Seeking help for psychological distress: Barriers for mental health professionals

Burnout Prevalence and Associated Factors Among Palliative and Hospice Care Professionals During the COVID-19 Endemic: An Exploratory Survey

BACKGROUND

Burnout is a significant issue for palliative and hospice professionals, exacerbated by the impact of Coronavirus Disease 2019 (COVID-19) on healthcare professionals. It is crucial to update our understanding of prevalence data, identify associated factors, and evaluate support resources during the COVID-19 pandemic.

METHODS

We aimed to explore the prevalence of burnout among palliative and hospice care workers, 2 years into the COVID-19 pandemic by using the Maslach's Burnout Inventory; anxiety, using General Anxiety Disorder-7 (GAD-7), workload, risk perception of COVID-19, confidence in protective measures (personal, workplace, and government), and usage and perceived helpfulness of support resources. Univariate logistic regression analysis was conducted to analyse burnout against these factors.

RESULTS

Of the 115 respondents encompassing doctors, nurses and social workers (76.5% female; average age 40.9), 48.7% experienced burnout. Burnout correlated with increased anxiety, higher COVID-19 risk perception, heavier workload, and reduced confidence in protective measures. Peer support, COVID information, and psychological programs were rated as the most effective for coping.

CONCLUSION

The study indicates considerable levels of burnout among palliative and hospice care workers, linked to workload, anxiety, and perceived risk. Traditional mental health interventions had limited efficacy; respondents favoured peer support and organisational changes. The findings stress the need for a holistic approach, including diverse resources, workload management, and regular mental health assessments.

Barriers and facilitators to seeking psychological support among healthcare professionals: a qualitative study using the Theoretical Domains Framework

BACKGROUND

Despite facing significant mental health risks, healthcare professionals often demonstrate a low frequency of seeking psychological support. This study aimed to explore the factors influencing healthcare professionals' psychological help-seeking behaviours in order to enhance the mental health of this critical population.

METHODS

Semi-structured interviews were conducted with registered clinical doctors, nurses, and hospital managers aged 21-55 years, recruited from comprehensive public hospitals in China. Participants were selected through purposive and snowball sampling to ensure diversity in roles, specialities, and work experiences. The interview guide was developed using the Theoretical Domains Framework (TDF) to explore the reasons for seeking psychological support. Data were analyzed using framework analysis and relevant domains were identified according to the frequency of participants' belief statements. The facilitators and barriers in each domain were summarized using the coded reference points.

RESULTS

A total of 34 participants were interviewed (12 nurses, 8 physicians, 14 hospital managers). We identified seven relevant domains in influencing the behaviour of seeking psychological support: knowledge, beliefs about capabilities, environmental context and resources, social/professional role and identity, emotion, social influences, and behavioural regulation. The most common facilitators of psychological help-seeking include accessible resources, positive interpersonal relationships, increased awareness, effective behavioural strategies, and emotional acknowledgement, while barriers include privacy concerns, stigma, time constraints, doubts about the effectiveness of psychological services, limited knowledge, and perceived professional role conflicts.

CONCLUSION

The behaviour of healthcare professionals seeking psychological support is complex and influenced by the interaction of multiple factors. The findings highlight the need for targeted interventions that enhance mental health literacy, address stigma, provide accessible psychological support resources, and cultivate a supportive organisational culture to improve their well-being.

Nurses Supporting Nurses: A Model for Providing Mental Health Services During War

Nurses routinely face psychological challenges as part of their work, acutely so during times of crises when nurses may treat many severely injured and dying patients. While the need for such support is well documented in the literature, mental health support programmes aimed at healthcare workers, even when available, are often underutilised, especially by nurses. To gain insights about needed mental health supports for nurses and programme implementation, this study examines a programme launched following a surprise attack on Israel on 7 October, 2023, resulting in thousands of deaths and injuries and precipitating a war. The programme deployed 30 volunteer nurses trained in cognitive behavioural therapy, trauma support and mental health first aid to offer up to three, anonymous, 30-min online therapy sessions to nurses around Israel in December 2023. Using a qualitative descriptive design, we engaged 22 of these volunteers in one of the three focus groups lasting 60-90 min each. Our findings highlight a range of mental health issues-among both the volunteers and therapy recipients-as well as barriers to providing mental health support to nurses. The importance of normalising the pursuit of mental health support in nursing education and ensuring the availability of support in healthcare organisations was emphasised.

