A Call to Coordinate Mental Health Teams

A Vision for Change set out a tripartite governance structure of mental health teams comprising of a clinical leader, a team co-ordinator and a practice manager. The team coordinator position is a key nondiscipline specific role within the team with significant responsibilities. This article sets out how the skill set of psychologists lends itself to effectively occupying this role. It outlines the opportunities for psychologists, through taking up this role, to impact positively upon mental health teams’ structures, processes and working environments. It concludes by suggesting a number of practical actions that would allow the psychology community to grasp these opportunities. The article is targeted at those psychologists working in secondary care mental health services, the vast majority of whom are clinically trained. Hence, if co-ordinator roles are to be occupied at all by psychologists, they most likely will be clinical psychologists. Introduction While the central feature of previous Irish mental health policy Planning for the Future (Department of Health, 1984) was deinstitutionalisation, more recently the focus has been on service transformation to a recovery-oriented system. To achieve this, our more recent policy A Vision for Change (Department of Health & Children, 2006) has as its central theme the development, at all levels, of true interdisciplinary mental health teams, including self-managed Community Mental Health Teams (CMHTs) at sector level. Although no rationale is given for the proposed skill mix and numbers of different professionals, this policy document recommended two psychologists per each sector CMHT covering a population of 50,000. It also recommended a tripartite governance structure of clinical leader, team coordinator and practice manager. The teamworking resource paper by our Mental Health Commission (MHC; 2010, p.22) provided much greater detail of the responsibilities of these roles. Those of the coordinator are listed in Table 1. A Vision for Change (Department of Health & Children, 2006) recommended that this team coordinator post be filled by “an experienced mental health professional, at least equivalent to a Clinical Nurse Manager 3 grade (CNM3) or assistant director of nursing grade, as appropriate” (p.80). The Commission’s (MHC, 2010) teamworking resource paper outlined that while this post is discipline nonspecific, the post holder must be “an experienced mental health professional who possesses the requisite organisational and interpersonal skills to coordinate the team’s activities” (p.23). Despite the team coordinator post being discipline nonspecific, the assumption may be that this team leadership role (as distinct from clinical leadership) is the preserve of nursing (Farhall, 2001). Anecdotally, some teams in Ireland are now ‘piloting’ this post with nurses (typically assistant directors of nursing). Psychologists, like other minority disciplines, have traditionally exerted little influence within CMHTs. Due to a lack of managerial support in some teams, creation of psychology posts has not been prioritised (over other disciplines) even in contexts that have established the need for psychological input. In some other teams with approved posts, recruitment remains problematic due to the perception that this is an unsatisfactory area within which to work. For those psychologists in CMHTs, due to a variety of other factors (e.g., not wanting to be too closely identified with teams, concern regarding generic working and accountability to non-psychology team leaders), some individuals have functioned in a semiautonomous and isolated manner within CMHTs (Peck & Norman, 1999). However, in doing so they may predispose ARTICLE