Burnout and employee turnover in mental health services are costly and can have a negative impact on service user outcomes. Using the Job Demands-Resources model as a foundation, the aim of this study was to explore the relationships between burnout, turnover intention and job satisfaction in relation to specific job demands and job resources present in the workplace in the context of one Australian mental health service with approximately 1100 clinical staff. The study took a cross-sectional survey approach. The survey included demographic questions, measures of burnout, turnover intention, job satisfaction, job demands and job resources. A total of 277 mental health personnel participated. Job satisfaction, turnover intention and burnout were all strongly inter-correlated. The job resources of rewards and recognition, job control, feedback and participation were associated with burnout, turnover intention and job satisfaction. Additionally, the job demands of emotional demands, shiftwork and work-home interference were associated with the exhaustion component of burnout. This study is the largest of its kind to be completed with Australian mental health personnel. Results can be used as a foundation for the development of strategies designed to reduce burnout and turnover intention and enhance job satisfaction.

Introduction: In recent times, much attention has been focused on the reduction of seclusion and restraint in psychiatric settings. This paper analyzes evidence available from evaluations of single seclusion and/or restraint reduction programmes. A total of 29 papers were included in the review. Results: Seven key strategy types emerged from the analysis: (i) policy change/ leadership; (ii) external review/debriefi ng; (iii) data use; (iv) training; (v) consumer/ family involvement; (vi) increase in staff ratio/crisis response teams; and (vii) programme elements/changes. Outcomes indicate that a range of reduction programmes are successful in reducing the frequency and duration of seclusion and restraint use, while at the same time maintaining a safe environment. Conclusion: The development of new seclusion and restraint reduction programmes should include strong leadership from local management; external seclusion and restraint review committees or post-incident debriefing and analysis; broad-based staff training and programme changes at a local level. Behavioural and cognitive-behavioural programmes appear to be very useful in child and adolescent services. Further systematic research should be conducted to more fully understand which elements of successful programmes are the most powerful in reducing incidents of seclusion and restraint.

Objective: The use of sensory rooms (also known as comfort rooms) to reduce seclusion rates has generated a great deal of interest. This study examined the outcomes associated with the introduction of a sensory room in an acute inpatient psychiatric unit. Method: Consumers rated distress and staff rated a variety of disturbed behaviours before and after each use of the room. Items used during each episode were recorded. Results: Use of the room was associated with significant reductions in distress and improvements in a range of disturbed behaviours. Those individuals who used the weighted blanket reported significantly greater reductions in distress and clinician-rated anxiety than those who did not. No changes were noted in rates of seclusion or aggression. Conclusions: The sensory room was an effective intervention to ameliorate distress and disturbed behaviour, although this did not translate into reductions in overall rates of seclusion or aggression. Weighted blankets appear to be particularly useful.