economic hardship, is an understudied antecedent of therapist turnover given the tumultuous financial environment in community mental health. We prospectively examined the relationship between therapist financial strain and turnover in 247 therapists in 28 community mental health agencies. We expected greater therapist financial strain to predict higher turnover and participation in a system-funded evidence-based practice (EBP) training initiative to alleviate this effect. Controlling for covariates, financial strain predicted therapist turnover (OR 1.12, p = .045), but not for therapists who participated in an EBP training initiative. Reducing financial strain and/or promoting EBP implementation may be levers to reduce turnover.
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Affiliation(s)
- Danielle R Adams
- School of Social Service Administration, University of Chicago, Chicago, IL, USA.,Department of Psychiatry, University of Pennsylvania, 3535 Market Street, 3rd Floor, Office 3015, Philadelphia, PA, 19104, USA
| | | | - Emily M Becker-Haimes
- Department of Psychiatry, University of Pennsylvania, 3535 Market Street, 3rd Floor, Office 3015, Philadelphia, PA, 19104, USA.,Hall-Mercer Community Mental Health Center, Philadelphia, PA, USA
| | - Laura Skriner
- Department of Psychiatry, University of Pennsylvania, 3535 Market Street, 3rd Floor, Office 3015, Philadelphia, PA, 19104, USA.,Evidence-Based Practitioners of New Jersey, Summit, NJ, USA
| | - Lauren Shaffer
- Department of Psychiatry, University of Pennsylvania, 3535 Market Street, 3rd Floor, Office 3015, Philadelphia, PA, 19104, USA.,University of Texas, Southwestern, TX, Dallas, USA
| | - Kathryn DeWitt
- Department of Psychiatry, University of Pennsylvania, 3535 Market Street, 3rd Floor, Office 3015, Philadelphia, PA, 19104, USA.,Qualtrics, Provo, UT, USA
| | | | | | - Rinad S Beidas
- Department of Psychiatry, University of Pennsylvania, 3535 Market Street, 3rd Floor, Office 3015, Philadelphia, PA, 19104, USA. .,Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. .,Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania, Philadelphia, PA, USA.
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Abstract
Quality of work life (QWL) is important to healthcare organisations that aim to increase patient and employee satisfaction and produce quality healthcare services. The literature lacks research investigating the relationship between QWL and burnout among in healthcare professionals. The purpose of this study is to determine healthcare workers’ QWL and burnout levels and to investigate whether there is a correlation them. The research population consisted of all healthcare workers serving in a public hospital in Ankara. The study did not make a sample selection but tried to access the entire population; a total of 328 usable surveys were obtained. ‘Quality of Work Life Scale’ and ‘Maslach Burnout Inventory’ scales were used for this research. A correlation analysis was performed to determine the correlation between healthcare workers’ QWL and burnout levels. The analysis results showed that healthcare workers had ‘good’ perceived QWL and ‘moderate’ level of burnout. Additionally, there was a statistically significant but weak correlation between healthcare workers’ levels of QWL and burnout (ρ = 0.184; p = 0.0008). Results can be used by healthcare managers to implement appropriate initiatives to improve QWL and reduce burnout of healthcare workers.
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Condon P, Makransky J. Recovering the Relational Starting Point of Compassion Training: A Foundation for Sustainable and Inclusive Care. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2020; 15:1346-1362. [PMID: 32745440 DOI: 10.1177/1745691620922200] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The cultivation of compassion through meditation training is of increasing interest to scientists, health-care providers, educators, and policymakers as an approach to help address challenging personal and social issues. Yet people encounter critical inner psychological barriers to compassion that limit the effectiveness of compassion training-including the lack of a secure base, aversion to suffering, feeling alone in suffering, and reductive impressions of others. These barriers emerge, in part, from a lack of relational support and are exacerbated by modernist conceptions that present meditation as an autonomous, self-help practice. This article proposes a solution centered on relationality that is derived from the integration of diverse areas of psychology with contemplative traditions. Theories and findings from social, developmental, and health psychology can inform meditation programs and help recover important relational elements of compassion training from traditional cultures that address common barriers to compassion and thus promote more sustainable and inclusive care. In so doing, this article illustrates the value of psychological theories for translating important contextual elements from contemplative traditions into diverse modern settings.
