Implementing personalisation in integrated mental health teams in England

Abstract

This article explores how role boundaries and professional priorities in integrated mental health teams have impacted on the implementation of personalised approaches to social care support. We focus on the use of personal budgets to meet mental health-related social care needs as a key mechanism for personalised care. Drawing on 28 qualitative interviews with mental health practitioners from three local authorities in England undertaken in 2013, we report nurses’, social workers’, and occupational therapists’ attitudes towards, and engagement with, personal budgets. Professional boundaries and competing priorities heavily influenced the extent to which personal budgets were perceived as a legitimate part of their roles. Across different professional groups, a sense emerged that personal budgets should be somebody else’s job. A focus on attention to treatment, stability, and risk management often resulted in low prioritisation of personal budgets and led practitioners to avoid recommending them or to exclude service users from the process as a way to save time. Implications of the dominant medical model and the protection of traditional professional roles for the implementation of new, person-centred models of practice are discussed.

• Integrated teams
• mental health
• personal budgets
• personalisation
• social care

Acknowledgements

The authors thank the local authorities who participated in this research and the members of the lived-experience advisory group who guided and contributed to the study. We are grateful to the study participants and their managers who made this research possible. The views expressed in this article are those of the authors alone.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the writing and content of this article.

The study was funded by the Big Lottery (grant RGT/1/0334566).