The role of exposure to violence, burnout and self-efficacy on the life satisfaction of clinical staff in a secure mental health hospital

Background: Increased burnout and decreased psychological wellbeing, such as life-satisfaction, of clinical mental health staff in secure mental health settings, is a continuing issue. To understand the most appropriate interventions and support streams for clinical staff in such settings, there is a need for an enhanced understanding of how job demands and resources affect burnout and life-satisfaction. Though the Job Demands-Resources Theory (JDRT) provides a framework for this, there is scarce research that applies this theory to staff working in secure mental health settings.

The health impairment process of the JDRT postulates that the exhaustion component of burnout mediates the relationship between job demands and outcomes. A demand commonly experienced by clinical staff in secure mental health settings is exposure to patient violence, which has a substantiated effect on burnout in various healthcare staff samples. As workplace stress can adversely affect employee’s life-satisfaction, it is important to understand the potential process in which exposure to violence and burnout can affect clinical staff’s life-satisfaction.

The motivational process of the JDRT posits that the disengagement component of burnout mediates the relationship between resources and outcomes. Self-efficacy is a personal resource that has been demonstrated to predict burnout, as well as engagement at work, and life satisfaction. However, there is piecemeal evidence of this process in secure mental health staff.

The JDRT’s buffering hypothesis suggests that resources moderate the effect of demands on outcomes, though there is scarce support in secure mental health settings. This was addressed in the current study by investigating the extent to which self-efficacy moderated the relationship between exposure to violence and life-satisfaction.

Method: Using a cross-sectional design, questionnaires were administered online to a sample of 110 clinical staff working in a secure mental health hospital. Using the dual-process model of the JDRT as a framework, the indirect effect of exposure to violence on life satisfaction with exhaustion as a mediator, and the indirect effect of self-efficacy on life satisfaction with disengagement as a mediator were investigated. In line with the buffering hypothesis, self-efficacy was explored as a moderator of the relationship between exposure to violence and life-satisfaction.

Results: Exhaustion did not significantly mediate the relationship between exposure to violence and life-satisfaction. Neither exposure to

violence nor exhaustion significantly predicted life satisfaction. Disengagement did not significantly mediate the relationship between self-efficacy and life-satisfaction, though disengagement and general self-efficacy significantly predicted life-satisfaction. Self-efficacy did not significantly moderate the relationship between exposure to violence and life satisfaction.

Conclusions: This study addresses the paucity of literature exploring the JDRT in secure mental health settings. The results indicate the need for further research to explore potential mediators and moderators between exposure to violence and life-satisfaction, such as resilience or desensitization. Further research is also required to explore potential predictors of disengagement in clinical staff, working in a secure mental health environment. Practical implications include promoting self-efficacy and engagement, as well as offering support to enhance these for clinical staff working in secure mental health settings.