Hostname: page-component-cd9895bd7-jkksz Total loading time: 0 Render date: 2024-12-22T19:47:58.026Z Has data issue: false hasContentIssue false
  • English
  • Français

Membership and management: structures of inter-professional working in community mental health teams for older people in England

Published online by Cambridge University Press:  04 June 2013

Mark Wilberforce ,
Sue Tucker ,
Michele Abendstern ,
Christian Brand ,
Clarissa Marie Giebel  and
David Challis
Mark Wilberforce*
Affiliation:
Personal Social Services Research Unit (PSSRU), University of Manchester, Manchester, UK
Sue Tucker
Affiliation:
Personal Social Services Research Unit (PSSRU), University of Manchester, Manchester, UK
Michele Abendstern
Affiliation:
Personal Social Services Research Unit (PSSRU), University of Manchester, Manchester, UK
Christian Brand
Affiliation:
Personal Social Services Research Unit (PSSRU), University of Manchester, Manchester, UK
Clarissa Marie Giebel
Affiliation:
Personal Social Services Research Unit (PSSRU), University of Manchester, Manchester, UK
David Challis
Affiliation:
Personal Social Services Research Unit (PSSRU), University of Manchester, Manchester, UK
*
Correspondence should be addressed to: Mark Wilberforce, Personal Social Services Research Unit (PSSRU), University of Manchester, Dover Street Building, Oxford Road, Manchester M13 9PL, UK. Phone: +44-0161-275-5391; Fax: +44-0161-275-5790. Email: [email protected].
Get access

Abstract

Background:

Community mental health services are regarded as the preferred first tier of specialist psychogeriatric support, with integrated multidisciplinary teams believed to offer improved decision-making and greater continuity of care than separate single-profession services. In England over 400 community mental health teams (CMHTs) form the cornerstone of such support, yet research has neither assessed progress toward integrating key professional disciplines nor the nature of their membership and management arrangements.

Methods:

A self-administered questionnaire was sent to all CMHTs for older people in England, seeking a combination of objective and subjective information on team structure and management.

Results:

Responses from 376 (88%) teams highlighted broader multidisciplinary membership than found in a 2004 survey, with particular growth in the number of support workers and other unqualified practitioners. Only modest progress was found in the integration of psychologists and social workers within CMHTs. The data also revealed a trend toward “core” team membership, and away from “sessional” membership in which staff may have divided loyalties between services. Multidisciplinary working was reported as beneficial by many respondents, but examples of “silo working” were also found, which may have hampered service delivery in a minority of teams.

Conclusions:

The reported growth in the number of practitioners without professional registration raises issues about the appropriate skill mix and substitution within CMHTs, while local agencies should review barriers to the integration of psychologists and social workers. Further research is required to explore the quality of multidisciplinary team working.

