Recruitment and retention issues for occupational therapists in mental health: Balancing the pull and the push

Background/aim: Recruitment and retention issues for mental health occupational therapists have been the subject of significant concern for many years. This paper describes recruitment and retention issues as reported by mental health occupational therapists employed by a large Area Health Service in metropolitan Sydney. Method: Thirty‐eight mental health occupational therapists (response rate 84%) completed a survey in the first half of 2008. Key themes investigated were: overall satisfaction; attractive elements of positions; positive aspects of positions; constraints of positions; factors associated with leaving positions; supervision; professional development; career pathways; and interest in and access to management positions. Results: Key elements that kept respondents in positions included the nature of the work, being in a supportive team and the opportunity to use occupational therapy skills. Elements that prompted people to consider leaving positions were the desire for new and different types of work, a desire to work closer to home, insufficient time or high workloads, feeling ‘bored’ or ‘stale’, organisational change or juggling multiple demands, working in unsupportive or dysfunctional teams and family or other personal factors. Conclusions: The results supported the development of a ‘push and pull’ conceptualisation of recruitment and retention issues, including job‐related (intrinsic) and non‐job‐related (extrinsic) issues. This conceptualisation allows organisations to closely examine factors that attract practitioners to positions and those that support or damage staff tenure.     

A community development role for occupational therapists working with children, adolescents and their families: A mental health perspective

With world-wide deregulation of mental health services, occupational therapy services are being decentralized with growing importance placed on community based interventions. The present article proposes a model of community development for child and adolescent mental health as one way of encompassing change. The model has five steps (developmental casework, mutual support, coalitions of mutual interest, pro-active community participation, social movements), each facilitating change for subsequent stages of mental health. In combination with the theories of occupational behaviour, role acquisition, developmental and psychosocial theories and the use of coping resources and theories of community development, the model offers an occupation-specific approach that empowers clients to take control of events that influence their health and lives.     

Work-related self-efficacy of occupational therapists in mental health

Abstract

Aim: Changes in the mental health field have created new job expectations of occupational therapists (OTs). The present research investigated differences in general self-efficacy (GSE) and work-related self-efficacy (WRSE) between occupational therapists (OTs) working in psychiatric hospitals and OTs working in community-based mental health services. Method: Thirty-four OTs working in psychiatric hospitals and 30 OTs working in community-based settings (n = 60) completed the General Self Efficacy Scale (GSE) and the WRSE in Mental Health Occupational Therapy Scale (WSMOT). Results: The two groups showed no differences in total WRSE score. Both evinced high self-efficacy in direct intervention activities, and low self-efficacy in managing and counseling. Conclusion: Results enlighten an overall high WRSE, which indicates successful adaptation of OTs to changing roles and tasks in mental health, similar to studies in other countries. However, it reveals discrepancies between job demands and self-efficacy of OTs that should be addressed at educational and managerial levels.     

Securing and retaining a mental health workforce in Far Western New South Wales

OBJECTIVE: To identify strategies local managers can use to optimise recruitment and retention of mental health staff in rural locations. DESIGN: Forty-one staff were interviewed about factors that attracted them to work in remote locations, their initial intentions and factors that encourage them to stay. SETTING: The former Far West Health Area of New South Wales. RESULTS: Overall job satisfaction was high (68%). Key attractors were rural lifestyle and environment. Family reasons, the field of work and the rural lifestyle were factors that keep staff in their positions. Some mentioned the desire to achieve professional goals and see projects completed. Many staff reported that their initial intentions to stay had remained the same (43.9%). Reasons for extended intention to stay were: greater career opportunities; a desire to complete professional goals; extension of positions; and personal factors. The most common reason for leaving was better career opportunities. Other reasons included: changes to personal commitments; heavy workloads or burnout; service management; and workplace politics. A large number of respondents mentioned key differences when comparing rural and metropolitan areas: more travel (greater distances); less service options for referral; greater spectrum of illnesses and conditions; more autonomy and responsibility. CONCLUSIONS: Strategies to recruit and retain staff must take account of personal needs and aspirations. While there is room for state strategies to improve employment incentives, there is also considerable scope for local managers to improve the design and attractiveness of jobs.     

