Factors influencing the career choice and retention of community mental health workers in Ghana.

Vincent I.O Agyapong,Eilish Mcauliffe,Conor K Farren,Akwasi Osei

doi:10.1186/s12960-015-0050-2

Abstract

BackgroundWhilst there have been several studies exploring retention in health workers, little is known about health workers engaged in the provision of mental health services and the factors that affect their recruitment and retention.AimsThe objective of this research was to examine the views of stakeholders about the factors which influence career choices and retention of community mental health workers (CMHWs) in Ghana.MethodsWe administered three separate, self-administered, semi-structured questionnaires to 11 psychiatrists, 29 health policy directors and 164 CMHWs across Ghana, including 71 (43.3%) community psychiatric nurses (CPNs), 19 (11.6%) clinical psychiatric officers (CPOs) and 74 (45.1%) community mental health officers (CMHOs).ResultsOverall, 34 (20.7%) of all CMHWs chose to work in mental health because of the job prospects in mental healthcare. Overall, 12 (16.2%) CMHOs, 1 (5.3%) CPO and 20 (28.2%) CPNs reported they had considered leaving the mental health profession because of the stigma, with 4 (36.4%) psychiatrists and 12 (41.4%) health policy coordinators also reporting that they knew some CMHWs who had considered leaving the mental health profession because of stigma. Similarly, 16 (21.6%) CMHOs, 4 (22.1%) CPOs and 38 (53.5%) CPNs said they had considered leaving the mental health profession because of concerns about risk. Furthermore, 6 (54.5%) psychiatrists and 3 (10.3%) health policy directors said they knew some CMHWs who had considered leaving the mental health profession because of concerns about risk. Overall, 61 (37.2%) of CMHWs reported that they have considered leaving the mental health profession for other reasons other than stigma and risk including the following: the lack of support, respect and recognition from healthcare managers, lack of opportunities for professional development and poor conditions of service including low salaries, lack of office and personal accommodation and lack of risk allowance and transportation as well as poor inter-professional relationships.ConclusionsSeveral factors affect the recruitment and retention of CMHWs in Ghana, including the prospects of easy employment, stigma, risk, lack of opportunities for career progression and low salaries.

Highlights

In order to tackle the workforce challenges specific to an organization, one must first understand the exact nature of those challenges
A comparison of the reasons why the Community mental health worker (CMHW) chose to work in mental health was made using cross tabulation
No community mental health officer (CMHO) got into the mental health profession accidentally

Summary

Introduction

In order to tackle the workforce challenges specific to an organization, one must first understand the exact nature of those challenges. Several other factors account for the relative lack of mental health professionals in LAMICs including insufficient training opportunities, deteriorating health of the workforce, brain drain and rural/urban imbalance [7]. In an in-depth survey of nursing leaders and in-practice nurses in both rural and urban Ghana on potential incentives to promote recruitment and retention in rural service, many respondents reported low satisfaction with rural practice influenced by the high workload and difficult working conditions, perception of being “forgotten” in rural areas by the Ministry of Health, lack of professional advancement and the lack of formal learning or structured mentoring [11]. Whilst there have been several studies exploring retention in health workers, little is known about health workers engaged in the provision of mental health services and the factors that affect their recruitment and retention

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Results

Discussion

Conclusion