Job Satisfaction and Burnout Among VA and Community Mental Health Workers

Building on two independent studies, we compared burnout and job satisfaction of 66 VA staff and 86 community mental health center staff in the same city. VA staff reported significantly greater job satisfaction and accomplishment, less emotional exhaustion and lower likelihood of leaving their job. Sources of work satisfaction were similar (primarily working with clients, helping/witnessing change). VA staff reported fewer challenges with job-related aspects (e.g. flexibility, pay) but more challenges with administration. Community mental health administrators and policymakers may need to address job-related concerns (e.g. pay) whereas VA administrators may focus on reducing, and helping workers navigate, administrative policies.     

Satisfaction and Mental Health Outcomes Associated with a Large Regional Helpline

We surveyed users of a behavioral health helpline serving New York City and surroundings, to assess their helpline experiences, changes in psychological distress after contacting the helpline, and factors associated with differences in these measures. We surveyed users twice: roughly 2 weeks following their helpline contact, from 4/2019 to 9/2019 (N?=?1097 respondents) and again 6 months following contact, from 10/2019 to 3/2020 (N?=?732 respondents). Eighty-nine percent of respondents reported that contacting the helpline helped them deal a little or a lot more effectively with their problems. Rates of psychological distress decreased from 41.3% 2 weeks following helpline contact to 29.0% 6 months after (P?<?0.05). Improvements in psychological distress were found across a range of demographic characteristics and were greatest for repeat users. Users reported broadly positive experiences with the helpline and improved psychological distress 6 months later. Behavioral health helplines can offer beneficial services to diverse populations, complementing the formal behavioral healthcare system.

     

Supervision Practices in Allied Mental Health: Relationships of Supervision Characteristics to Perceived Impact and Job Satisfaction

This study examined whether supervision characteristics impacted on mental health practice and morale, and developed a new Supervision Attitude Scale (SAS). Telephone surveys were conducted with a representative sample of 272 staff from public mental health services across Queensland. Although supervision was widely received and positively rated, it had low average intensity, and assessment and training of skills was rarely incorporated. Perceived impact on practice was associated with acquisition of skills and positive attitudes to supervisors, but extent of supervision was related to impact only if it was from within the profession. Intention to resign was unrelated to extent of supervision, but was associated with positive attitudes to supervisors, accessibility, high impact, and empathy or praise in supervision sessions. The SAS had high internal consistency, and its intercorrelations were consistent with it being a measure of relationship positivity. The study supported the role of supervision in retention and in improving practice. It also highlighted supervision characteristics that might be targeted in training, and provided preliminary data on a new measure.     

Perceived Risk and Mental Health Problems among Healthcare Professionals during COVID-19 Pandemic: Exploring the Mediating Effects of Resilience and Coronavirus Fear

During coronavirus (COVID-19) pandemic, healthcare professionals were particularly at high-risk of developing symptoms of mental health problems due to being on the frontline in the battle against COVID-19. This study examined the mediating roles of resilience and coronavirus fear in the relationship between perceived risk and mental health problems among healthcare professionals including doctors and nurses who were actively treating patients confirmed with COVID-19. We recruited 204 healthcare professionals (50% females) with a mean age of 32.92 years (SD?=?7.01). Results showed that perceived risk and coronavirus fear positively predicted depression, anxiety, and stress while resilience negatively predicted those mental health problems. Coronavirus fear mediated the relationship between perceived risk and resilience, depression, anxiety, and stress. Additionally, resilience mitigated the effect of coronavirus fear on depression, anxiety, and stress. This study is among the first indicating the importance of resilience and fear as a critical mechanism that explains the relationship between perceived risk and mental health problems among health professionals directly caring for COVID-19 patients.

