S-64-01

Morale and job perception of community mental health professionals in Berlin and London

S. Priebe, K. Hoffman, R. Powell, W. Fakhoury. Barts atzd the London Medical S, London, United Kingdom

Objective: A positive morale of staff is central to recruitment and retention of committed professionals and effective service delivery. The study aimed to assess and compare morale and job perception of different groups of community mental health professionals in two European capitals.

Methods: A sample of 30 professionals was randomly selected from each of six groups: psychiatrists, nurses and social workers in Berlin and London. Morale and job perception were assessed using standardised questionnaires and simple open questions, which were subjected to content analysis.

Results: Despite the small sample sizes of single professional groups, the analysis revealed various statistically significant differences. Morale varied between the professional groups in London, but not in Berlin. Nurses and particularly social workers in London showed a low morale with high burn out scores. Most professionals enjoy direct work with patients and feel stressed through bureucracy and managerial tasks. Yet, various specific aspects what professionals like and dislike in their jobs differs between Berlin and London.

Conclusion: Low morale appears a serious problem for nurses and social workers in London. Although both cities share various challenges of mental health care in European capitals, what professionals view as positive and negative in their jobs varies. The differences might be due to cultural factors and features of the health care systems. The results may inform initiatives to improve morale of staff in community mental health care.

S-64-02

A national survey of mental health social workers in England and Wales: Decision latitude, organisational justice and mental health

S. Evans. institute of Psychiatry & SCWR, London, United Kingdom

Objective: The study aimed to: • characterise the mental health social work workforce in terms of their demography, experience, job content, workload, working environment, health and wellbeing; • explain the nature and direction of associations between these explanatory variables and mental health, burnout and jobsatisfaction.

Methods: A postal survey (in England & Wales) incorporating

the GHQ-12, Maslach Burnout Inventory, Karasek Job Content

Questionnaire and a job-satisfaction measure.

Results: Respondents (n=237) reported high stress and emotional exhaustion levels and low levels of job-satisfaction. Feeling valued at work, job demands, decision latitude and feelings about the place of MHSW in modem services contributed to the explanation of job-satisfaction and most aspects of burnout. Approved Social Worker status was associated with job dissatisfaction.

Conclusion: Stress factors within the workforce may exacerbate recruitment and retention problems, if employers fail to recognise the demands placed upon MHSWs and to value their contribution to the mental health services.

S-64-03

Social workers in adult mental health - survey results from the Republic of Ireland

P. Quinn. St Patricks Hospital, Dublin, Ireland

Objective: The purpose of this study is to look at mental health social workers' perceptions of the quality of their work environment in Ireland, both in terms of facilities available and support systems.

Methods: A postal survey was carried out in January/Febuary 2003, where a questionnaire was sent to practitioners providing adult mental health social work services in Ireland (either within public sector Health Boards or in private hospitals). The questionnaire consisted of 58 questions, structured in 7 sections: background of respondents; working environment and current work, supervision; practice teaching; working with other agencies/ professionals; training and professional development; service provision.

Results: The study identifies substantial disparities among mental health social service providers both with regard to facilities, such as office accommodation and computing facilities, and support systems (administrative support, supervision).

Conclusion: The quality of the work environment affects the quality of the service delivery that workers are able to provide. Poor work environment will lead to an inefficient service and short-term economies may constitute diseconomies in the longer term. The study suggests that there is a need to develop nation-wide standards and the means to ensure these standards are followed.

S-64-04

Consultant psychiatrists working patterns: Are progressive approaches the key to staff retention?

A. Mears. Royal College of Psychiatrists, London, United Kingdom

Objective: The objective of our research was to investigate how different styles of working affect the occupational burdens experienced by consultant psychiatrists in the UK, and how interventions might improve mental health and retention.

Methods: A questionnaire (the design informed by three speciality-specific focus groups: general adult psychiatry, old age psychiatry and child and adolescent psychiatry) was sent to a randomly selected group of 500 consultant psychiatrists. The questionnaire form included sections for demographic data, work patterns, roles and responsibilities, work style, job content and work environment. Other sections used validated tools: the Karasek Job Content Questionnaire (JCQ; Karasek et al, 1998), the Maslach Burnout Inventory (MBI; Maslach & Jackson, 1993) and the 12- item version of the General Health Questionnaire (GHQ; Goldberg, 1992).

Results: Three factors emerged from the data reduction exercise carried out on the data. Positive Workload pattern (PWP): A high PWP score indicates a positive, progressive workload pattern. The more positive the consultants' WP score, the better they felt about their job, the better their scores on all 3 JCQ scales, the lower the score on the MBI emotional exhaustion scale, and the lower their GHQ score. Clarity of Role (CR): A high CR score indicated a low level of ambiguity surrounding the consultants' role. The higher the CR score, the better the consultants felt about their job and the higher their satisfaction, the better their score on all three MBI and JCQ scales, and the lower the GHQ score. Perceived support (PS): A high 'Perceived Support' score indicated by reporting a high level of support from their multidisciplinary team. A good PS score is associated with good job satisfaction, and postive scores on the social support and decision latitude scales from the JCQ.

Conclusion: Consultant psychiatrists working in a more progressive way appear to be suffering less from the occupational pressures than their more traditional colleagues.

S-64-05

Morale of staff in community mental health care in a province in Northern Italy

G. M. Galeazzi, S. Priebe, S. Delmonte, W. Fakhouri. Community Mental Health Service of Sassuolo, Sassuolo, Italy

Objective: Burnout and job satisfaction can have a substantial impact on the nature and quality of care delivered by mental health professionals. This study aimed at exploring morale of psychiatrists and nurses working in Community Mental Health Centres of the Province of Modena, and at finding perceived influential factors.

Methods: 30 psychiatrists and 30 psychiatric nurses completed a survey on work morale. Established scales (Maslach Burnout Inventory, Minnesota Job Satisfaction Scale, Team Identity Scale) were associated to open-ended questions, scored using a posteriori formed categories (inter-rater agreement on the final categories had kappas ranging from .60 to .91). Regression analyses were used to determine predictors of morale as measured by the scales.

Results: Nurses had lower scores on emotional exhaustion and depersonalisation than psychiatrists. The perceived most enjoyable aspects of the job were the emotional contact with patients, possibility of teamwork and humanitarian aspects of the profession. 22% of the variance of the emotional exhaustion score was predicted by being a psychiatrist (instead of a nurse) and by reporting team conflict as a pressure in the job. The same variables explained 14% of the vm'iance of the overall burnout score.

Conclusion: The "human" element of the profession and relational aspects, both with clients and colleagues, are considered more important than technical competence or other potential sources of stress in determining work morale and satisfaction. Training in skills to establish a positive therapeutic relationship and strategies to reduce team conflicts could have a positive impact on staff morale.