“Why keep it all on my shoulders?”: Emotional Experiences and Wellbeing of Administrative Staff Working in Forensic Mental Health Services; an Interpretative Phenomenological Analysis

Paper 1 is a literature review of eleven research articles exploring the risk and mitigating factors of secondary traumatic stress (STS), vicarious trauma (VT) and compassion fatigue (CF) in frontline staff working in domestic and sexual violence services. The umbrella term “STS” was utilised. The findings were mixed, but indicated that there were individual and organisational level risk factors of STS. Despite being identified as a risk factor in other systematic reviews, the findings suggested that victim status was not a risk factor of STS in frontline staff, however, the validity of the outcome measures used were questioned. The findings indicated that age strongly predicted STS, with younger frontline staff being at greater risk. Other individual level factors such as ethnicity and education were not sufficiently investigated to draw meaningful conclusions. The findings indicated that organisational factors accounted for the most variation. Across the organisational level factors, direct hours working with victims, workload and a lack of autonomy were predictors of STS. The findings indicated that good quality/ frequent supervision and social support could mitigate STS. Limitations of this review included the methodology and a lack of consistency in defining and operationalising STS, CF and VT across the eleven research articles. Paper 2 is an empirical study that utilised Interpretative Phenomenological Analysis to explore the wellbeing and emotional experiences of administrative staff who work in Forensic Mental Health Services (FMHS’s). Semi-structured interviews were conducted and analysis revealed six Group Experiential Themes and six subthemes: ‘feeling threatened and unsafe’, ‘vicarious emotional toll’, ‘deeper empathy and compassion’, ‘bask in their glory, ‘safe and supported’, and ‘not bottom of the pile’. Findings indicated the importance of a psychologically safe and supportive work environment where administrative staff feel able to share their experiences and feelings without judgement. Administrative staff may benefit from reflective practice, formulation focused sessions, conflict-management training and access to peer support. This is one of the only emerging studies considering the emotional needs and wellbeing of administrative staff, further research is needed in both FMHS’s and other healthcare settings.

Paper 3 is an executive summary that provides an accessible version of the empirical study. Four participants provided feedback on the content and design of this executive summary in order to ensure it is accessible and understandable. This paper will be disseminated to the participants, alongside leadership/ management of Forensic Mental Health Services within the NHS. The aims, method, results, implications, limitations and future research are summarised. 10