Mental health workforce

  • 文章类型: Journal Article
    以前的研究集中在影响心理健康员工离职的因素上,然而,很少有研究探索员工留下来的原因。为了促进保留多样化的心理健康劳动力,本研究旨在阐明影响员工在社区心理健康中心(CHMC)任职的因素,并比较黑人和白人员工的这些看法。来自一个城市CMHC(n=22)的长期员工(7年或以上)完成了半结构化住宿者访谈。使用紧急主题分析,留任者的采访揭示了他们为什么在该组织呆了7年或更长时间的四个主要主题:(1)作为一种使命,(2)支持关系,(3)增长或有意义的贡献的机会,(4)组织使命与个人属性或价值观的一致性。黑白住宿者叙事之间的比较揭示了他们对工作的看法上的差异,这些工作是对成长和有意义的贡献的呼唤和机会。以住宿者采访的主题为指导,当前的研究讨论了理论(例如,工作嵌入理论,种族化组织理论,自决理论)和实际意义(例如,支持工作自主权,领导层中的黑人声音),以改善员工的保留率并解决心理健康组织内的结构性种族主义。
    Previous research has focused on factors influencing turnover of employees in the mental health workforce, yet little research has explored reasons why employees stay. To facilitate retaining a diverse mental health workforce, the current study aimed to elucidate factors that contributed to employees\' tenure at a community mental health center (CHMC) as well as compare these perceptions between Black and White employees. Long-term employees (7 years or more) from one urban CMHC (n = 22) completed semi-structured stayer interviews. Using emergent thematic analysis, stayer interviews revealed four major themes for why they have stayed at the organization for 7 years or more: (1) work as a calling, (2) supportive relationships, (3) opportunities for growth or meaningful contribution, and (4) organization mission\'s alignment with personal attributes or values. Comparison between Black and White stayer narratives revealed differences in their perceptions with work as a calling and opportunities for growth and meaningful contribution. Guided by themes derived from stayer interviews, the current study discusses theoretical (e.g., job embeddedness theory, theory of racialized organizations, self-determination theory) and practical implications (e.g., supporting job autonomy, Black voices in leadership) in an effort to improve employee retention and address structural racism within a mental health organization.
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  • 文章类型: Journal Article
    目的:探讨区域公共精神卫生工作人员的准备和培训需求,以支持智力残疾和精神疾病患者。
    方法:维多利亚州地区公共精神卫生服务机构的工作人员,澳大利亚。
    方法:混合方法设计包括一项调查,访谈和一个焦点小组,以收集有关员工态度的数据,信心,关于支持智力残疾和精神病患者的教育和专业发展。使用描述性和主题分析。
    结果:来自31名调查受访者的数据,分析了七次访谈和一个焦点小组。调查描述性分析显示,参与者认为治疗智障人士是他们角色的一部分,但报告的领域信心不足,以及智障心理健康方面的教育和培训不足。访谈的主题分析表明,支撑信心,教育和培训是主题(1)需要灵活性,例如有更多的时间和(2)解决方案,但面临挑战,例如提高技能的机会有限和专家的可用性。焦点小组分析的一个关键主题是需要协作解决问题,工作人员分享技能和信息,以寻求以人为本的解决方案。
    结论:区域公共精神卫生队伍需要智力残疾精神卫生方面的专业发展,但需要考虑所经历的挑战并反映团队如何运作。对所描述的准备工作的探索提供了一种可能的学习方法,该方法由劳动力成员提供。建议采用协作学习方法来支持智障和精神疾病患者。
    OBJECTIVE: To explore the preparedness and training needs of a regional public mental health workforce to support people with intellectual disability and mental ill health.
    METHODS: Staff from a regional public mental health service in Victoria, Australia.
    METHODS: A mixed-methods design comprised a survey, interviews and a focus group to collect data about staff attitudes, confidence, education and professional development regarding supporting people with intellectual disability and mental ill health. Descriptive and thematic analyses were used.
    RESULTS: Data from 31 survey respondents, seven interviews and one focus group were analysed. Survey descriptive analyses showed participants believed treating people with intellectual disability was part of their role but reported areas of low confidence along with insufficient education and training in intellectual disability mental health. Thematic analyses from interviews showed that underpinning confidence, education and training were the themes (1) need for flexibility, such as having more time and (2) solutions but with challenges, such as limited opportunity to upskill and availability of experts. A need for collaborative problem-solving where staff share skills and information to work towards person-centred solutions was a key theme from the focus group analysis.