PsyHELP pocket guide: Development of an educational tool to promote professional mental health help-seeking among the health workforce

INTRODUCTION

Ensuring the mental well-being of the health workforce is important in maintaining a robust healthcare system. This paper aims to describe the development of PsyHELP pocket guide and its potential to encourage the health workforce to recognise and seek help from mental health professionals for their mental health concerns.

METHOD

Developed with the Health Belief Model (HBM) as its theoretical framework, this PsyHELP pocket guide integrates theoretical and practical strategies, employing a user-centric design that combines text, visuals, and interactive elements, such as QR codes linked to animation videos, to enhance engagement and accessibility. The content development involved a thorough literature review and was structured to align with the HBM, addressing various constructs that influence help-seeking.

RESULT

The PsyHELP pocket guide series, conceptualised as multiple pocket guides, begins with foundational information about mental health and progresses to offer actionable strategies tailored for the health workforce. It addresses vital mental health concepts, combating stigma, recognising the need for professional help, and providing steps towards mental well-being, ensuring a comprehensive approach to mental health awareness and action among the health workforce.

CONCLUSION

The PsyHELP pocket guide stands out as a promising resource, aiming to enhance mental health awareness and encourage help-seeking behaviours among the health workforce, fostering a supportive and mentally healthy work environment.

Psychological Help-Seeking Status for Living with Mental Health Conditions in Türkiye: Using a Multivariate Probit Model

BACKGROUND/AIM

Mental disorders constitute a significant public health concern, contributing significantly to the overall disease burden. Individuals experiencing mental distress often delay or avoid seeking psychological help or do not seek help due to varying factors. This study examines the factors affecting individuals' preferences, particularly young people, in seeking psychological help in Türkiye.

METHODS

This study utilized microdata from the Türkiye Health Survey conducted by TURKSTAT in 2016 and 2019. The factors influencing decisions to consult with a psychologist, psychotherapist, or psychiatrist were determined by multivariate probit regression analysis. The Türkiye Health Survey employed a stratified two-stage cluster sampling method, surveying 17,242 individuals over the age of 15 in 9470 households in 2016 and 17,084 individuals over the age of 15 in 9470 households in 2019.

RESULTS

The analysis findings indicated that, in the entire sample, women are more likely to seek psychological help, while younger women are less likely to do so. In the entire sample, as the education level increased, the probability of individuals receiving psychological help increased, while it decreased for young people. It was determined that people who use tobacco and alcohol are more likely to receive psychological help than others. It was also determined that individuals who perceive their health status as good, especially those who are both young and perceive their health status as good, are less likely to seek psychological help.

CONCLUSIONS

The significance and impact of the variables on the probability of individuals seeking psychological help vary for both the entire sample and young people. There may be various restrictions in getting psychological help, and people may resort to informal methods instead of professionals to cope with their existing problems. In developing preventive strategies to safeguard mental health, factors related to young people's and individuals' psychological help-seeking status should be prioritized, and more attention should be paid to them.

Mindful Self-Compassion as an Antidote to Burnout for Mental Health Practitioners

The objective of this correlational study was to explore the relationship between levels of self-compassion and burnout for currently practicing mental health practitioners (MHPs) in the United States. All professionals are vulnerable to burnout based on various types of organizational stressors, but burnout is of particular concern for health care service providers who may need to adopt a stance of detachment, or emotional distance, as relief from intense workloads, with clients. The data were collected through an online survey. Regression analysis found that scores from Neff's Self-Compassion Scale were a significant negative predictor of levels of MHP burnout, as assessed by Schaufeli et al.'s Burnout Assessment Tool, p < 0.001. The implication of this finding is that cultivating self-compassion appears to be a pragmatic self-care strategy for MHPs to mitigate the negative effects of burnout. More educational and occupational training in self-compassion practices as self-care should be provided to help protect the physical and emotional well-being of MHPs. The deleterious systemic effects of burnout make MHP self-care an ethical issue, along with the need to identify protective factors, prevention, and treatment of burnout.

