Psychological and the physical health impacts of forensic workplace trauma

Abstract

Purpose Health-care professionals working in inpatient forensic mental health settings are exposed to a range of traumatic and distressing incidents with impacts discussed variously as “burnout”, “compassion fatigue”, “secondary trauma stress” and “vicarious traumatisation”. This study aims to explore the short- and long-term psychological and physical health effects of trauma exposure in the workplace for frontline staff in a forensic setting. Design/methodology/approach Semi-structured interviews were conducted with 14 nursing staff members working in the male personality disorders care stream in a Medium Secure Hospital. Findings Thematic analysis yielded five themes: categories of trauma; how well-being is impacted; ways of coping and managing; protective factors; and systemic factors, with sub-themes within each of the superordinate themes. Practical implications The findings demonstrate that some staff members were affected both physically and psychologically as a result of trauma-focused work whereas other staff members were unaffected. The psychological and physical health effects were broadly short-term; however, long-term effects on staff member’s social networks and desensitisation to working conditions were observed. A broad range of coping methods were identified that supported staff member’s well-being, which included both individual and organisational factors. Staff member’s health is impacted by exposure to workplace trauma either directly or indirectly through exposure to material, and there is a greater need to support staff members after routine organisational provisions are complete. Staff should receive education and training on the possible health effects associated with exposure to potentially traumatic material and events. Originality/value This research has further contributed to understanding the staff needs of nursing staff members working with the forensic personality disorder patients within a secure hospital setting. This research has identified the following service developments: the need for ongoing support particularly after organisational provisions are complete; further prospects to engage in psychological formulations; greater opportunities for informal supervision forums; staff training to understand the potential health impact associated with trauma-focused work; supervisors being appropriately trained and supported to elicit impacts of trauma-focused work on staff members; and additional opportunities to discuss well-being or monitor well-being.

"I can't unsee the things I've seen": Exploring Police Prosecutors' Experiences of Engaging with Potentially Traumatic Materials

“…Much like others working within the CJS, police prosecutors in the current study found it easier to seek help from trusted individuals who understood the complexities of their role, because it was easily accessible, informal and validating (Birze, Regehr, & Regehr, 2022a;Duran & Woodhams, 2022;R. Kim, 2021;Mistry et al, 2022;Perez et al, 2010;Ravera, 2022;Te Miha, 2023). The constraints of confidentiality, and not wanting to burden those around you have also been observed in other helping professionals (R. Kim, 2021;Te Miha, 2023;Weir et al, 2021;Wijeratne et al, 2021).…”

Exposure to patient aggression and health outcomes for forensic mental health nurses: A cross‐sectional survey

“…Nurses caring for patients who self‐harm are therefore at increased risk of generalized stress response, negatively impacting their well‐being from an accumulative effect of exposure to traumatic events and increased use of risk‐adverse, controlling practices (Morris et al, 2022). Maladaptive coping strategies, such as increased alcohol consumption and changes to diet/eating patterns, in response to accumulative exposure to traumatic events and use of restrictive practices may also affect nurses' physical health (Mistry et al, 2022).…”

“…Interestingly, nurses working on acute units had comparable mental health to nurses working on nonacute units, despite having significantly greater exposure to patient aggression. Individual differences regarding impact of exposure to patient aggression among forensic mental health staff working on one unit has also been reported (Mistry et al, 2022), indicating factors other than unit type also influence impact. Influencing factors may be protective and include individuals' resilience and well-being and access to support, supervision and incident debriefing (Mistry et al, 2022).…”

“…Individual differences regarding impact of exposure to patient aggression among forensic mental health staff working on one unit has also been reported (Mistry et al, 2022), indicating factors other than unit type also influence impact. Influencing factors may be protective and include individuals' resilience and well-being and access to support, supervision and incident debriefing (Mistry et al, 2022). The mental health of nurses exposed to occupational violence was also strongly influenced by ethnicity; in one study, white British participants had significantly worse mental health than those of other ethnicities (Renwick et al, 2019).…”

“…Witnessing an episode of physical violence caused stress and anxiety in a qualitative study of nurses working in British mainstream mental health services (Fuller, 2016). It is therefore likely that nurses may use sick leave as a strategy for coping with the psychological impact of exposure to patient aggression, rather than only physical illness or injury (Mistry et al, 2022).…”