     

Behavioural Phenotypes and their Relevance to Child Mental Health Professionals

The study of behavioural phenotypes and their clinical relevance diagnostically and therapeutically is receiving increasing attention. A clear understanding of their nature, aetiology and implications by child mental health professionals is essential if they are to be of real benefit to clients with such problems and their families. This article addresses these issues and considers historical aspects as well as contrasting clinical approaches to the interface between genetics and child mental health. Important examples of conditions with associated behavioural phenotypes are reviewed followed by a discussion of the importance of diagnosis and the roles and responsibilities of child mental health professionals.     

Perceived Ideological Differences, Job Satisfaction and Organizational Commitment Among Psychiatrists in a Community Mental Health Center

Physician turnover has long been a problem incommunity mental health centers. While explanations forthe problem have been offered, there have been nosystematic studies of factors associated with the high turnover. In this study, the MinnesotaSatisfaction Questionnaire and the OrganizationalCommitment Questionnaire were given to psychiatristsemployed by a community mental health center. Subjects were also asked to identify their treatmentideology, and to rate their perception of the ideologyof other clinicians and administrators with whom theywork. Psychiatrists perceived significant differences in many ideological areas. Analysisdemonstrated a correlation between these differences andthe commitment of the psychiatrists to theorganization.     

Transformational and Transactional Leadership Skills for Mental Health Teams

Many treatments for persons with severe mentalillness are provided by mental health teams. Teammembers work better when led by effective leaders.Research conducted by organizational psychologists, and validated on mental health teams, haveidentified a variety of skills that are useful for theseleaders. Bass (1990, 1997) identified two sets ofespecially important skills related to transformational and transactional leadership. Leaders usingtransformational skills help team members to view theirwork from more elevated perspectives and developinnovative ways to deal with work-related problems.Skills related to transformational leadership promoteinspiration, intellectual stimulation, individualconsideration, participative decision making, andelective delegation. Mental health and rehabilitationteams must not only develop creative and innovativeprograms, they must maintain them over time as a seriesof leader-team member transactions. Transactionalleadership skills include goal-setting, feedback, and reinforcement strategies which help teammembers maintain effective programs.     

Factors Associated with Mental Health Service Need and Utilization among Unaccompanied Refugee Adolescents

This study is the first to address the need for mental health Care (MHC) and the patterns of utilization of MHC services among Unaccompanied Refugee Minors (URM). Information concerning the well being, mental health need, and utilization of services of URM was collected from three informants, the minors themselves (n = 920), their legal guardians (n = 557), and their teachers (n = 496). The well-being, need and utilization of MHC services of URM was compared with those of a representative Dutch adolescent sample (n = 1059). The findings of this study indicated that URM that report a mental health care need (57.8%) also report higher levels of emotional distress than Dutch adolescents who report a similar need for MHC (8.2%). In addition, guardians and teachers detect emotional distress and mental health care needs in only a small percentage (30%) of URM. The referral of URM to mental health care services does not appear to be driven by the reported needs of the URM, but by the need and emotional distress as observed and perceived by guardians. This resulted in the fact that 48.7% of the URM total sample reported that their need for mental health care was unmet.     

Threats to Mental Health and Well-Being Associated with Climate Change

Climate change is a contributor to extreme weather events and natural disasters. The mental health effects of climate change are multifaceted, with post-traumatic stress disorder and depression predominant. This paper aims to describe the impact of climate change on mental health conditions, including risk and protective factors related to the expression of mental health conditions post-disaster, as well as a discussion of our local experience with a devastating wildfire to our region within Canada. The risk of the development of mental health conditions post-disaster is not equally distributed; research has consistently demonstrated that specific risk factors (e.g., gender, socioeconomic status and education, pre-existing mental health symptomatology), are associated with increased vulnerability to mental health conditions following natural disasters. There are multiple strategies that must be undertaken by communities to enhance adjustment and coping post-disaster, including improved access to care, inter-agency cooperation, enhanced community resiliency, and adequate preparation.     