Healthcare Professionals' Own Experiences of Domestic Violence and Abuse: A Meta-Analysis of Prevalence and Systematic Review of Risk Markers and Consequences

Background: Globally, healthcare professionals (HCPs) are increasingly asked to identify and respond to domestic violence and abuse (DVA) among patients. However, their own experiences of DVA have been largely ignored.Aim: To determine the prevalence of current and lifetime DVA victimisation among HCPs globally, and identify risk markers, consequences and support-seeking for DVA.Method: PubMed, EMBASE, PsycINFO, CINAHL ASSIA and ProQuest were searched. Studies about HCPs' personal experience of any type of DVA from any health service/country were included. Meta-analysis and narrative synthesis were adopted.Results: Fifty-one reports were included. Pooled lifetime prevalence was 31.3% (95% CI [24.7%, 38.7%] p < .001)) and past-year prevalence was 10.4% (95% CI [5.8%, 17.9%] p <.001). Pooled lifetime prevalence significantly differed (Qb=6.96, p < .01) between men (14.8%) and women (41.8%), and between HCPs in low-middle income (64.0%) and high-income countries (20.7%) (Qb = 31.41, p <.001). Risk markers were similar to those in the general population, but aspects of the HCP role posed additional and unique risks/vulnerabilities. Direct and indirect consequences of DVA meant HCP-survivors were less able to work to their best ability. While HCP-survivors were more likely than other HCPs to identify and respond to DVA among patients, doing so could be distressing. HCP-survivors faced unique barriers to seeking support. Being unable to access support - which is crucial for leaving or ending relationships with abusive people - leaves HCP-survivors entrapped.Conclusion: Specialised DVA interventions for HCPs are urgently needed, with adaptations for different groups and country settings. Future research should focus on developing interventions with HCP-survivors.

Translation, Adaptation, and Validation of the Malay Version of the Barriers to Access to Care Questionnaire for Assessing the Barriers to Seeking Mental Health Care Among the Health Workforce in the East Coast Region of Peninsular Malaysia

Background Mental health problems among the health workforce are a significant concern worldwide, including in Malaysia. Unfortunately, some health workforce may perceive various barriers or challenges that prevent them from seeking help. Identifying and addressing these barriers is crucial for enhancing mental health services and support. The Barriers to Access to Care Evaluation (BACE-3) questionnaire is a valuable tool that can be used for assessing these barriers among health workers. However, a validated Malay version is needed. Therefore, this study aims to translate, adapt, and validate the original version of Barriers to Access to Care Evaluation (BACE-3) into the Malay version (MBACE). Methods A rigorous process of translation and adaptation was followed to develop the Malay version of the BACE-3 questionnaire (MBACE). A cross-sectional study was conducted to assess the psychometric properties of the questionnaire, with purposive sampling employed to recruit 188 participants from various job categories, including doctors, nurses, pharmacists, and non-clinical staff, such as health assistants and clerks. The analysis was conducted using the R software version 4.2.2 (R Foundation, Vienna, Austria). Construct validity was determined using confirmatory factor analysis (CFA). To assess the convergent validity, internal consistency, and reliability of the instrument, measures such as the average variance extracted (AVE), composite reliability (CR), and Cronbach's alpha values were calculated. Results During the CFA process, two items with a factor loading less than 0.5 (items 15 and 16) were removed to improve the convergent validity and model fit. The CFA results revealed that the 2-factor model MBACE had good construct validity (root mean square error of approximation (RMSEA) = 0.053; comparative fit index (CFI) = 0.939; Tucker-Lewis fit index (TLI) = 0.934). The internal consistency was supported by Cronbach's alpha values ranging from 0.92 to 0.94 for the stigma factor and non-stigma factor. The average variance extracted (AVE) and composite reliability (CR) values further supported the questionnaire's reliability and convergent validity. Conclusion The translated and adapted 28-item MBACE questionnaire is a valid and reliable tool for assessing the barrier to seeking professional mental health care among the Malaysian health workforce. This instrument has the potential to aid in the development of targeted interventions to promote mental health help-seeking behavior and enhance the well-being of the Malaysian health workforce.

