New Ways of Working in UK mental health services: developing distributed responsibility in community mental health teams?

Abstract

Background: This paper examines the introduction and operation of a number of support roles in mental health services. This is done in the context of concerns about the effectiveness of CMHTs.

Aims: Three questions are addressed: the degree to which concern for the work of consultant psychiatrists informed the introduction of the new roles; what the reforms implied for the work of the psychiatrist and those in new roles; and the impact of any changes on the operation of CMHTs.

Method: Data were collected as part of a national-level evaluation. The main means of collection was the semi-structured interview.

Results: The study shows: that reform was underpinned by concerns about the workload of psychiatrists; and that while in principle the responsibilities of the psychiatrist were to be distributed across other team members, those in new roles felt themselves to be isolated.

Conclusions: Despite the intentions of policy, the creation of the new roles did little to extend the idea of distributed responsibility in CMHTs.

• Mental health services
• community mental health teams
• new ways of working
• interprofessional working
• workforce change
• NHS
• teams
• support workers

Declaration of interest

The research upon which this paper is based was funded by the Policy Research Programme of the UK Department of Health.