Dowling, Sarah Frances; (2021) Staff Morale in Mental Health Supported Accommodation Services. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Abstract Background Mental health supported accommodation is an important component of the care pathway for those with complex mental health conditions. Despite an estimated 60,000-80,000 people living in supported accommodation in England, little is known about the staff working in these services. Aim To survey the morale of staff working in mental health supported housing services in England and investigate associations between staff morale and service quality, job demands and job resources, and staff turnover and sickness absence 12 months later. Methods Staff of all mental health supported housing services in 14 representative areas of England were surveyed using a battery of standardised measures to assess staff morale (comprising burnout, work engagement, job satisfaction and psychological distress), job demands, job resources and personal resources. Service managers also completed a standardised measure to assess service quality. Guided by the Job Demands-Resources Theory, associations between staff morale and job demands, job resources, personal resources and service quality were investigated cross-sectionally using multilevel regression models. Associations of job demands, job resources, personal resources and morale with staff outcomes (turnover and sickness absence) assessed 12 months later were also investigated using regression modelling. Results Morale was found to be good, with low-to-moderate levels of burnout, average levels of work engagement and moderate satisfaction with work. However, 35% of staff reported high levels of emotional exhaustion and 36% had scores which reached the threshold for probable psychological ill-health. Those demands and resources which were significantly associated with response variables were all in the expected direction: job demands were negatively associated with engagement and job satisfaction and positively associated with burnout and psychological ill-health; job resources and personal resources were negatively associated with burnout and psychological ill-health and positively associated with engagement and job satisfaction. The service quality domain of recovery based practice was positively associated with one component of burnout - depersonalisation. Few associations were identified between job demands, job resources, personal resources and morale and staff turnover and sickness absence at 12 months. Conclusion This is the first comprehensive survey of staff morale in mental health supported accommodation services in England. Although morale was generally good, there are concerns about levels of emotional exhaustion and psychological distress reported by some staff. Support in the form of relevant qualifications, enhanced training and clinical supervision should be considered to help supported housing staff manage the emotional demands inherent in their work. Further research is needed to investigate morale in other types of supported accommodation.

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