Burnout prevention interventions for mental health professionals: a systematic review and investigation into the role of personal resources in the development of burnout in mental health nurses
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Mental health professionals are at high risk of experiencing work-related stress and burnout due to the challenging and highly emotive environments in which they work. This may lead to a range of physical and psychological symptomology which may affect them and also the quality of care provided to patients. This thesis presents a systematic review of the literature regarding the effectiveness of workplace interventions designed to reduce or prevent work-related stress and burnout when compared to no intervention or alternative interventions for mental health professionals working in adult mental health settings. The thesis then presents an empirical study, using the Job Demands-Resources model of burnout. Personal resources (styles of coping, self-compassion, cognitive fusion and valued living) were tested as (a) moderators of the relationship between job demands and exhaustion and (b) mediators of the relationship between job resources and disengagement within a sample of mental health nurses. Methods: A systematic review and meta-analysis of randomised controlled trials (RCTs), non-randomised controlled trials (N-RCTs), controlled before and after (CBA) and interrupted time series workplace (ITS) interventions were conducted. Primary outcomes were occupational stress and burnout. An assessment of strength of evidence was made using GRADE criteria. A quantitative cross-sectional survey of 214 mental health nurses was used to examine the role of: self-compassion, cognitive fusion, engaged living and coping in the development of burnout. Results Thirteen eligible studies were identified comprising 11 RCTs and 2 CBA’s. Overall, there was no beneficial effect of organisational and relaxations intervention was found for reducing burnout or work-related stress. There are some promising findings for the effectiveness of staff training and psychosocial interventions in the short and medium-term. Overall, the quality of studies was low due to risk of bias and a lack of precision due to low number of participants in each study. In the empirical paper, the moderating role of personal resources in the development of exhaustion was not supported. By contrast the mediating role of personal resource between job resources and disengagement was supported. Discussion At present, there is limited evidence for the effectiveness of workplace interventions. This is influenced by the low number of intervention studies and the quality of interventions to date for mental health professionals. There is preliminary evidence for the potential for third-wave cognitive behavioural interventions such as acceptance commitment therapy in reducing disengagement in mental health nurses. Interventions to reduce exhaustion need to include strategies to reduce job demands.