    CONCLUSIONS: Professional development in intellectual disability mental health is required for the regional public mental health workforce but needs to account for the challenges experienced and reflect how teams function. Exploration of described preparedness offered a possible learning approach informed by workforce members. Collaborative learning approaches to supporting people with intellectual disability and mental ill health are suggested.
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  • 文章类型: Letter
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  • 文章类型: Editorial
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  • 文章类型: Journal Article
    为女同性恋服务的心理健康提供者的劳动力,同性恋,双性恋,变性人,酷儿,和/或提问(LGBTQ+)青年远远落后于以LGBTQ为重点的精神保健的需求。不令人满意的培训和缺乏认可计划的标准化培训指标,使提供者之间缺乏准备。LGBTQ+教师和导师在医学教育中的存在增加了向学员讲授的LGBTQ+内容的数量,并改善了LGBTQ+学员的专业发展。包容性的工作场所做法和肯定的护理政策也可以改善为LGBTQ服务的精神卫生提供者的保留和招聘。
    The workforce of mental health providers serving lesbian, gay, bisexual, transgender, queer, and/or questioning (LGBTQ+) youth lags far behind the demand for LGBTQ-focused mental health care. Unsatisfactory training and a lack of standardized training metrics for accredited programs perpetuate the lack of preparedness among providers. The presence of LGBTQ+ faculty and mentors in medical education increases the amount of LGBTQ+ content taught to trainees and improves professional development for LGBTQ+ trainees. Inclusive workplace practices and affirming care policies may also improve retention and recruitment of LGBTQ-serving mental health providers.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    在澳大利亚公共精神卫生劳动力中,高员工流失率很普遍,导致劳动力短缺,并最终影响提供稳定高效的能力,有效,以及对社区的持续最佳护理。在这项研究中,我们的目标是(a)建立与澳大利亚公共精神卫生劳动力流动意愿增加相关的最相关因素,(b)确定大城市和农村服务之间的这些因素是否不同。我们用了一个横截面,使用在线调查方法进行相关设计。总的来说,235名不同学科和级别的精神卫生服务人员,来自维多利亚的四家公立医院,澳大利亚参加了这项研究。我们使用了三个前馈多元回归分析来评估研究目标。我们发现工作满意度,职业倦怠,人员不足可能是考虑离职意向的最相关因素。工作满意度和职业倦怠是整个样本中认可的因素,特别是在大都市和农村服务中,虽然人员不足是整个样本和农村服务人员离职意向的一个相关因素,但不是都市服务。我们关于工作满意度相关性的发现,职业倦怠,和离职意向人员不足提供了关键信息,可用于告知旨在减少澳大利亚公共精神卫生劳动力流失的干预目标。
    High staff turnover is common within the Australian public mental health workforce, contributing to workforce shortages and ultimately impacting the ability to provide stable efficient, effective, and ongoing optimal care to the community. In this study, we aimed to (a) establish the most pertinent factors associated with increased turnover intention in the public mental health workforce in Australia, and (b) establish whether such factors differ between metropolitan and rural services. We used a cross-sectional, correlational design using an online survey method. In total, 235 mental health service staff of various disciplines and levels, from four public hospitals in Victoria, Australia participated in the study. We used three feed-forward multiple regression analyses to assess the study aims. We found that job satisfaction, occupational burnout, and understaffing may be the most pertinent factors to consider regarding turnover intention. Job satisfaction and occupational burnout were factors endorsed across the entire sample, as well as specifically within both the metropolitan and rural services, while understaffing was a pertinent factor regarding turnover intention across the entire sample and for rural services, but not metropolitan services. Our findings regarding the pertinence of job satisfaction, occupational burnout, and understaffing in turnover intention provide key information that may be used to inform interventional targets aimed at reducing attrition from the public mental health workforce in Australia.
