Costs of Caring and the Psychological Wellbeing of UK Mental Health Professionals

Linford-Downes, Sian and Bourne, Katy and Twist, Laura (2024) Costs of Caring and the Psychological Wellbeing of UK Mental Health Professionals. PhD thesis, Lancaster University.

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Abstract

‘Costs of caring’, such as burnout (BO), compassion fatigue (CF) and secondary traumatic stress (STS) are well documented as occurring within healthcare professions. Chapter One will describe a systematic literature review identifying risk and protective factors for these in mental health professionals (MHPs) in the UK. Six databases were searched (Academic Search Ultimate, AMED, CINAHL, PsychArticles, PsychInfo and Medline), with 11 papers fitting the inclusion criteria. Limited research was available in relation to STS and CF. All papers included reported BO, with factors found to increase risk including increased overtime hours, whilst increased availability and time for supervision acted as protective factors. Despite the small amount of research in the area, support is provided for the job-demands resources model. Practical suggestions (such as providing protected time) and areas for future research are discussed. Chapter Two reports an empirical study investigating the impact of leadership and adult attachment style on psychological safety (PS) in National Health Service (NHS) mental health staff, using leader-member exchange and attachment theories as a basis. Participants (N = 154) completed an online survey consisting of validated measures of PS, adult attachment style and leadership factors. Regression modelling showed that leadership significantly accounted for 42.4% of the variance in PS scores. There were no significant correlations between attachment and PS, or leadership. Clinical implications look at supporting leadership at all levels to develop a psychologically safe environment, as well as how commissioners can provide input to support with this. Future research will benefit from using longitudinal methodologies to increase the ability to prove causality. Chapter Three provides a critical appraisal of the research process, expanding more on limitations, as well as both clinical and research implications of Chapters One and Two. Key decisions and learning from the process are also discussed, including reflections on the process.