An exploration of factors which affect employment retention in the UK mental health nursing workforce.

Introduction
There is evidence that the rate of mental health nurses (MHNs) leaving the profession in the UK has rapidly increased in recent years, leading to critical staffing shortages. These losses have detrimental consequences for service user’s care and safety. A recent literature review highlighted that the factors affecting retention are likely to vary between clinical settings in mental health due to the differences in work environments and services they provide.

Aim
To identify any differences in registered MHNs intention to leave across different clinical settings within the NHS; and explore the experiences that influence retention in inpatient and community clinical settings.

Methods
An explanatory mixed-methods study design was used. A survey of MHNs across three mental health NHS Trusts gained 392 responses. The responses were analysed using descriptive and inferential statistics. Thirty MHNs were purposefully selected for individual interviews along with ten senior leaders to explore the experiences influencing MHNs intention to leave in different clinical settings. Qualitative data was analysed using thematic analysis and then integrated with the quantitative data in the form of a joint display.

Results
Almost wo thirds (n=246, 62.8%) of the sample indicated that they are considering leaving their jobs, with almost one third (n=112, 28.6%) considering leaving nursing all together. Clinical setting, Trust, staff grade, nursing experience, work-related stress, mental wellbeing, and age were significantly associated with intent to leave or stay to some extent. Five themes were generated from the qualitative data: Disillusionment with Mental Health Nursing, The Impact of Leadership and Management, The Impact of the Work Environment, The impact of Training and Development, and The Impact of Staffing.

Conclusion
The retention of MHNs should remain a priority of the National Health Service (NHS) Long-Term Workforce Plan and other workforce policies. Findings from this study can be used to inform policy and retention strategies that can be tailored to inpatient and community mental health clinical settings.