An investigation into staff experiences of working in the community with hard to reach severely mentally ill people

Uttarkar, Vimala (2008) An investigation into staff experiences of working in the community with hard to reach severely mentally ill people. Professional Doctorate thesis, Tavistock and Portman NHS Foundation Trust / University of East London. Full text available

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Several studies have evaluated the effectiveness of community mental health services by measuring economic viability and client outcomes. Whilst some surveys have emphasized the pressures experienced by mental health staff in the community, none have elicited details of these pressures, how staff cope and what qualities and structures might be more or less effective. This study attempts to understand how mental health staff deal with the emotional impact of working with people suffering from severe mental illness in the community. Observation of and interviews with staff from mental health teams in the community were carried out. Using grounded theory, emerging themes were clustered together and ideas drawn from systems and psychoanalytical theories were used to develop an understanding of how the teams worked and whether there were particular personal attributes that staff possessed which help them carry out such work and, what organisational structures enhance these qualities. Although an important measure of the competence and efficiency of these teams is their impact on their patients, this study does not focus on patient outcomes nor does it elaborately scrutinise the overall effectiveness of the teams; instead it focuses on staff and attempts to explore what facilitates them to cope with the emotional demands of this work. Three different types of community teams were studied; an Outreach Team for Homeless Mentally III people (OHT), an Assertive Outreach Team [AOT], and a 'standard' Community Mental Health Team (CMHT). Clients of the three teams varied in the severity of their illnesses and thus the intensity of their needs. The specific skills needed were found to be different in the three teams: those in the OHT were persistence and tolerance of high levels of risk with their most chaotic and damaged clients; in the AOT it was the ability to share skills in the team and develop all the professional skills necessary to maintain people out of hospital; whilst in the CMHT it was the ability to cope with working individually with larger client caseloads, to organise and coordinate community resources.

Item Type: Thesis (Professional Doctorate)
Additional Information: This thesis is submitted in partial fulfilment of a Professional Doctorate in Social Work awarded by the University of East London in collaboration with the Tavistock and Portman NHS Foundation Trust
Uncontrolled Keywords: Professional Doctorate in Social Work, D60
Subjects: Disabilities & Disorders (mental & physical) > Mental Health - Social Welfare
Social Welfare > Social Work
Department/People: Research

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