Sources of stress experienced by occupational therapists and social workers in mental health settings

This study examined the sources of stress experienced by occupational therapists and social workers employed in Australian public mental health services and identified the demographic and work-related factors related to stress using a cross-sectional survey design. Participants provided demographic and work-related information and completed the Mental Health Professionals Stress Scale. The overall response rate to the survey was 76.6%, consisting of 196 occupational therapists and 108 social workers. Results indicated that lack of resources, relationships and conflicts with other professionals, workload, and professional self-doubt were correlated with increased stress. Working in case management was associated with stress caused by client-related difficulties, lack of resources, and professional self-doubt. The results of this study suggest that Australian occupational therapists and social workers experience stress, with social workers reporting slightly more overall stress than occupational therapists.     

Health‐personnel recruitment and retention target policy for health care providers in the rural communities: A retrospective investigation at Pudong New Area of Shanghai in China

To tackle the shortage of health personnel in the rural areas of Pudong New Area of Shanghai, the local government issued an incentive policy as one of the medical reforms. The current investigation focused on the relevant incentive measures and their corresponding effects and problems with a view to providing referential and useful experiences for those who are engaged in addressing the same problem at home and abroad. The details of the incentive policy were derived from the government document, and the related data about the flow of the rural community health care providers, from the institutional investigation. As indicated by the current investigation, the incentive policy produced some positive effect in attracting health care providers to work in the rural community health centers, especially general practitioners, nurses, MS/MD degree holders, and intermediate professional title holders to be employed in the farther ones. However, it was turned out that the population of high quality health care providers was still not sufficient enough to cover the whole rural areas, which suggested that it was still hard to draw such qualified medical individuals. To conclude in the current investigation, we made three recommendations for the policymakers to take into account in terms of policy maintenance, benefits for health personnel, and guarantee of their lawful rights and interests.     

Upscaling the recruitment and retention of human resources for health at primary healthcare centres in Lebanon: a qualitative study

The sustainability of primary healthcare (PHC) worldwide has been challenged by a global shortage in human resources for health (HRH). This study is a unique attempt at systematically soliciting and synthesising the voice of PHC and community stakeholders on the HRH recruitment and retention strategies at the PHC sector in Lebanon, the obstacles and challenges hindering their optimisation and the recommendations to overcome such obstacles. A qualitative design was utilised, involving 22 semi‐structured interviews with PHC experts in Lebanon conducted in 2013. Nvivo qualitative data analysis software was employed for the thematic analysis of data collected from interviews. Five comprehensive themes emerged: understanding PHC scope, HRH recruitment issues, HRH retention challenges, rural areas' specific challenges and stakeholders' recommendations. Analysis of stakeholders' responses revealed a lack of a unified understanding of the PHC scope impacting the capacity for appropriate HRH planning. Identified impediments to recruitment included the suboptimal supply of HRH, financial constraints and poor management. Retention difficulties were attributed to poor working environments, financial constraints and lack of professional development. There was consensus that HRH challenges faced were aggravated in rural areas, jeopardising the equitable access to PHC services of quality. Equitable access was also jeopardised by the reported shortage of female HRH in a sociocultural context where many females prefer providers of the same gender. The study sets the path towards upscaling recruitment and retention policies and practices through the endorsement of a nationally acknowledged PHC definition and scope, the sustainable development of the PHC workforce and through the implementation of targeted recruitment and retention strategies addressing rural settings and gender equity. Decision‐makers and planners are urged to identify HRH as the most important input for the success of PHC programmes and interventions, especially in the growing fields of mental health and geriatric care.     