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Affiliation(s)
- Paul Condon
- Department of Psychology, Southern Oregon University
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Kunzler AM, Helmreich I, Chmitorz A, König J, Binder H, Wessa M, Lieb K. Psychological interventions to foster resilience in healthcare professionals. Cochrane Database Syst Rev 2020; 7:CD012527. [PMID: 32627860 PMCID: PMC8121081 DOI: 10.1002/14651858.cd012527.pub2] [Citation(s) in RCA: 104] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Resilience can be defined as the maintenance or quick recovery of mental health during or after periods of stressor exposure, which may result from a potentially traumatising event, challenging life circumstances, a critical life transition phase, or physical illness. Healthcare professionals, such as nurses, physicians, psychologists and social workers, are exposed to various work-related stressors (e.g. patient care, time pressure, administration) and are at increased risk of developing mental disorders. This population may benefit from resilience-promoting training programmes. OBJECTIVES To assess the effects of interventions to foster resilience in healthcare professionals, that is, healthcare staff delivering direct medical care (e.g. nurses, physicians, hospital personnel) and allied healthcare staff (e.g. social workers, psychologists). SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, 11 other databases and three trial registries from 1990 to June 2019. We checked reference lists and contacted researchers in the field. We updated this search in four key databases in June 2020, but we have not yet incorporated these results. SELECTION CRITERIA Randomised controlled trials (RCTs) in adults aged 18 years and older who are employed as healthcare professionals, comparing any form of psychological intervention to foster resilience, hardiness or post-traumatic growth versus no intervention, wait-list, usual care, active or attention control. Primary outcomes were resilience, anxiety, depression, stress or stress perception and well-being or quality of life. Secondary outcomes were resilience factors. DATA COLLECTION AND ANALYSIS Two review authors independently selected studies, extracted data, assessed risks of bias, and rated the certainty of the evidence using the GRADE approach (at post-test only). MAIN RESULTS We included 44 RCTs (high-income countries: 36). Thirty-nine studies solely focused on healthcare professionals (6892 participants), including both healthcare staff delivering direct medical care and allied healthcare staff. Four studies investigated mixed samples (1000 participants) with healthcare professionals and participants working outside of the healthcare sector, and one study evaluated training for emergency personnel in general population volunteers (82 participants). The included studies were mainly conducted in a hospital setting and included physicians, nurses and different hospital personnel (37/44 studies). Participants mainly included women (68%) from young to middle adulthood (mean age range: 27 to 52.4 years). Most studies investigated group interventions (30 studies) of high training intensity (18 studies; > 12 hours/sessions), that were delivered face-to-face (29 studies). Of the included studies, 19 compared a resilience training based on combined theoretical foundation (e.g. mindfulness and cognitive-behavioural therapy) versus unspecific comparators (e.g. wait-list). The studies were funded by different sources (e.g. hospitals, universities), or a combination of different sources. Fifteen studies did not specify the source of their funding, and one study received no funding support. Risk of bias was high or unclear for most studies in performance, detection, and attrition bias domains. At post-intervention, very-low certainty evidence indicated that, compared to controls, healthcare professionals receiving resilience training may report higher levels of resilience (standardised mean difference (SMD) 0.45, 95% confidence interval (CI) 0.25 to 0.65; 12 studies, 690 participants), lower levels of depression (SMD -0.29, 95% CI -0.50 to -0.09; 14 studies, 788 participants), and lower levels of stress or stress perception (SMD -0.61, 95% CI -1.07 to -0.15; 17 studies, 997 participants). There was little or no evidence of any effect of resilience training on anxiety (SMD -0.06, 95% CI -0.35 to 0.23; 5 studies, 231 participants; very-low certainty evidence) or well-being or quality of life (SMD 0.14, 95% CI -0.01 to 0.30; 13 studies, 1494 participants; very-low certainty evidence). Effect sizes were small except for resilience and stress reduction (moderate). Data on adverse effects were available for three studies, with none reporting any adverse effects occurring during the study (very-low certainty evidence). AUTHORS' CONCLUSIONS For healthcare professionals, there is very-low certainty evidence that, compared to control, resilience training may result in higher levels of resilience, lower levels of depression, stress or stress perception, and higher levels of certain resilience factors at post-intervention. The paucity of medium- or long-term data, heterogeneous interventions and restricted geographical distribution limit the generalisability of our results. Conclusions should therefore be drawn cautiously. The findings suggest positive effects of resilience training for healthcare professionals, but the evidence is very uncertain. There is a clear need for high-quality replications and improved study designs.
