Understanding the factors that affect retention within the mental health nursing workforce: a systematic review and thematic synthesis

Int J Ment Health Nurs. 2021 Dec;30(6):1476-1497. doi: 10.1111/inm.12904. Epub 2021 Jun 28.

Abstract

There are over 41 000 vacant nursing posts across the United Kingdom's National Health Service (NHS), with more people leaving the profession that joining it. Despite mental health being acknowledged as a priority area, some of the most significant staff shortages are occurring within mental health services. Urgent action is needed to retain the mental health nurses (MHNs) currently in post to ensure the profession is fit for purpose and aid future recruitment efforts. This review set out to identify the individual factors that affect the retention of MHNs. A systematic search of six databases was conducted (CINAHL, PsychINFO, MEDLINE, Web of Science (Core collection), EMBASE and the British Nursing Index). Studies were systematically screened for inclusion based on predetermined eligibility criteria. The studies were quality assessed using the Mixed Methods Appraisal Tool (MMAT). Findings were synthesized using Thematic Synthesis. A total of 23 studies consisting of a range of study designs were included in the review. Four key themes emerged from the synthesis: Individual characteristics, Working within mental health services, Training and skills and Work environment. The findings from this review suggest that MHNs encounter some factors unique to working in mental health services, which suggests that retention strategies should be specific to each nursing speciality. Beyond nursing speciality, the factors identified vary between clinical settings in mental health due to the differences in work environments and services they provide. Future studies should now set out to explore what factors exist in which clinical settings to inform better tailored retention strategies to generate better outcomes.

Keywords: RMN; intent to leave; intent to stay; mental health nurse; retention.

Publication types

  • Systematic Review

MeSH terms

  • Health Personnel
  • Humans
  • Mental Health Services*
  • Psychiatric Nursing*
  • State Medicine
  • Workforce