The Psychological and Wellbeing Impacts of Quarantine on Frontline Workers during COVID-19 and Beyond

OBJECTIVE

The current study investigated the experiences, wellbeing impacts, and coping strategies of frontline workers who participated in "Hotels for Heroes", an Australian voluntary hotel quarantine program during the COVID-19 pandemic. The program was open to those who were COVID-19 positive or exposed to COVID-19 as part of their profession.

METHODS

Frontline workers who had stayed in voluntary quarantine between April 2020 and March 2021 were invited to participate in a voluntary, anonymous, cross-sectional online survey including both quantitative and qualitative responses. Complete responses were collected from 106 participants, which included data on sociodemographic and occupational characteristics, experiences of the Hotels for Heroes program, and validated mental health measures.

RESULTS

Mental health problems were prevalent amongst frontline workers (e.g., moderate anxiety symptoms, severe depression symptoms, and greater than usual impact of fatigue). For some, quarantine appeared to be helpful for anxiety and burnout, but quarantine also appeared to impact anxiety, depression, and PTSD negatively, and longer stays in quarantine were associated with significantly higher coronavirus anxiety and fatigue impacts. The most widely received support in quarantine was from designated program staff; however, this was reportedly accessed by less than half of the participants.

CONCLUSIONS

The current study points to specific aspects of mental health care that can be applied to participants of similar voluntary quarantine programs in the future. It seems necessary to screen for psychological needs at various stages of quarantine, and to allocate appropriate care and improve its accessibility, as many participants did not utilise the routine support offered. Support should especially target disease-related anxiety, symptoms of depression and trauma, and the impacts of fatigue. Future research is needed to clarify specific phases of need throughout quarantine programs, and the barriers for participants receiving mental health supports in these contexts.

What are the barriers and facilitators to seeking help for mental health in NHS doctors: a systematic review and qualitative study

BACKGROUND

The mental health of healthcare professionals is reaching a breaking point, and the COVID-19 pandemic has exacerbated current mental health issues to unprecedented levels. Whilst some research has been carried out on the barriers that doctors face when seeking mental health help, there is little research into factors which may facilitate seeking help. We aimed to expand the research base on factors which act as barriers to seeking help, as well as gain insight into facilitators of help-seeking behaviour for mental health in NHS doctors.

METHODS

We conducted a systematic literature review which identified the barriers and facilitators to seeking help for mental health in healthcare professionals. Following this, we conducted semi-structured interviews with 31 NHS doctors about their experiences with mental health services. Finally, through thematic analysis, key themes were synthesised from the data.

RESULTS

Our systematic literature review uncovered barriers and facilitators from pre-existing literature, of which the barriers were: preventing actions, self-stigma, perceived stigma, costs of seeking treatment, lack of awareness and availability of support, negative career implications, confidentiality concerns and a lack of time to seek help. Only two facilitators were found in the pre-existing literature, a positive work environment and availability of support services. Our qualitative study uncovered additional barriers and facilitators, of which the identified barriers include: a negative workplace culture, lack of openness, expectations of doctors and generational differences. The facilitators include positive views about mental health, external confidential service, better patient outcomes, protected time, greater awareness and accessibility, open culture and supportive supervisors.

CONCLUSION

Our study began by identifying barriers and facilitators to seeking mental health help in healthcare workers, through our systematic literature review. We contributed to these findings by identifying themes in qualitative data.. Our findings are crucial to identify factors preventing NHS doctors from seeking help for their mental health so that more can be done on a national, trust-wide and personal level to overcome these barriers. Likewise, further research into facilitators is key to encourage doctors to reach out and seek help for their mental health.

Thoughts of suicide or self-harm among healthcare workers during the COVID-19 pandemic: qualitative analysis of open-ended survey responses

BACKGROUND

Healthcare workers are at higher risk of suicide than other occupations, and suicidal thoughts appear to have increased during the COVID-19 pandemic.