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Affiliation(s)
| | | | - Andrea Chmitorz
- Faculty of Social Work, Health Care and Nursing, Esslingen University of Applied Sciences, Esslingen, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Jochem König
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Harald Binder
- Institute for Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Michèle Wessa
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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Rodriguez A, Kim JJ, Zhan C, Lau AS, Hamilton AB, Palinkas LA, Gellatly R, Brookman-Frazee L. A Mixed-Method Analysis on the Impacts of a System-Driven Implementation of Multiple Child Evidence-Based Practices on Community Mental Health Providers. ACTA ACUST UNITED AC 2020; 52:67-79. [PMID: 34349341 DOI: 10.1037/pro0000353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Initiatives to scale up evidence-based practices (EBPs) in routine care are likely to have myriad impacts on community providers, but these impacts have not yet been examined in depth. This is especially true within the context of simultaneous implementation of multiple evidence-based practices. The aim of this study was to characterize the multifaceted impacts on community mental health therapists within a system-driven implementation of multiple EBPs for youth and families. Semistructured interview and survey data were gathered from 60 therapists at 11 agencies contracted with the Los Angeles County Department of Mental Health to deliver EBPs within the Prevention and Early Intervention initiative. Therapists' accounts of impacts varied, and were either predominately negative, predominantly positive, or mixed-valence. Mixed-methods analyses using Kruskal-Wallis tests showed therapist valence groups varied on mean levels of self-reported burnout on surveys. Themes from qualitative data revealed several favorable (e.g., increased EBP knowledge, structure) and unfavorable (e.g., distress, feeling constrained by EBPs) impacts of county-contracted EBP implementation. These findings inform the development and implementation of future system-driven EBP initiatives that consider therapist perspective to optimize positive impacts and minimize negative impacts on therapists.
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Affiliation(s)
| | | | | | | | | | | | | | - Lauren Brookman-Frazee
- University of California, San Diego and San Diego State University/University of California, San Diego
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Impact of Supervisory Support on Turnover Intention: The Mediating Role of Burnout and Job Satisfaction in a Longitudinal Study. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2020; 46:488-497. [PMID: 30810850 DOI: 10.1007/s10488-019-00927-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
High rates of provider turnover are problematic for our mental health system. Research indicates that supervisory support could alleviate some turnover intention by decreasing emotional exhaustion (a key component of burnout) as well as by increasing job satisfaction. However, the potential mediation mechanisms have not been rigorously tested. Longitudinal data collected from 195 direct clinical care providers at two community mental health centers identified positive effects of supervisory support on reduced turnover intention through reduced emotional exhaustion. Job satisfaction was not a significant mediator. Supervisory support may help mitigate turnover intention through work-related stress reduction.
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Zhou H, Jiang F, Rakofsky J, Hu L, Liu T, Wu S, Liu H, Liu Y, Tang YL. Job satisfaction and associated factors among psychiatric nurses in tertiary psychiatric hospitals: Results from a nationwide cross-sectional study. J Adv Nurs 2019; 75:3619-3630. [PMID: 31566793 DOI: 10.1111/jan.14202] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 08/19/2019] [Accepted: 09/04/2019] [Indexed: 11/26/2022]
Abstract
AIMS To investigate the job satisfaction among psychiatric nurses in China and to explore its associated factors. DESIGN A cross-sectional survey among a nationwide sample from 32 tertiary psychiatric hospitals in 29 provincial capitals in China. METHODS Nurses (N = 9.907) were targeted for this survey in December 2017. In all, 8,493 responded (response rate = 85.7%) and 7,881 (79.5%) were included in the analysis. An online questionnaire was used to collect demographics and factors related to the work environment. The short version of the Minnesota Satisfaction Questionnaire was used to assess job satisfaction. Multilevel regression was used to examine the association between job satisfaction and these factors. RESULTS The mean job satisfaction score was 73.7. The multiple regression analysis indicated that self-rated health, monthly income, medical liability insurance coverage, perceived respect from patients, social recognition, nurse-physician collaboration, and trust were significantly associated with higher job satisfaction scores, while age, work hours, and directly experiencing patient-initiated violence were negatively associated with job satisfaction (p < .05). CONCLUSION Overall, Chinese psychiatric nurses are closer to satisfied than neutral and some demographics and factors related to stressful work environments were associated with nurses' job satisfaction scores. IMPACT This study examined factors associated with the job satisfaction of Chinese psychiatric nurses in a nationwide sample and indicated that to improve nurses' job satisfaction, the government and hospital administrators could consider ways to promote nurses' personal health and to modify the stressful work environments, such as improving income, reducing work hours, promoting the psychiatric nursing specialty in ways that increase the public's respect for it, increasing awareness of medical liability insurance coverage, and protecting nurses from patients' violence.
