Multi-disciplinary community teams: Clinging to the wreckage

Abstract

In this paper we critically evaluate the claim that Multi-Disciplinary Community Teams (MDCTs) offer the most effective means of providing comprehensive mental health services. We draw upon empirical studies where possible, and upon our own extensive experience of such teams. We conclude that MDCTs usually result in unfocused, inefficient and low quality service provision. Team members are typically left deskilled, confused and demoralised. We argue that these deficiencies are due to fundamental flaws in the MDCT concept, and that they cannot be rectified by improved planning and training or by sheer perseverance. We go on to examine why such a manifestly inadequate model is continuing to be promoted and adopted around the country. We conclude that the recent changes in the Health and Social care systems necessitate the creation and evaluation of alternative models of mental health service provision.