title: Recruitment and retention of mental health workers in Ghana.
abstract: BACKGROUND
  The lack of trained mental health workers is a primary contributor to the mental health treatment gap worldwide. Despite the great need to recruit and retain mental health workers in low-income countries, little is known about how these workers perceive their jobs and what drives them to work in mental health care. Using qualitative interviews, we aimed to explore factors motivating mental health workers in order to inform interventions to increase recruitment and retention.
  
  
  METHODS
  We conducted 28 in-depth, open-ended interviews with staff in Ghana's three public psychiatric hospitals. We used the snowballing method to recruit participants and the constant comparative method for qualitative data analysis, with multiple members of the research team participating in data coding to enhance the validity and reliability of the analysis. The use of qualitative methods allowed us to understand the range and depth of motivating and demotivating factors.
  
  
  RESULTS
  Respondents described many factors that influenced their choice to enter and remain in mental health care. Motivating factors included 1) desire to help patients who are vulnerable and in need, 2) positive day-to-day interactions with patients, 3) intellectual or academic interest in psychiatry or behavior, and 4) good relationships with colleagues. Demotivating factors included 1) lack of resources at the hospital, 2) a rigid supervisory hierarchy, 3) lack of positive or negative feedback on work performance, and 4) few opportunities for career advancement within mental health.
  
  
  CONCLUSIONS
  Because many of the factors are related to relationships, these findings suggest that strengthening the interpersonal and team dynamics may be a critical and relatively low cost way to increase worker motivation. The data also allowed us to highlight key areas for resource allocation to improve both recruitment and retention, including risk pay, adequate tools for patient care, improved hospital work environment, and stigma reduction efforts.
authors.affiliation: School of Public Health, Yale University, New Haven, Connecticut, United States of America.
authors.forename: Helen
authors.initials: H
authors.lastname: Jack
authors.forename: Maureen
authors.initials: M
authors.lastname: Canavan
authors.forename: Angela
authors.initials: A
authors.lastname: Ofori-Atta
authors.forename: Lauren
authors.initials: L
authors.lastname: Taylor
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Bradley
mesh_terms: D002322:Career Mobility; D005195:Family Relations; D005869:Ghana; D006280:Health Workforce / Q000191:economics / Q000706:statistics & numerical data*; D006608:Hierarchy, Social; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007360:Intelligence; D008603:Mental Health; D009042:Motivation; D010560:Personnel Selection / Q000191:economics / Q000706:statistics & numerical data*; D057766:Policy; D011369:Professional-Patient Relations; D012306:Risk; D035862:Vulnerable Populations