There is a growing body of evidence that suggests that many community mental health nurses (CMHNs) experience considerable stress and burnout. This review aimed to bring together the research evidence in this area for CMHNs working within the UK. Seventeen papers were identified in the literature, seven of which looked at stress and burnout for all members of community mental health teams (CMHTs) and the remaining 10 papers focused on CMHNs. The evidence indicates that those health professionals working as part of community teams are experiencing increasing levels of stress and burnout as a result of increasing workloads, increasing administration and lack of resources. For CMHNs specific stressors were identified. These included increases in workload and administration, time management, inappropriate referrals, safety issues, role conflict, role ambiguity, lack of supervision, not having enough time for personal study and NHS reforms, general working conditions and lack of funding and resources. Areas for future research are described and the current study of Welsh CMHNs is announced. This review has been completed against a background of further significant changes in the health service. In the mental health field, specific new initiatives will have a significant impact on the practice of community mental health nursing. A new National Framework for Mental Health, along with a review of the Mental Health Act (1983), will undoubtedly help to shape the future practice of mental health nursing.

Factors influencing the effectiveness of clinical supervisionClinical supervision is widely accepted as an essential prerequisite for high quality nursing care. This paper reports findings from a study that aims to identify the factors that may influence the effectiveness of clinical supervision for community mental health nurses (CMHNs) in Wales, UK. Two hundred and sixty (32%) CMHNs from an estimated total population of 817 completed the Manchester Clinical Supervision Scale (MCCS) and a demographic questionnaire. The MCCS is a 36-item questionnaire measuring the quality and effectiveness of the supervision received. Three-quarters of CMHNs reported having participated in six or more sessions of supervision in their current posts. Clinical supervision was more positively evaluated where sessions lasted for over one hour, and took place on at least a once-monthly basis. Perceived quality of supervision was also higher for those nurses who had chosen their supervisors, and where sessions took place away from the workplace. These findings have important implications for the organization and delivery of mental health nursing services.

Psychiatry is a stressful profession. Psychiatrists identified several stressors in their professional and personal lives.

Stress and its outcomes are significant problems for mental health workers. Questionnaires were sent to 614 community mental health nurses (CMHNs) in Wales. Three hundred and one responded (49%). Of these, 283 completed the Maslach Burnout Inventory (MBI) (Maslach et al. 1996). Half of those who responded indicated that they were emotionally overextended and exhausted by their work. One quarter of respondents were found to possess negative attitudes towards their clients, and approximately one in seven experienced little or no sense of satisfaction with their work. Working in an urban environment and lacking a supportive line manager were indicators for higher emotional exhaustion. CMHNs were significantly more likely to have negative attitudes towards their clients if they: were male; worked with an elderly care caseload; lacked job security; and had an unsupportive line manager. However, CMHNs who had worked longer within the field of community mental health were more likely to have positive attitudes towards their clients. Those CMHNs who had not completed a specialist postqualifying education course and those who did not hold a supervisory or management position were found to have a lowered sense of personal satisfaction in their work. Those CMHNs who reported that they drank alcohol were more satisfied with their sense of personal accomplishments achieved in their work.

English In the UK mental health social workers reported role conflict, role ambiguity and fulfilling statutory responsibilities as possible sources of stress. Burnout was related to workload, degree of involvement with patients, lack of social support and role conflict. Further work, which investigates coping strategies and stress management interventions, is recommended. French Au Royaume-Uni, les travailleurs sociaux en santé mentale signalent un problème de conflit de rôle, de l’ambiguïté de rôle et des responsabilités statutaires en tant que sources possibles de stresse. L’épuisement professionnel (burnout) a été lié à la charge de travail, au niveau d’implication auprès des patients, au manque d’appui social et aux conflits de rôle. L’article souligne la nécessité d’entreprendre d’autres études sur les stratégies employées pour gérer et maîtriser le stresse. Spanish En el Reino Unido, los trabajadores sociales en el área de salud mental nos informan que el conflicto y la ambigüedad de roles, así como las responsabilidades estatutarias son posibles causas de estrés. El desgaste profesional (burnout) fue relacionado con la cantidad de trabajo, el grado de envolvimiento con los pacientes, la falta de apoyo social y el conflicto de roles. Se recomienda la investigación de estrategias ‘para arreglárselas’ (‘coping strategies’) e intervenciones para controlar el estrés.