AIMS

To understand the experiences of healthcare workers with frequent thoughts of suicide or self-harm during the pandemic, including factors that contributed to their distress, and the supports that they found helpful.

METHOD

We used content analysis to analyse free-text responses to the Australian COVID-19 Frontline Healthcare Workers Study, from healthcare workers who reported frequent thoughts that they would be better off dead or of hurting themselves, on the Patient Health Questionnaire-9.

RESULTS

A total of 262 out of 7795 healthcare workers (3.4%) reported frequent thoughts of suicide or self-harm in the preceding 2 weeks. They described how the pandemic exacerbated pre-existing challenges in their lives, such as living with a mental illness, working in an unsupportive environment and facing personal stressors like relationship violence or unwell family members. Further deterioration in their mental health was triggered by heavier obligations at home and work, amid painful feelings of loneliness. They reported that workplace demands rose without additional resources, social and emotional isolation increased and many healthful activities became inaccessible. Tokenistic offers of support fell flat in the face of multiple barriers to taking leave or accessing professional help. Validation of distress, improved access to healthcare and a stronger sense of belonging were identified as helpful supports.

CONCLUSIONS

These findings highlight the need for better recognition of predisposing, precipitating, perpetuating and protective factors for thoughts of suicide and self-harm among healthcare workers.

Healthcare workers use of psychological support resources during COVID-19; a mixed methods approach utilising Pillar Integration Analysis

Objectives

We sought to examine healthcare workers (HCWs) utilisation of formal and informal psychological support resources in the workplace during the first and third waves of the COVID-19 pandemic in Ireland.

Methods

A convergent mixed methods approach was undertaken. Four hundred and thirty HCWs in the Mid West and South of Ireland responded to an online survey in terms of their use of psychological support resources during Wave 1 (April/May 2020) of COVID-19. Thirty-nine HCWs undertook in depth interviews at Wave 3 (January/February 2021), and a further quantitative survey was distributed and completed by 278 HCWs at this time. Quantitative data arising at Wave 1 and Wave 3, were synthesised with Qualitative data collected at Wave 3. A Pillar Integration Process (PIP) was utilised in the analysis of the quantitative and qualitative data.

Results

Five pillars were identified from the integration of results. These were: a) the primacy of peer support, b) the importance of psychologically informed management, c) a need to develop the organisational well-being ethos, d) support for all HCWs, and e) HCWs ideas for developing the well-being path. These pillars encapsulated a strong emphasis on collegial support, an emphasis on the need to support managers, a questioning of the current supports provided within the healthcare organisations and critical reflections on what HCWs viewed as most helpful for their future support needs.

Conclusions

HCWs who utilised supportive resources indicated ‘in house’ supports, primarily collegial resources, were the most frequently used and perceived as most helpful. While formal psychological supports were important, the mechanism by which such psychological support is made available, through utilising peer support structures and moving towards psychologically informed supervisors and workplaces is likely to be more sustainable and perceived more positively by HCWs.

A systematic review of the evidence relating to disclosure of psychological distress by mental health professionals within the workplace

Objective

To systematically review evidence regarding prevalence and choices of disclosure of psychological distress, by mental health professionals within the workplace.

Methods

Six databases were searched in June 2020. Studies were included if they were published in English language and included empirical quantitative, qualitative or mixed‐methods data. Studies were excluded if they focused on general healthcare professionals or the general population, or on stress or physical health problems. Study quality was assessed using the Mixed Methods Quality Appraisal tool.

Results

Nine studies, with a total of 1891 participants, were included. Study quality varied, with studies generally reporting descriptive surveys using hypothetical disclosure scenarios. Distress was often conceptualized in psychiatric terms. These limitations mean conclusions should be treated with caution. Individuals were less likely to disclose in work and had negative experiences of doing so compared to social circles. Fear of stigma inhibited disclosure. There were differing levels of disclosure relating to recipient, trust, quality of supervision, how distress was conceptualized, and type of problem. Disclosure was experienced by some as valuable.

Conclusion

There is a need for further research, which addresses the nuanced complexities surrounding disclosure choices for mental health professionals.