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  • 文章类型: Journal Article
    受众细分是一种分析技术,可以在人群中识别有意义的子群体,以告知对传播策略的定制。我们使用有关他们最经常咨询的知识来源的调查数据,对有执照的心理学家进行了实证聚类受众细分研究,以指导他们的临床决策。我们确定了人群中有意义的亚组,并为基于证据的实践(EBP)材料的传播策略提供了定制。
    数据来自2018-2019年对美国心理学会成员的持牌心理学家的网络调查(APA;N=518,反应率=29.8%)。十个二分变量评估了心理学家定期咨询以告知临床决策的来源(例如,同事们,学术文献,和实践指南)。我们使用潜在类别分析来识别转向相似来源的心理学家的片段,并根据片段的最显著特征命名每个片段。
    确定了四个受众群体:无指南(45%的心理学家),研究驱动(16%),渴求知识(9%),和无评论(30%)。这四个部分不仅在他们喜欢的知识来源上有所不同,而且在他们提供的基于证据的创伤后应激障碍(PTSD)治疗类型中,他们对APAPTSD临床实践指南的认识和使用意图,以及对临床实践指南的态度。
    结果表明,有执照的心理学家在寻求知识的行为和对知识来源的偏好方面是异质的。这些部分的独特特征可以指导定制传播材料和策略,以随后在心理学家中加强EBP的实施。
    受众细分是一种传播策略,它根据他们的信念将一组目标用户或受众分类为有意义的子组,行为,和/或其他特征。像许多其他科学或医学领域一样,由于实践挑战,临床心理学也难以在日常实践中使用经过临床测试的心理治疗(或EBP)。为了帮助解决这些障碍,像美国心理学会(APA)这样的专业组织发布临床实践指南,从业者可以使用这些指南来了解有关EBP的更多信息。然而,即使这些临床实践指南也不经常使用,因此,这项研究采用了受众细分分析来更好地理解心理学家的不同态度,行为,以及有关临床实践指南和其他临床信息来源的偏好。我们的研究发现,在大约600个APA注册的心理学家中,有四个不同的亚组,基于他们喜欢的知识来源:无指南(45%的心理学家),研究驱动(16%),求知欲(9%),和无评论(30%)。每个亚组提供的循证治疗类型也各不相同,以及他们的意识,愿意使用,以及对临床实践指南的态度。这一结果表明,有执照的心理学家不是一个统一的群体,传播策略应该根据每个亚组的特征进行调整,以最大限度地增加心理学家对EBP的使用。
    UNASSIGNED: Audience segmentation is an analysis technique that can identify meaningful subgroups within a population to inform the tailoring of dissemination strategies. We have conducted an empirical clustering audience segmentation study of licensed psychologists using survey data about the sources of knowledge they report most often consulting to guide their clinical decision-making. We identify meaningful subgroups within the population and inform the tailoring of dissemination strategies for evidence-based practice (EBP) materials.
    UNASSIGNED: Data come from a 2018-2019 web-based survey of licensed psychologists who were members of the American Psychological Association (APA; N = 518, response rate = 29.8%). Ten dichotomous variables assessed sources that psychologists regularly consult to inform clinical decision-making (e.g., colleagues, academic literature, and practice guidelines). We used latent class analysis to identify segments of psychologists who turn to similar sources and named each segment based on the segment\'s most salient characteristics.
    UNASSIGNED: Four audience segments were identified: the No-guidelines (45% of psychologists), Research-driven (16%), Thirsty-for-knowledge (9%), and No-reviews (30%). The four segments differed not only in their preferred sources of knowledge, but also in the types of evidence-based posttraumatic stress disorder (PTSD) treatments they provide, their awareness and usage intention of the APA PTSD clinical practice guideline, and attitudes toward clinical practice guidelines.
    UNASSIGNED: The results demonstrate that licensed psychologists are heterogeneous in terms of their knowledge-seeking behaviors and preferences for knowledge sources. The distinctive characteristics of these segments could guide the tailoring of dissemination materials and strategies to subsequently enhance the implementation of EBP among psychologists.
    Audience segmentation is a dissemination strategy that categorizes a group of intended users or audience into meaningful subgroups based on their beliefs, behaviors, and/or other characteristics. Like many other scientific or medical fields, clinical psychology also struggles to use clinically tested psychological treatments (or EBPs) in everyday practice due to practical challenges. To help address such barriers, professional organizations like the American Psychological Association (APA) publish clinical practice guidelines that practitioners can use to learn more about EBPs. However, even these clinical practice guidelines are not often used, so this study employed the audience segmentation analysis to better understand psychologists’ diverse attitudes, behaviors, and preferences regarding clinical practice guidelines and other clinical information sources. Our study found four distinct subgroups within approximately 600 APA-registered psychologists based on their preferred source of knowledge: the no-guidelines (45% of psychologists), research-driven (16%), thirsty-for-knowledge (9%), and no-reviews (30%). Each subgroup also varied in the types of evidence-based treatments they provide, as well as their awareness, willingness to use, and attitudes toward clinical practice guidelines. This result shows that licensed psychologists are not a uniform group and that dissemination strategies should be adjusted to each subgroup\'s characteristics to maximize the effort to increase the use of EBPs among psychologists.
