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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: mark.wilberforce@manchester.ac.uk.
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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 

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