Supporting the Sharing of Mental Health Challenges in the Workplace: Findings from Comparative Case Study Research at Two Mental Health Services

Personal experience with mental health (MH) challenges has been characterized as a concealable stigma. Identity management literature suggests actively concealing a stigma may negatively impact wellbeing. Reviews of workplace identity management literature have linked safety in revealing a stigma to individual performance, well-being, engagement and teamwork. However, no research to date has articulated the factors that make sharing MH challenges possible. This study employed a comparative case study design to explore the sharing of MH challenges in two Australian MH services. We conducted qualitative analyses of interviews with staff in direct service delivery and supervisory roles, to determine factors supporting safety to share. Workplace factors supporting safety to share MH challenges included: planned and unplanned "check-ins;" mutual sharing and support from colleagues and supervisors; opportunities for individual and team reflection; responses to and management of personal leave and requests for accommodation; and messaging and action from senior organizational leaders supporting the value of workforce diversity. Research involving staff with experience of MH challenges provides valuable insights into how we can better support MH staff across the workforce.

The Essential Network (TEN): Protocol for an implementation study of a digital-first mental health solution for Australian healthcare workers during COVID-19 (Preprint)

Background

The COVID-19 pandemic has placed health care workers (HCWs) under severe stress, compounded by barriers to seeking mental health support among HCWs. The Essential Network (TEN) is a blend of digital and person-to-person (blended care) mental health support services for HCWs, funded by the Australian Federal Department of Health as part of their national COVID-19 response strategy. TEN is designed as both a preventative measure and treatment for common mental health problems faced by HCWs. New blended services need to demonstrate improvements in mental health symptoms and test acceptability in their target audience, as well as review implementation strategies to improve engagement.

Objective

The primary objective of this implementation study is to design and test an implementation strategy to improve uptake of TEN. The secondary objectives are examining the acceptability of TEN among HCWs, changes in mental health outcomes associated with the use of TEN, and reductions in mental health stigma among HCWs following the use of TEN.

Methods

The implementation study contains 3 components: (1) a consultation study with up to 39 stakeholders or researchers with implementation experience to design an implementation strategy, (1) a longitudinal observational study of at least 105 HCWs to examine the acceptability of TEN and the effectiveness of TEN at 1 and 6 months in improving mental health (as assessed by the Distress Questionnaire [DQ-5], Patient Health Questionnaire [PHQ-9], Generalized Anxiety Disorder [GAD-7], Oldenburg Burnout Inventory [OBI-16], and Work and Social Adjustment Scale [WSAS]) and reducing mental health stigma (the Endorsed and Anticipated Stigma Inventory [EASI]), and (3) an implementation study where TEN service uptake analytics will be examined for 3 months before and after the introduction of the implementation strategy.

Results

The implementation strategy, designed with input from the consultation and observational studies, is expected to lead to an increased number of unique visits to the TEN website in the 3 months following the introduction of the implementation strategy. The observational study is expected to observe high service acceptability. Moderate improvements to general mental health (DQ-5, WSAS) and a reduction in workplace- and treatment-related mental health stigma (EASI) between the baseline and 1-month time points are expected.

Conclusions

TEN is a first-of-a-kind blended mental health service available to Australian HCWs. The results of this project have the potential to inform the implementation and development of blended care mental health services, as well as how such services can be effectively implemented during a crisis.

International Registered Report Identifier (IRRID)

DERR1-10.2196/34601

Psychometric Properties of the Korean Version of the Mental Health Professionals Stress Scale

