What personal and professional factors protect and/or support NHS staff when facing stress-inducing events in community and inpatient hospital settings?

Staff in forensic settings experience a wide number of stressful events, e.g., witnessing or being a victim of violence, and supporting people who self-harm or complete suicide. Some staff manage these events differently than others, with some experiencing adverse effects, such as poor mental health and burnout. How supported one feels in work as well as use of leisure time outside of work, are important for managing mental health and well-being. The Job Demands-Resources model (JD-R, (Bakker & Demerouti, 2007) explains how "job demands" and "job resources" impact employee well-being, while off-job crafting (de Bloom et al., 2020) explains employee’s capacity to seek changes in their lives outside of work, allowing them to meet their psychological needs. This research aimed to explore staff’s responses to stressful events and the personal and professional factors that may influence this, informed by concepts of off-job crafting and the JDRS. The study asked three research questions: RQ1: Are constructs of the job demands-resources model and off-job crafting associated with staff well-being within a forensic setting? RQ2: What are the strengths and limitations of working in a forensic setting and how does this impact staff well-being? RQ3: What are the challenges and opportunities for staff working in a forensic setting meeting their psychological needs in their leisure time?This multimethod study used a quantitative approach (cross-sectional surveys for RQ1) followed by a qualitative study (semi-structured interviews for RQ2 & RQ3) with staff employed by the NHS in both inpatient and community forensic settings within one Health Board. Participants were recruited via emails and signposting at meetings. An anonymous questionnaire measured Life Satisfaction, Anxiety and Depression, Compassion Satisfaction, Secondary Traumatic Stress, Burnout, Job Demands Resources and Off Job Crafting. Due to small sample size (n = 11), measures are reported descriptively. For the qualitative study, participants (n = 17) engaged in semi-structured interviews and explored topics of working in forensic settings, how staff cope with these roles and what they do in their lives outside of work. These topics were analysed via thematic analyses. This project was approved by IRAS (323671).Participants who completed the survey indicated they experienced anxiety and depression, had high levels of compassion satisfaction, challenges with organisational support, growth opportunities and work overload. Qualitative findings showed participants struggled with the wider occupational forensic system, and engaging with support to address their wellbeing. They also identified how the role had changed them, and expressed the challenges of meeting their psychological needs outside of work.Recommendations have been made based on the findings to support staff in these settings, including, organisational structures to encourage the use of the TIM, consideration of CRS, implementation of G-TEP/ G-REP, therapy that understands the forensic population and options to reduce stress on shift.