Contemporary mental healthcare in the UK is based on an emerging service model that requires a number of ‘functional’ mental health teams to work together in providing comprehensive secondary mental healthcare to a catchment area. This model replaces the painfully won dominance of the single local community mental health team. At the time of writing, four teams are mandatory: in the phraseology of the Department of Health these are ‘ primary care liaison, assertive outreach, early intervention and crisis resolution and home treatment’ teams (the logic of functional differentiation suggests that ever more specialist teams will emerge). All health economies have been required to develop these four teams, producing a potentially complex and confusing service system.
A book that provides a map of this brave new world should be valuable both for the experienced practitioner and the tyro. I cannot think of anyone better placed to write such a book than Tom Burns, now Professor of Social Psychiatry at Oxford, who has for many years been at the forefront of innovations in service delivery. With a career stretching back to the high point of traditional social psychiatry as practised at Dingleton Hospital, Burns has undertaken important research into the primary/secondary care interface, the workings of community mental health teams and intensive case management/assertive outreach teams. In Community Mental Health Teams he has supplemented his considerable personal experience and knowledge of the literature with direct observation of mental health teams both in the UK and North America. The structure of the book is simple and the writing is clear. Two introductory chapters summarise, perhaps rather too briefly, the origins of community psychiatry and some key issues in multidisciplinary team-working. Chapters describing the four ‘functional’ teams provide the core of the book: Burns underlines the commonalities between these teams as well as describing their differences. Two short chapters allude to highly specialised teams and the research agenda (which is very large). It provides all the information that an examination candidate should know, but like all good books this text raises more questions for the perceptive reader than it answers.
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