Stressors, moderators and stress outcomes: findings from the all-Wales community mental health nurse study

The All-Wales Community Mental Health Nurse Stress Study was the largest study undertaken in the UK to date to investigate stress, burnout and coping amongst the CMHN workforce. The aim of the study was to examine the variety, frequency and severity of stressors, to describe coping strategies used to reduce work-based stress, and to determine stress outcomes. Questionnaires were sent out to 614 CMHNs from ten NHS Trusts throughout Wales. The response rate was 49% (n = 301). The measures used included the Maslach Human Services Survey, the CPN Stress Questionnaire, the Psychnurse Methods of Coping Questionnaire, the Rosenberg Self-Esteem Scale and the General Health Questionnaire GHQ-12. Community mental health nurses indicated that trying to maintain a good quality service in the midst of long waiting lists, poor resources, and having too many interruptions while trying to work in the office were particularly stressful items. The coping strategies that CMHNs utilized the most were having a stable home life and looking forward to going home at the end of the day, having outside interests and hobbies and talking to people that they got on well with. Forty per cent of CMHNs tended to view themselves negatively, feeling that others did not hold much respect for them. The GHQ-12 measure indicated that 35% of CMHNs had crossed a threshold of psychiatric caseness. Measured against a normative sample of mental health workers, 51% of CMHNs were experiencing high levels of long-term emotional exhaustion. Twenty-four per cent were suffering from high levels of depersonalization burnout and were not relating well to clients, whilst 14% were experiencing severe long-term feelings of lack of personal accomplishment. The results from the study provided us with a picture of stress and coping in CMHNs in Wales. Addressing these factors may help to reduce levels of experienced stress and burnout