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  • 文章类型: Journal Article
    这项研究调查了纽约市指定的心理健康专业短缺地区(MHHPSA)与心理健康相关的911电话之间的关系。在调整了人口规模和其他邻域特征后,使用负二项回归模型来估计MHHPSA与MH911呼叫之间的关系。研究发现,与非短缺地区相比,指定为MHHPSA的社区拥有更高的MH911呼叫,调整后预期911MH呼叫增加27%。此外,结果表明,无家可归和贫困率较高的社区产生了更多的MH911呼叫.研究结果表明,有必要改善获得精神卫生服务的机会,以减轻在资源有限的地区进行危机干预的警察和紧急服务的负担。
    This study examines the relationship between designated Mental Health Professional Shortage Areas (MH HPSAs) and mental health-related 911 calls in New York City. Negative binomial regression models were used to estimate the relationship between MH HPSAs and MH 911 calls after adjusting for the population size and other neighborhood characteristics. The study found that neighborhoods designated as MH HPSAs had higher MH 911 calls compared to non-shortage areas, with a 27% increase in expected MH 911 calls after adjustment. Moreover, the results indicated that neighborhoods with higher rates of homelessness and poverty generated more MH 911 calls. The findings suggest a need to improve access to mental health services to reduce the burden on police and emergency services for crisis interventions in areas with limited resources.
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  • 文章类型: Journal Article
    背景:有记录表明,在COVID-19大流行期间,卫生专业人员的职业压力水平增加。尽管对服务的需求增加,但很少有研究检查大流行对精神卫生专业人员的影响。
    方法:多语言,纵向,世卫组织全球临床实践网络(GCPN)成员在大流行期间的三个时间点进行了全球调查。来自86个国家的786名GCPN成员对评估职业困扰的调查做出了回应,健康和创伤后压力症状。
    结果:平均而言,受访者的幸福感随着时间的推移而恶化,而他们的创伤后应激症状显示出适度的改善。线性生长模型表明,作为女性,更年轻,为COVID-19患者提供面对面的医疗服务,生活在低收入或中等收入国家或COVID-19死亡率较高的国家,随着时间的推移,幸福感差和压力症状水平较高的风险更大。增长混合模型确定了职业幸福感和压力症状的轨迹。大多数心理健康职业对幸福感没有影响,保持适度,非临床水平的压力症状,或在最初的困难时期后表现出改善。然而,一些参与者组表现出健康状况恶化,接近临床阈值(25.8%),并且随着时间的推移,创伤后应激症状持续较高水平和具有临床意义的水平(19.6%).
    结论:这项研究表明,尽管大多数心理健康专业人员在大流行期间表现出稳定的积极幸福感和低压力症状,在大流行期间,已经负担沉重的全球精神卫生工作人员中,有相当一部分人的心理状况持续恶化或恶化。
    Increased levels of occupational stress among health professionals during the COVID-19 pandemic have been documented. Few studies have examined the effects of the pandemic on mental health professionals despite the heightened demand for their services.
    A multilingual, longitudinal, global survey was conducted at 3 time points during the pandemic among members of the World Health Organization\'s Global Clinical Practice Network. A total of 786 Global Clinical Practice Network members from 86 countries responded to surveys assessing occupational distress, well-being, and posttraumatic stress symptoms.
    On average, respondents\' well-being deteriorated across time while their posttraumatic stress symptoms showed a modest improvement. Linear growth models indicated that being female, being younger, providing face-to-face health services to patients with COVID-19, having been a target of COVID-related violence, and living in a low- or middle-income country or a country with a higher COVID-19 death rate conveyed greater risk for poor well-being and higher level of stress symptoms over time. Growth mixed modeling identified trajectories of occupational well-being and stress symptoms. Most mental health professions demonstrated no impact to well-being; maintained moderate, nonclinical levels of stress symptoms; or showed improvements after an initial period of difficulty. However, some participant groups exhibited deteriorating well-being approaching the clinical threshold (25.8%) and persistently high and clinically significant levels of posttraumatic stress symptoms (19.6%) over time.
    This study indicates that although most mental health professionals exhibited stable, positive well-being and low stress symptoms during the pandemic, a substantial minority of an already burdened global mental health workforce experienced persistently poor or deteriorating psychological status over the course of the pandemic.
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