Views and Opinions of Healthcare Workers in the South of England on Community Mental Healthcare (original) (raw)
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The social worker in community mental health teams: Findings from a national survey
Journal of Social Work
Summary Social workers have been members of community mental health teams (CMHTs) for many years. However, a combination of factors has resulted in their removal from CMHTs in some areas in recent years. This study presents findings from a 2018 national survey of CMHT team managers (44% response rate), to ascertain the current position of the social worker within CMHTs in England. Analyses focussed on membership, roles and tasks, and change within the previous 12 months. Descriptive statistics were used to analyse the quantitative data and content analysis to interpret free text comments. Findings Social workers were found to undertake a variety of generic roles and tasks but were reported to do so proportionally less often than nurses. A large minority were involved in non-traditional social work tasks such as monitoring medication. In one-fifth of teams, managers thought they had too few social workers. Free text comments suggested that managers valued social workers for their soc...
2008
Several studies have evaluated the effectiveness of community mental health services by measuring economic viability and client outcomes. Whilst some surveys have emphasized the pressures experienced by mental health staff in the community, none have elicited details of these pressures, how staff cope and what qualities and structures might be more or less effective. This study attempts to understand how mental health staff deal with the emotional impact of working with people suffering from severe mental illness in the community. Observation of and interviews with staff from mental health teams in the community were carried out. Using grounded theory, emerging themes were clustered together and ideas drawn from systems and psychoanalytical theories were used to develop an understanding of how the teams worked and whether there were particular personal attributes that staff possessed which help them carry out such work and, what organisational structures enhance these qualities. Alt...
Why do health professionals work in a community mental health service?
Australasian Psychiatry, 2006
The aim of this pilot study was to determine the reasons why mental health professionals work in a community mental health service. Methods: A survey of psychiatrists and trainees (n = 13) and other mental health professionals (n = 67) was conducted in an Australian community mental health service with a socioeconomically deprived catchment population. Respondents were asked to list their main reasons for working and to complete measures of job design, well-being, social support, role clarity, teamwork and job satisfaction. The qualitative results were validated using focus groups. Results: The response rate was 53.7% (43/80). Income (31/43), belonging (21/43), self-esteem (30/43) and self-actualization (9/43) were the main reasons given for working. Mental health professionals, who reported self-actualization as a reason for work, had significantly higher well-being and job satisfaction than other subjects. Mental health professionals who cited self-actualization as a reason for work perceived that their work was more significant and had higher task identity compared with other subjects. Conclusions: This study is limited by a small sample size and the inability to exclude confounding variables. Maslow's hierarchy of needs was a useful framework for categorizing reasons for work. Some practical approaches to meet the needs of the mental health workforce are discussed.
Community Mental Health Teams: Interacting Groups of Citizen-Agent
Community mental health teams (CMHT) are a core feature of mental health services. They comprise employees (of the NHS in the UK and other organisations elsewhere) providing for clients in a variety of settings. Although these teams and their activities are formally overseen and audited there is little understanding of how their members conduct themselves, what they see their goals to be and how these are achieved. This is a significant and strategic research need and opportunity. Findings of relevant investigations are reviewed. Clients and practitioners concur that a critical component of CMHTs' work is the building and maintenance of supportive relationships. This occurs alongside more formally defined activities, and allows interpretation of this work as an example of street level bureaucracy. The work of CMHTs might be best understood as a form of enabled citizenship offering additional insight into tensions between formal bureaucracies and intuitive, humanitarian concerns. Service Setting; Community Mental Health Teams. Community mental health teams are organised around the needs of clients living within a geographically defined area. In the UK every such area will have several teams, each one charged with providing for a particular set of clients. Sets of clients deemed to be the responsibility of distinct teams are differentiated on the basis of age, perceived risk, chronicity of difficulties and psychiatric diagnosis. Thus, broadly, in the UK a geographically defined population of some 300,000 will be provided for by a Child and Adolescent Mental Health Service team (CAMHS) serving the under eighteens, a Mental Health Service for Older People team (MHSOP) serving the over sixty fives, an Early Interventions for Psychosis team (EIP) serving younger adults with incipient psychosis, an Assertive Outreach team (AO) providing for people of working age who have proved both a source of continuing concern and reluctant to accept assistance, a Crisis Resolution and Home Treatment team (CRHT) providing intense, short term care for those in acute difficulty, a Rehabilitation and Recovery team (R&R) offering support and rehabilitation to stable but persistently disabled adults, a Drug and Alcohol team focusing upon the particular needs of the chemically dependent, and a Primary Care team providing liaison with general practitioners and short term therapeutic interventions when these are considered to be most appropriate. Teams range in size from 3-4 to 20+ whole time equivalent practitioners. Configurations vary depending upon geography, demographics and choices made by service providers and commissioners. Nevertheless, in the UK this configuration continues to largely respect Department of Health guidelines issued in 2001 (Department of Health 2001).
2000
The present study explored the current competency status of residential mentai health support workers (n=121). Competency was assessed through the domains of skills, attitudes and perception of the work environment. Consistent with a recovery model, the National Mental Health Workforce Development Coordinating Committee (1999) put forward 10 basic core competencies that they recommended that all mental health workers should be able to demonstrate in their work practice. Skills and attitudes selfreport measures were developed to assess participant performance on these competencies. In addition, a standard measure (Ward Atmosphere Scale) was utilised to evaluate the perceived atmosphere of the participants' work environment. The aggregated results of this study appeared to show that participants were generally competent in a number of areas of work practice. However, deficiencies in critical areas of client support were identified on closer examination of the data. With regard to participants' reported skills, shortcomings were found in particular in the core competencies knowledge, assessment and intervention. Similar deficits were found regarding participant attitudes with shortcomings found in the core competencies knowledge, culturally appropriate practice, assessment and safe/ethical practice. While superior education and training did appear to influence performance on certain competencies, some deficiencies were nevertheless reported by the more highly educated and trained participants. In addition, participants generally characterised their work settings in a very negative manner such that it appears that many settings are not adhering to the philosophies of rehabilitation and recovery. Despite the identification of deficiencies, many participants did demonstrate a number of competencies combined with a commitment to professional growth. In fact, one of the most positive findings in this study was the importance practically all the participants placed on promotion of their own professional growth.
Journal of mental health (Abingdon, England), 2015
This paper examines the introduction and operation of a number of support roles in mental health services. This is done in the context of concerns about the effectiveness of CMHTs. Three questions are addressed: the degree to which concern for the work of consultant psychiatrists informed the introduction of the new roles; what the reforms implied for the work of the psychiatrist and those in new roles; and the impact of any changes on the operation of CMHTs. Data were collected as part of a national-level evaluation. The main means of collection was the semi-structured interview. The study shows: that reform was underpinned by concerns about the workload of psychiatrists; and that while in principle the responsibilities of the psychiatrist were to be distributed across other team members, those in new roles felt themselves to be isolated. Despite the intentions of policy, the creation of the new roles did little to extend the idea of distributed responsibility in CMHTs.