Multidisciplinary community teams: Where is the wreckage?

Abstract

Galvin and McCarthy's (1994) recent critique of community mental health teams (CMHTs) over-emphasized process issues rather than the outcomes of multi-disciplinary provision. When examining the outcome literature it is clear that, when focused on providing intensive and proactive support to people with severe and long term mental health problems, multi-disciplinary CMHTs can be a cost-effective option that is positively evaluated by users, carers and referrers. In addition, inter- disciplinary team work and support from colleagues is often cited as an important source of reward for team members and may be critical to effective provision. Far from providing a fundamental critique of the need for CMHTs, Galvin & McCarthy highlight a range of implementation issues. Responsibility for failing to effectively implement the CMHTs lies with all levels of purchasing and providing agencies, not with the concept of community multidisciplinary teamworking itself. Recommendations for improving the functioning of CMHTs are made.