Working in a demanding environment: employee wellbeing in secure forensic settings
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Introduction: Care professionals suffering with poor wellbeing is a phenomenon that has been found to have a damaging effect upon individual employees, service users and organisations. Employees working in forensic settings are believed to be at increased risk of damaged wellbeing due to the unique demands of their working environment, including exposure to violence and aggression. This issue was addressed in two ways. Firstly, a systematic review of the literature on the effectiveness of person-centred interventions to improve the wellbeing of forensic professionals was prepared. Following this, an empirical study was completed which examined the ability of demands related to violence and aggression, and resources of two types (cognitive and contextual behavioural) to predict the wellbeing of employees in a high secure forensic mental health (FMH) hospital. Method: For the systematic review, relevant databases were systematically searched and 7 papers that met the inclusion criteria were identified. The included studies were quality assessed to identify strengths and weaknesses. For the empirical study, 142 employees at a high secure FMH hospital completed self-report questionnaires which examined their wellbeing, perceptions of the prevalence of aggression, beliefs about safety, attitudes towards aggression, and psychological flexibility. Results: The reviewed studies included psychological, educational and mixed type interventions. Evidence for the effectiveness of interventions was mixed, and problems with methodological quality common. The results of the empirical paper suggested that exposure to violence and aggression was not a good predictor of wellbeing. However, the beliefs staff held about safety and staff‘s level of psychological flexibility were predictive of wellbeing. Conclusions: The review concluded that the existing evidence for the effectiveness of person-centred wellbeing interventions for forensic professionals was generally of poor quality, and inadequate to provide firm recommendations. Further research to assess the effectiveness of interventions and the underlying mechanisms of wellbeing change in forensic settings was advised. The empirical paper concluded that job demands related to staff‘s cognitive appraisal of safety, and the contextual behavioural resource, psychological flexibility, were predictive of staff wellbeing. It was recommended that future interventions to improve the wellbeing of forensic professionals consider the psychological processes staff encounter in the workplace, with a particular focus on contextual behavioural resources, which have an existing evidence base in broader occupational fields. Further research using contextual behavioural interventions within forensic settings is recommended in order to develop the limited research on forensic professionals‘ workplace wellbeing.