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Multidisciplinary primary care mental health teams: a challenge to communication

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Abstract:

Recent national guidelines have caused primary care trusts to explore new ways of providing mental health care for patients with mild to moderate mental health problems. This study examines communication in a new team in one primary care organisation. In order to provide mental health services within the primary care organisation, general practices were grouped together in 'clusters'. While this allowed the primary care organisation to provide a range of services to the patients within its locality, it also created several potential difficulties as a consequence of bringing together different working practices, different professional groups and different cultures. This paper examines the mechanisms for communication within the teams and the issues that arose across these interpractice and interprofessional boundaries.

Multiple qualitative methodologies were used to explore these issues. The first was participant observation carried out at a residential conference run by the primary care organisation to develop its mental health strategy. The data from this early stage of the study were used to develop a framework for a series of focus groups with healthcare professionals who were members of the primary mental healthcare teams. Focus groups were carried out with GP mental health leads (n = 13), district nurses (n = 8), health visitors (n = 7) and counsellors (n = 8). Finally, semi-structured interviews (n = 10) were carried out with primary care mental health team key workers and general practitioners (GPs) (n = 3).

Four themes emerged from the data: communication within the primary care mental health team (PCMHT), communication with the rest of the primary healthcare team (PHCT), communication with patients, and confidentiality.

This paper highlights the difficulties of interprofessional communication that need to be addressed if the 'cluster' model is to be an effective mechanism for delivering primary care mental health services.

Keywords: COMMUNICATION; INTERDISCIPLINARY WORKING; MENTAL HEALTH; PRIMARY CARE; PRIMARY CARE MENTAL HEALTH TEAMS

Document Type: Research Article

Publication date: September 1, 2005

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