Keywords

multidisciplinary workinginter-professional workingintegrated carecommunity careold-age psychiatrycommunity mental health teams
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 9 , September 2013 , pp. 1485 - 1492
Copyright
Copyright © International Psychogeriatric Association 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Audit Commission. (2000). Forget Me Not: Mental Health Services for Older People. London: Audit Commission.Google Scholar
Brown, B., Crawford, P. and Darongkamas, J. (2000). Blurred roles and permeable boundaries: the experience of multidisciplinary working in community mental health. Health and Social Care in the Community, 8, 425–435.CrossRefGoogle ScholarPubMed
Carpenter, J., Schneider, J., Brandon, T. and Wooff, D. (2003). Working in multidisciplinary community mental health teams: the impact on social workers and health professionals of integrated mental health care. British Journal of Social Work, 33, 1081–1103.CrossRefGoogle Scholar
Challis, D., Hughes, J. and Sutcliffe, C. (2010). Social Work and care/case management, In Ames, D., Burns, A. and O’Brien, J. (eds.) Dementia (pp. 180–185). London: Hodder Arnold.Google Scholar
Department of Health. (2001). National Service Framework for Older People. London: Department of Health.Google Scholar
Department of Health and Care Services Improvement Partnership. (2005). Everybody's Business: Integrated Mental Health Services for Older Adults: A Service Development Guide. London: Department of Health.Google Scholar
Draper, B. (2000). The effectiveness of old age psychiatry services. International Journal of Geriatric Psychiatry, 15, 687–703.3.0.CO;2-K>CrossRefGoogle ScholarPubMed
Draper, B. and Anderson, D. (2010). The baby boomers are nearly here – but do we have sufficient workforce in old age psychiatry? International Psychogeriatrics, 22, 947–949.CrossRefGoogle ScholarPubMed
Evans, S. (2004). A survey of the provision of psychological treatments to older adults in the NHS. The Psychiatrist, 28, 411–414.Google Scholar
Evans, S.et al. (2012). The social care component of multidisciplinary mental health teams: a review and national survey. Journal of Health Services Research and Policy, 17, 23–29.CrossRefGoogle ScholarPubMed
Fay, D., Borrill, C., Amir, Z., Haward, R. and West, M. (2006). Getting the most out of multidisciplinary teams: a multi-sample study of team innovation in health care. Journal of Occupational and Organizational Psychology, 79, 553–567.CrossRefGoogle Scholar
House of Commons. (2008). Improving Services and Support for People with Dementia: Sixth Report of the Committee of Public Accounts, Session 2007–08. London: TSO (The Stationery Office).Google Scholar
Huxley, P., King, S., Evans, S., Davidson, B. and Beresford, P. (2003). ‘No Recovery Without Time and Support’ (or ‘More than Bowling Together’): Evaluation of the Introduction of Support, Time and Recovery Workers in Three Pilot Sites. London: NHS, Social Care Workforce Research Unit, King's College London.Google Scholar
Huxley, P., Evans, S., Beresford, P., Davidson, B. and King, S. (2009). The principles and provisions of relationships: findings from an evaluation of Support, Time and Recovery workers in mental health services in England. Journal of Social Work, 9, 99–117.CrossRefGoogle Scholar
McKenna, H. F., Kenney, S. and Hasson, F. (2005). Health care assistants: the views and perceptions of course co-ordinators in the Republic of Ireland. Journal of Nursing Management, 13, 165–172.CrossRefGoogle ScholarPubMed
McRae, N., Banerjee, S., Murray, J., Prior, S. and Silverman, A. M. (2008). An extra pair of hands? A case study of the introduction of support workers in community mental health teams for older adults. Journal of Nursing Management, 16, 734–743.CrossRefGoogle Scholar
Miller, C., Freeman, M. and Ross, N. (2001). Interprofessional Practice in Health and Social Care: Challenging the Shared Learning Agenda. London: Hodder Arnold.Google Scholar
Mistral, W. and Velleman, R. (1997). CMHTs: the professionals’ choice? Journal of Mental Health, 6, 125–140.Google Scholar
National Audit Office. (2007). Improving Services and Support for People With Dementia. London: NAO.Google Scholar
Ng, C., Herrman, H. and Chiu, E. (2009). Community mental health care in the Asia-Pacific region: using current best-practice models to inform future policy. World Psychiatry, 8, 49–55.CrossRefGoogle ScholarPubMed
Norman, I. and Peck, E. (1999). Working together in adult community mental health services: an inter-professional dialogue. Journal of Mental Health, 8, 217–230.CrossRefGoogle Scholar
Onyett, S. (2011). Revisiting job satisfaction and burnout in community mental health teams. Journal of Mental Health, 20, 198–209.CrossRefGoogle ScholarPubMed
Onyett, S. and Ford, R. (1996). Multidisciplinary community teams: where is the wreckage? Journal of Mental Health, 5, 47–55.CrossRefGoogle Scholar
Ovretveit, J. (1993). Coordinating Community Care: Multidisciplinary Teams and Care Management. Buckingham, UK: Open University Press.Google Scholar
Priest, P., Dunn, C., Hackett, J. and Wills, K. (2011). How can mental health professionals best be supported in working with people who experience significant distress? Journal of Mental Health, 20, 543–554.CrossRefGoogle ScholarPubMed
Rosen, A. and Callaly, T. (2005). International teamwork and leadership: issues for psychiatrists. Australasian Psychiatry, 13, 234–240.CrossRefGoogle Scholar
Royal College of Psychiatrists. (2006). Raising the Standard: Specialist Services for Older People with Mental Illness. Report of the Faculty of Old Age Psychiatry. London: Royal College of Psychiatrists.Google Scholar
Simpson, A. (2006). Shared care and inter-professional practice. In Rassool, G. (ed.), Dual Diagnosis Nursing (pp. 130–139). Oxford, UK: Blackwell.CrossRefGoogle Scholar
Tucker, S.et al. (2007). Old age mental health services in England: implementing the National Service Framework for Older People. International Journal of Geriatric Psychiatry, 22, 211–217.CrossRefGoogle ScholarPubMed
Wilberforce, M., Harrington, V., Brand, C., Tucker, S., Abendstern, M. and Challis, D. (2011). Towards integrated community mental health teams for older people in England: progress and new insights. International Journal of Geriatric Psychiatry, 26, 221–228.CrossRefGoogle ScholarPubMed
World Health Organization and Alzheimer's Disease International. (2012). Dementia: A Public Health Priority. Geneva, Switzerland: WHO.Google Scholar
World Health Organization and World Psychiatric Association. (1997). Organisation of Care in Psychiatry of the Elderly. Geneva, Switzerland: WHO.Google Scholar