Staff assessment of structural empowerment and ability to work according to evidence-based practice in mental health care.

Abstract

To study associations between staff members' self-rated structural empowerment in mental health care, organisational type, and the ability and willingness to work according to evidence-based practice. Questionnaire data were collected from 253 mental health staff members. Multivariate logistic regressions analyses revealed that participants who scored higher on opportunity (OR 2.5) and were employed by the county council (OR 1.9) vs. the municipality were more likely to report high evidence-based practice ability. A generalised estimating equation taking into account unknown correlations within units found opportunity and resources to be significant predictors of evidence-based practice ability. Regarding evidence-based willingness, increased odds were found for higher scores of opportunity (OR 2.2) and being employed by the county council (OR 2.9). The generalised estimating equation also found resources to be a significant predictor of evidence-based willingness. In both organisations, the values for empowerment were moderate. Structural conditions such as access to opportunities and resources are important for creating supporting structures for practice to be evidence-based. Our results emphasise the managers' essential role in creating empowering structures, and especially access to opportunities and resources, for their staff to carry out evidence-based practice.