Background: Job stress of mental health professionals can have a negative impact on them, particularly their psychological health and mortality, and may also affect organizations' and institutions' ability to provide quality mental health services to patients. Aim: This study aimed to: (1) investigate the validity and reliability of the Korean Mental Health Professionals Stress Scale (K-MHPSS), (2) develop K-MHPSS cut-off points to measure clinical depression and anxiety, and (3) examine whether specific stressors vary by area of expertise. Methodology: Data were collected via an online survey over 3 months, from August to October 2020. An online survey using a survey website was administered to volunteers who accessed the link and consented to participate. Data from 558 participants (200 clinical psychologists, 157 nurses, and 201 social workers) were included in the final analysis. Confirmatory and exploratory factor analyses were conducted to examine the factor structure of the K-MHPSS; concurrent validity of the scale was determined by analyzing correlation; internal consistency was determined by Cronbach's alpha coefficient. In addition, ROC curve analysis and Youden's index were used to estimate optimal cut-off points for K-MHPSS; one-way ANOVA was performed to investigate the difference among the three groups. Results: The seven-factor model of the original scale did not be replicated by Korean mental health professionals. The K-MHPSS had the best fit with the six-factor model, which consists of 34 items. Concurrent validity was confirmed, and overall reliability was found to be good. The K-MHPSS cut-off points for depression and anxiety appeared to slightly different by professional groups. Furthermore, nurses and social workers showed significantly higher total scores compared to clinical psychologists, and there are significant differences in subscale scores among professionals. Conclusion: The Korean version of the MHPSS has appropriate psychometric properties and can be used to assess the occupational stress of mental health professionals. It can also serve as a reference point for screening clinical level of depression and anxiety in mental health professionals.

Le dévoilement de soi dans la recherche d’aide et le suivi dans les services de santé mentale et psychiatrie

Le dévoilement de soi des patients est essentiel au travail des professionnels de la santé, et ceci est encore plus critique en santé mentale où la parole du patient est le reflet du contenu de la psyché. Le dévoilement de soi concerne alors des symptômes invisibles qui sont associés à des problèmes de santé où la discrimination et la stigmatisation sont encore très présentes. Cet article explore les enjeux éthiques de ce phénomène encore très peu étudié. Le dévoilement en tant que processus décisionnel, interpersonnel, dynamique et complexe sera défini et approfondi à l’aide d’exemples tirés de la recherche. Par la suite, la vulnérabilité de la personne qui se dévoile sera abordée, suivie des enjeux liés aux normes de pratique professionnelle associées au dévoilement des patients et à leur responsabilité avers celui-ci. Ces éléments mettent en lumière de nombreuses questions éthiques et nous amènent, en dernier lieu, à une amorce de proposition pour positionner les professionnels impliqués.

Factors Affecting Mental Health Professionals' Sharing of Their Lived Experience in the Workplace: A Scoping Review

OBJECTIVE

Research has suggested that some mental health professionals (MHPs) continue to hold stigmatized beliefs about persons with emotional distress. These beliefs may be amenable to contact-based interventions with similar peers. To inform future interventions, policy, and research, this scoping review examined existing literature to identify factors that affect disclosure of lived experience by MHPs to colleagues and supervisors.

METHODS

A systematic search was conducted of four online databases, gray literature, and the reference lists of included articles. Primary research studies of any design conducted with MHPs with lived experience of emotional distress and their colleagues were included. The findings of included studies were inductively coded within the themes of enabling, constraining, and intrapersonal factors influencing disclosure.

RESULTS

A total of 23 studies were included in data extraction and synthesis. Factors that influenced MHPs' sharing of their lived experience in the workplace were categorized into five overarching themes: the "impaired professional," the "us and them" divide, the "wounded healer," belief in the continuum of emotional distress, and negotiating hybrid identities. MHPs with lived experience described feeling conflict between professional and service user identities that affected the integration and use of their clinical and experiential knowledge. Enabling factors reflected best-practice human resource management, such as organizational leadership, access to supervision and training, inclusive recruitment practices, and the provision of reasonable accommodations.

CONCLUSIONS

Findings of this scoping review suggest that organizational interventions to support MHPs in order to share their lived experience may improve workplace diversity and well-being, with implications for service users' experience.

Development of a measure of stigma towards occupational stress for mental health professionals

PURPOSE

Stigma is a common barrier to mental health professionals (MHPs) seeking help for occupational stress and burnout, although there is a lack of psychometrically sound tools to measure this construct. The current study aimed to develop and validate a scale (the Mental Health Professional Stigma Scale; MHPSS) for this purpose.

METHODS

The MHPSS and related measures were completed by 221 Australian MHPs via online survey, with a subsample completing the MHPSS again 2 weeks after initial completion.

