Multidisciplinary primary care mental health teams: a challenge to communication

Miller, Julia S BSc (Hons) MA
Charles-Jones, Huw D MA MSc MBBS FRCGP DCH DRCOG PhD
Barry, Angela BA MA
Saunders, Tim BSc MB ChB

Assistant Director of Research and Development, Greater Manchester Strategic Health Authority, Manchester, UK
General Practitioner, Medical Director of Out of Hours Service, Cheshire West Primary Care Trust, Lache Health Centre, Chester and School of Primary Care, University of Manchester, UK
Health Promotion Officer, Cheshire West Primary Care Trust, UK
General Practitioner and PCT Mental Health Lead, Cheshire West Primary Care Trust and Heath Lane Medical Centre, Chester, UK

CONFLICTS OF INTEREST

None.

ADDRESS FOR CORRESPONDENCE

Julia Miller, Gateway House, Piccadilly South, Manchester M60 7LP, UK. Tel: +44 (0)161 237 2895; email: [email protected]

Accepted September 2005

Primary Care Mental Health 3(3):p 171-180, 2005.

Recent national guidelines have caused primary care trusts to explore new ways of providing mental health care for patients with mild to moderate mental health problems. This study examines communication in a new team in one primary care organisation. In order to provide mental health services within the primary care organisation, general practices were grouped together in ‘clusters’. While this allowed the primary care organisation to provide a range of services to the patients within its locality, it also created several potential difficulties as a consequence of bringing together different working practices, different professional groups and different cultures. This paper examines the mechanisms for communication within the teams and the issues that arose across these interpractice and interprofessional boundaries.

Multiple qualitative methodologies were used to explore these issues. The first was participant observation carried out at a residential conference run by the primary care organisation to develop its mental health strategy. The data from this early stage of the study were used to develop a framework for a series of focus groups with health-care professionals who were members of the primary mental healthcare teams. Focus groups were carried out with GP mental health leads (n = 13), district nurses (n = 8), health visitors (n = 7) and counsellors (n = 8). Finally, semi-structured interviews (n = 10) were carried out with primary care mental health team key workers and general practitioners (GPs) (n = 3).

Four themes emerged from the data: communication within the primary care mental health team (PCMHT), communication with the rest of the primary healthcare team (PHCT), communication with patients, and confidentiality.

This paper highlights the difficulties of inter-professional communication that need to be addressed if the ‘cluster’ model is to be an effective mechanism for delivering primary care mental health services.