Abstract
Objectives: To explore the perceived roles and functions of psychiatry medical staff in two multidisciplinary teams at two state-funded health services (a CMHC and an A&D Clinic) and the factors influencing these roles and functions.
Method: Data was derived from nominal and focus groups, key informant interviews, participant observation and document review.
Results: Clinical roles were emphasised in both services with good concordance between medical and non-medical staff. Team and leadership roles however were not well-conceptualised and areas of confusion and conflict arose. Teaching and support roles were well-accepted. Different staff groups placed different emphasis on the other roles. Factors perceived as influencing these roles were categorised as individual, interpersonal, role confusion and conflict, service-related and external factors. Service-related factors influenced clinical and several other roles. Individual factors especially personality and level of experience influenced a variety of roles. Power and cultural differences between medical and non-medical staff influenced team and leadership roles. CMHC non-medical staff wanted doctors with a collaborative working style. A&D staff noted that cultural differences contributed to role confusion. Many factors were similar to those identified in the literature for psychiatrist burnout.
Conclusions: Addressing lack of role clarity, and teaching interpersonal and team leadership skills to psychiatry medical staff, is likely to improve multidisciplinary team functioning and work satisfaction for psychiatrists in these settings.