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Affiliation(s)
- Huixuan Zhou
- School of Sport Science, Beijing Sport University, Beijing, China.,School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Feng Jiang
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jeffrey Rakofsky
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Linlin Hu
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tingfang Liu
- Institute for Hospital Management of Tsinghua University, Shenzhen, China
| | - Shichao Wu
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Yuanli Liu
- School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yi-Lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA.,Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA, USA
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Slemon A, Jenkins E, Bungay V, Brown H. Undergraduate students' perspectives on pursuing a career in mental health nursing following practicum experience. J Clin Nurs 2019; 29:163-171. [DOI: 10.1111/jocn.15074] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 08/29/2019] [Accepted: 09/24/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Allie Slemon
- School of Nursing University of British Columbia Vancouver BC Canada
| | - Emily Jenkins
- School of Nursing University of British Columbia Vancouver BC Canada
| | - Vicky Bungay
- School of Nursing University of British Columbia Vancouver BC Canada
| | - Helen Brown
- School of Nursing University of British Columbia Vancouver BC Canada
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Vuong W, Ledi D, Kelland J, Hunter D, Boffa E, Agyapong VIO. Promoting Staff and Physician Well-Being With a Single-Day Event: Event Satisfaction and Perceived Well-Being Benefits of an Addiction and Mental Health Sports Day. Workplace Health Saf 2019; 68:6-12. [DOI: 10.1177/2165079919875731] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Addiction and mental health (AMH) professionals often experience high levels of burnout, which can lead to detrimental outcomes for patient care and safety and the AMH professional themselves. Interventions aimed at improving well-being can be useful to tackle the issues surrounding burnout. Specifically, implementing activity-based events (ABEs), which encourages individuals to be more physically active, can be useful in improving physical, mental, and social well-being. Alberta Health Services AMH, Edmonton Zone, implemented a Sports Day event to promote well-being as a way to help offset the risk of burnout. Methods: This was an online anonymous cross-sectional, postsurvey evaluation. The postsurvey was administered to 243 AMH staff and physicians who registered for Sports Day. Findings: The responses from 66 AMH staff and physician attendees indicated that individuals were highly satisfied with the event and felt that Sports Day promoted positive mental and physical well-being, helped to develop a sense of community, and strengthened colleague relationships. Conclusions/Application to Professional Practice: The results build on the literature examining the effects of single-day ABEs and can be implemented by health care organizations to promote staff and physician well-being via increased physical activity. Single-day ABEs, like Sports Day, can promote mental, physical, and social well-being. Organizing a sports day event is a feasible way to help offset the risk of burnout and is generally well received by individuals.
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Affiliation(s)
| | | | | | | | - Ernie Boffa
- Alberta Health Services
- University of Alberta
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50
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Aalsma MC, Dir AL, Zapolski TCB, Hulvershorn LA, Monahan PO, Saldana L, Adams ZW. Implementing risk stratification to the treatment of adolescent substance use among youth involved in the juvenile justice system: protocol of a hybrid type I trial. Addict Sci Clin Pract 2019; 14:36. [PMID: 31492186 PMCID: PMC6729049 DOI: 10.1186/s13722-019-0161-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 08/10/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Youth involved in the juvenile justice system (YIJJ) have high rates of substance use problems; however, rates of YIJJ engagement in substance use services is low. Barriers to service engagement include lack of appropriate screening and connection to services by the juvenile justice system, as well as lack of resources for delivering evidence-based treatment in community-based settings. To address these barriers, this paper describes a protocol for a type 1 hybrid design to (1) implement universal substance use screening for YIJJ; (2) implement and evaluate the feasibility and effectiveness of a brief, three-session substance use interventions based in motivational interviewing for youth with mild/moderate substance use: Teen Intervene (an individual-based intervention); (3) implement ENCOMPASS, an evidence-based substance use intervention based in motivational enhancement and cognitive behavioral therapy for youth with severe substance use; and (4) evaluate facilitators and barriers to implementing these interventions for mild to severe substance use among YIJJ in community mental health centers (CMHC). METHODS/DESIGN Using a hybrid type 1 clinical effectiveness-implementation design, we will collaborate with CMHCs and juvenile justice in two rural Indiana counties. Guided by the EPIS (exploration, preparation, implementation, sustainability) framework, we will measure factors that affect implementation of substance use screening in juvenile justice and implementation of substance use interventions in CMHCs utilizing self-reports and qualitative interviews with juvenile justice and CMHC staff pre- and post-implementation. YIJJ with mild/moderate substance use will receive a brief interventions and YIJJ with severe substance use will receive ENCOMPASS. We will measure the effectiveness of a brief and comprehensive intervention by assessing changes in substance use across treatment. We anticipate recruiting 160 YIJJ and their caregivers into the study. We will assess intervention outcomes utilizing baseline, 3-, and 6-month assessments. DISCUSSION Findings have the potential to improve screening and intervention services for YIJJ.
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Affiliation(s)
- Matthew C Aalsma
- Department of Pediatrics, Section of Adolescent Medicine, Indiana University School of Medicine, 410 West 10th Street Suite 2000, Indianapolis, IN, 46202, USA.
- Adolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Allyson L Dir
- Adolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tamika C B Zapolski
- Adolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Psychology, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA
| | - Leslie A Hulvershorn
- Adolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Patrick O Monahan
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Zachary W Adams
- Adolescent Behavioral Health Research Program, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
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