Burnout and compassion in acute mental health wards

Tane, Elizabeth and Fletcher, Ian and Bensa, Sian (2019) Burnout and compassion in acute mental health wards. PhD thesis, Lancaster University.

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Abstract

Section one of this doctoral thesis presents a literature review examining the prevalence of burnout in mental health inpatient staff, whilst synthesising relevant factors linked to the development of burnout. Across the 17 papers examined, emotional exhaustion was high whilst depersonalisation and personal accomplishment were average when compared with mental health worker norms. Factors consistently related to burnout were divided into two groups: staff factors and organisational factors. Within staff factors, negative attitudes and poor mental and physical health were related to higher levels of burnout, whilst within organisational factors, a poor ward climate, lack of social support and team working, and exposure to violence were related to higher burnout. The clinical implications and methodological and theoretical limitations were considered. Section two reports the findings of the empirical paper, that qualitatively explored staffs’ conceptualisation of the development, loss and restoration of compassion within acute mental health wards. A total of 11 participants were interviewed, and using grounded theory informed methodology, five theoretical categories were identified: a compassionate stance, the challenges of acute mental health wards, feeling under threat and the negative appraisal system, restoring compassion and the compassionate organisation. This informed a sequential model of the processes underpinning the development, loss and restoration of staff compassion within this environment. The findings highlight the importance of colleague support, knowing and understanding patients and their history, accessing a reflective space and a compassionate organisation in the maintenance and restoration of compassion. The clinical implications arising from the findings are considered. Finally, a critical appraisal of the work is presented, which offers reflections on the process, the influence of epistemology and terminology, adopting a compassionate stance towards the project and directions for future research.