Managed Care and Provider Satisfaction in Mental Health Settings

We assess the satisfaction of mental health providers using four dimensions from the medical practice literature—degree of autonomy, relationship with patients, compensation, and administrative burden—and extend current work on professional satisfaction to include frontline service providers rather than only psychiatrists or other physicians. In contrast to results reported for primary care settings, we find that the impact of managed care on satisfaction is minimal for the mental health providers in our study of a Medicaid capitation demonstration in the southeastern US. Instead, variables relevant to everyday working conditions have an important effect on job satisfaction.

Youth and Caregiver Access to Peer Advocates and Satisfaction with Mental Health Services

Access to peer advocates is increasingly available to youth and their caregivers who are receiving services in the public mental health system. This study examines associations between reported access to a youth or family advocate and perceptions of satisfaction with mental health services. A cross-sectional survey of youth (N = 768) and caregivers (N = 1,231) who utilized public mental health services in New York State in 2012 was conducted. The survey includes items on access to youth or family advocates and degree of satisfaction with mental health services. A greater proportion of youth or caregivers with access to peer advocates compared to those without access responded positively on the satisfaction domains of access to services, appropriateness of services, participation in services and overall/global satisfaction. Access to peer advocates was also positively associated with agreement on the psychotropic medication comprehension domain for youth and on perceptions of child functioning and social connectedness for caregivers compared to those without access. This study adds to the growing understanding of the important role peer advocates play in engaging youth with mental health needs and their caregivers in mental health services.     

Predictors of Frequent Recourse to Health Professionals by People With Severe Mental Disorders

Objective:

Based on Andersen’s behavioural model, our study sought to determine predictors and blocks of factors that could explain why people with severe mental disorders (SMDs) more often seek the services of health professionals.

Methods:

This longitudinal study involved 292 users with SMDs located in Le Sud-Ouest, the southwest borough of Montreal. Data were collected from participants’ medical records and through 7 questionnaires. Using Andersen’s Behavioral Model of Health Services Use, independent variables were divided into 3 classes—predisposing factors, enabling factors, and need factors—and were introduced in this order in a hierarchical logistic model.

Results:

Among 292 users, 110 (37.7%) were frequent users who consulted about one health professional every 3 days. Participants who were more likely to call on health professionals were single and older, depended on welfare as their main source of income, lived in supervised housing, suffered from schizophrenia, schizophrenia spectrum disorders, and adjustment disorders, and, marginally, exhibited multiple mental disorders.

Conclusion:

Mental health services could promote strategies to overcome the reluctance of younger people to seek professional services. Professionals should pay close attention to subsidiary conditions, such as adjustment disorders, from which people with SMDs may suffer. Interventions to improve the socioeconomic condition of unemployed people with SMDs may help to reduce health care service use among that clientele. Programs such as supported employment should be tailored and enhanced for people receiving welfare to decrease stigmatization and improve job market integration.     

Social Support and Social Adjustment: Implications for Mental Health Professionals

The general importance of an individual's support network has been recognized in the field of community mental health; yet a more detailed understanding of how a client's available social ties may contribute to his or her adjustment is presently lacking. This study used network analysis to examine differences in the social networks of mental health clients to identify factors associated with positive social adjustment. Subjects were selected from three different types of mental health programs as well as from the general population of Marion County, Oregon. Results generally revealed that subjects from the community sample more often would look to immediate family members for support. Better functioning chronic clients emphasized professional contacts, whereas more poorly adjusted chronic clients would look to friends for support. The results have implications both for understanding the nature of the support available to a client and mobilizing the support resources of the existing network of relationships to aid adjustment to community living.     

Mental Health Promotion,Psychiatry and Related Fields

Rational fields are groupings of related goals and behaviours. They have varying degrees of stability. Psychiatry and mental health promotion are disintegrating rational fields because they have vague goals, exhibit multiple oversimplifications and overcomplications of meaning, and disregard the ‘beyond the evidence decision points’ that created and sustain them. Consequently, psychiatry and mental health promotion should be subsumed within a broad, explicitly health promoting field, governed by the understanding that promoting a person's health means promoting the autonomy of an integrated social being. Were this to be the case there would be no need for a discipline called ‘mental health promotion’, and psychiatric practice would change radically.