A pilot demonstration of comprehensive mental health services in inner-city public schools

BACKGROUND: National policy statements increasingly espouse the delivery of comprehensive mental health services in schools. In response to the limited evidence supporting this recommendation, the purpose of this study was to assess the need for, and feasibility, desirability, and outcomes of a full model of comprehensive mental health services in 2 public elementary schools in inner‐city neighborhoods. METHODS: The program, based upon a national model for comprehensive school mental health services, comprised universal and indicated preventive as well as clinical interventions designed to target needs identified in a baseline screening survey. The program was implemented over 1 school year by mental health professionals in collaboration with school teachers. Mental health outcomes comparing baseline to follow‐up data were assessed in multiple domains among students and teachers. RESULTS: After 1 year of intervention, students had significantly fewer mental health difficulties, less functional impairment, and improved behavior, and reported improved mental health knowledge, attitudes, beliefs, and behavioral intentions. Teachers reported significantly greater proficiency in managing mental health problems in their classrooms. School staff overwhelmingly endorsed satisfaction with the program. CONCLUSION: If the observed favorable findings from this pilot demonstration can be replicated in methodologically rigorous studies, additional support would be garnered for national policy recommendations about comprehensive school mental health services.     

Occupational therapists' perception of usage of information and communication technology (ICT) in Western Australia and the association of availability of ICT on recruitment and retention of therapists working in rural areas

Objective:  The purpose of this study was to investigate occupational therapists' usage of information and communication technology (ICT) in Western Australia and the association of availability of ICT on recruitment and retention of rural therapists.
Methods:  One thousand, one hundred and thirty-eight surveys were sent to all occupational therapists registered with the Western Australian Occupational Therapy Registration Board in January 2003. The survey was used to identify ICT access, support and literacy. The attitude of therapists towards using ICT as a communication tool and therapists' usage patterns of ICT in metropolitan and rural localities were analysed by using the Chi-squared test.
Results:  Email and the personal computer were used most frequently. On ICT global competency, 58% of therapists rated their competency level as good or better. Competence was rated lower for web searching (48.5%) and searching for electronic articles (29.8%). Approximately one-third of respondents were dissatisfied with the level of technical support available and only 38.4% of therapists had participated in basic computer training provided by their current employer. Rural therapists had less access to a computer in their work environments in comparison to their metropolitan peers (P  <  0.05). Nevertheless, rural therapists were using email, teleconferencing and videoconferencing more frequently than their metropolitan counterparts.
A proportion of rural therapists (45.5%) felt that ICT influenced their decision to continue working in rural areas.
Discussion and Conclusion:  Professional isolation has been cited as an inhibitor to recruit and retain health-care workers in rural areas. The higher ICT usage by rural therapists may represent the utility of ICT as a means of circumventing professional isolation that is inherent in rural and remote areas.     

驻马店市医专学生心理健康状况调查

目的了解医专学生心理健康状况,为开展心理健康教育提供依据。方法采用SCL—90症状自评量表,对河南省某医学专科学校365名学生进行测试。结果医专学生心理健康状况水平低于全国常模。主要心理卫生问题是抑郁、强迫、偏执、敌对,人际关系等(检出率1.92%-12.33%);心理问题发生率(23.84%)高于全国大学生抽样调查结果。心理问题发生率一年级学生最高(26.15%),其次是二年级(23.36%),再次是三年级(21.13%),主要心理问题基本相似。结论医专学校健康教育应针对学生心理健康状况和特点进行。     

Latino recruitment and retention strategies: community-based HIV prevention

Latinos are disproportionately affected by HIV/AIDS. The need for community-based AIDS prevention programs that are culture specific is well recognized. Lay Health Advisor (LHA) interventions are a culturally appropriate way to provide information about HIV/AIDS to community members. LHA programs use natural helpers in the community to disseminate information through their social networks. Natural helpers are community members who informally provide support to their neighbors and to whom others naturally turn for advice. This paper reports the recruitment and retention experiences of a Lay Health Advisor Program: Protegiendo Nuestra Familia (Protecting Our Family) for prevention of HIV/AIDS among Latinos in North Carolina.