RESULTS

Exploratory factor analysis revealed a four-factor solution, comprising of 13 items and accounting for 50.16% of variance. Factors were Perceived Other Stigma, Perceived Structural Stigma, Personal Stigma, and Self stigma. The internal consistency, test-retest reliability, and validity of the scale were supported.

CONCLUSIONS

The MHPSS has utility to capture stigmatising attitudes and beliefs related to occupational stress and burnout among MHPs. It may be used to assist in the development and evaluation of initiatives to reduce stigma and increase help-seeking among MHPs.

Online assessment of suicide stigma, literacy and effect in Australia's rural farming community

Background

In Australia, farming populations have been identified as having higher rates of suicide, in comparison to metropolitan, rural and regional communities. The reasons for this are unclear although stigma is considered a risk factor. This study was designed to understand the role of suicide stigma and suicide literacy and the relationship between these.

Methods

A mixed-methods online intervention was developed. This paper reports on baseline quantitative data (suicide stigma, suicide literacy and suicide effect) collected from male and female rural Australian participants (N = 536) with an experience of suicide.

Results

When compared with previous Australian community samples, our sample demonstrated higher levels of stigma and higher levels of suicide literacy. Males were more likely to have considered suicide than females. Females were more likely than males to report a devastating and ongoing effect of suicide bereavement, but less likely than a previous Australian community sample.

Conclusion

Results of this study reiterate the need for improved understanding of the risk factors and experience of suicide within the context of life and work in rural Australian farming communities and how ‘best practice’ can be adapted to improve stigma reduction and suicide prevention efforts.

Trial registration

This research project was registered with the Australian New Zealand Clinical Trials Registry (ANZCTR) (ACTRN12616000289415) on 7th March, 2016.

Psychological distress in student nurses undertaking an educational programme with professional registration as a nurse: Their perceived barriers and facilitators in seeking psychological support

WHAT IS KNOWN ON THE SUBJECT?: Psychological distress is a major health concern, and university student populations are at a risk due to high academic, economic and interpersonal demands at this time. While a number of studies have been conducted looking at distress and service uptake amongst university students, there is a lack of comparative information in the student nurse population. Therefore, this study focuses on level of psychological distress and service uptake in student nurses during their training. Student nurses in training are acknowledged as particularly vulnerable to anxiety and depression. Anxiety and depression can interfere with educational achievement and interfere with working relationships, which are an important aspect of clinical practice. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This study investigates psychological distress and service uptake in student nurses, in a single study, by measuring the level of distress and comparing this with adult nonpatient norms. The key findings suggest high levels of anxiety and depression and poor uptake of support in student nurses. The main barrier to seeking support was the fear of disclosure about their anxiety and/or depression, and feared impact on their suitability to train as a nurse. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Due to the fear of disclosure and low levels of support seeking, mental health nurses and academics have a key role to play in mental health literacy. It seems reasonable, given the key findings, to suggest that interventions be directed at decreasing anxiety and depression such as mindfulness training and other evidence-based strategies. It is recommended that psychological distress needs due attention from higher education sector and those health professionals involved in mental health service provision to support evidence-based strategies that target these issues.

ABSTRACT

Introduction This study adds to the existing international evidence on psychological distress in the student population by focusing on student nurses. It quantitatively assesses psychological distress with comparative norms and investigates service uptake in a single study. Aim The aim of this study was to investigate the level of psychological distress in students and compare this with population norms and highlight potential facilitators and barriers to help seeking. Methods This study recruited N = 121 student nurses from one university in a cross-sectional design. Data were analysed using descriptive statistics, independent t tests and one-way ANOVAs. Findings The key findings show high levels of psychological distress, which is above levels seen in the general population. The main barriers to seeking support were fear of disclosure and the perceived impact on their suitability as a student nurse. Discussion The study highlights that high levels of distress identified in the literature are seen in student nurses and that fear of disclosure may account for some not seeking support. Relevance The fear of disclosure and low levels of seeking support suggest there is a need for mental health nurses and academics to play a key role in mental health literacy and evidence-based interventions such as mindfulness to combat these issues.