Defining professionalism for mental health services: a rapid systematic review

Abstract

Background: Efforts have been made to define professionalism across the professions, yet little attention has been paid to the concept in mental health services, where patients’ needs differ to that in other healthcare specialties.

Aims: To derive a definition of professionalism for mental health services using the existing literature.

Method: A rapid, systematic review was conducted to identify empirical and non-empirical records that described professionalism in a mental health service context from 2006 to 2017. Studies were synthesised narratively using thematic analysis.

Results: Seventy records were included in the review. Professionalism was described on two levels; at a societal level, a dynamic social contract between professions and society, and; at an individual level, having intrapersonal, interpersonal, and working professionalism. Utilising emerging themes, an operationalised definition of professionalism, suitable for a mental health service context was derived.

Conclusions: Within mental health services, emphasis is placed on the interpersonal aspects of practice such as communication skills, maintaining boundaries and humanity. Themes relating to the vulnerability of patients and the challenge of supporting autonomy and choice whilst maintaining safety and acting in a client’s best interest are also evident. ‘Practical wisdom’ and a flexible approach to working are needed to manage these challenging situations.

Keywords:

• Mental health
• professionalism
• systematic review
• values
• skills
• professional attributes

Acknowledgements

We would like to thank Naomi Hay-Gibson for supporting the lead author during the early stages of the review. We are grateful to Naomi Hay-Gibson and Adrian Clark for their support with the development of a search strategy. Last but not least, we would like to thank Fred Hafferty and Madeline Carter for kindly providing feedback on earlier drafts of the manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

Additional information

Funding

LA is in receipt of a PhD scholarship awarded by Hull York Medical School. PAT is supported in his research by an NIHR Career Development Fellowship. This paper presents independent research part-funded by the National Institute for Health Research (NIHR).