TY - JOUR

T1 - Staff compassion in acute mental health wards: a grounded theory investigation

AU - Tane, E.

AU - Fletcher, I.

AU - Bensa, S.

PY - 2022/9/3

Y1 - 2022/9/3

N2 - Background: Staff working on acute inpatient mental health wards face unique challenges in terms of short admissions, acuity, complexity and exposure to violence, suicide and self-harm. They experience high levels of stress and burnout, which can impact compassion. Aim: To qualitatively explore staff’s understanding and conceptualisation of the development, loss and restoration of compassion within acute inpatient environments. Method: Eleven participants from a variety of professional backgrounds currently working on acute wards were interviewed. Using constructivist grounded theory, data were synthesised into theoretical categories and sub-categories. Results: A conceptual model of the facilitators and inhibitors of compassionate care was developed, based on five categories that emerged from the data: A compassionate stance; the challenges of acute wards; feeling under threat; restoring compassion; and a compassionate organisation. Conclusions: Findings outline the process whereby staff compassion can be challenged or depleted, leading to a negative appraisal of the patient. Colleague support, knowing and understanding patients, and accessing a reflective space all supported the restoration of compassion. Staff reported lack of organisational compassion influenced their ability to maintain a compassionate stance. The importance of appropriate training and support structures is discussed, alongside recommendations to support the development of compassionate acute mental health care. 

AB - Background: Staff working on acute inpatient mental health wards face unique challenges in terms of short admissions, acuity, complexity and exposure to violence, suicide and self-harm. They experience high levels of stress and burnout, which can impact compassion. Aim: To qualitatively explore staff’s understanding and conceptualisation of the development, loss and restoration of compassion within acute inpatient environments. Method: Eleven participants from a variety of professional backgrounds currently working on acute wards were interviewed. Using constructivist grounded theory, data were synthesised into theoretical categories and sub-categories. Results: A conceptual model of the facilitators and inhibitors of compassionate care was developed, based on five categories that emerged from the data: A compassionate stance; the challenges of acute wards; feeling under threat; restoring compassion; and a compassionate organisation. Conclusions: Findings outline the process whereby staff compassion can be challenged or depleted, leading to a negative appraisal of the patient. Colleague support, knowing and understanding patients, and accessing a reflective space all supported the restoration of compassion. Staff reported lack of organisational compassion influenced their ability to maintain a compassionate stance. The importance of appropriate training and support structures is discussed, alongside recommendations to support the development of compassionate acute mental health care. 

KW - acute mental health

KW - compassionate healthcare

KW - inpatient

KW - Staff compassion

U2 - 10.1080/09638237.2021.1875402

DO - 10.1080/09638237.2021.1875402

M3 - Journal article

VL - 31

SP - 657

EP - 665

JO - Journal of Mental Health

JF - Journal of Mental Health

SN - 0963-8237

IS - 5

ER -