Abstract
Effective mental health care requires a high performing, interprofessional team. Among 79 mental health teams in Quebec (Canada), this exploratory study aims to 1) determine the association between work role performance and a wide range of variables related to team effectiveness according to the literature, and to 2) using structural equation modelling, assess the covariance between each of these variables as well as the correlation with other exogenous variables. Work role performance was measured with an adapted version of a work role questionnaire. Various independent variables including team manager characteristics, user characteristics, team profiles, clinical activities, organizational culture, network integration strategies and frequency/satisfaction of interactions with other teams or services were analyzed under the structural equation model. The later provided a good fit with the data. Frequent use of standardized procedures and evaluation tools (e.g. screening and assessment tools for mental health disorders) and team manager seniority exerted the most direct effect on work role performance. While network integration strategies had little effect on work role performance, there was a high covariance between this variable and those directly affecting work role performance among mental health teams. The results suggest that the mental healthcare system should apply standardized procedures and evaluation tools and, to a lesser extent, clinical approaches to improve work role performance in mental health teams. Overall, a more systematic implementation of network integration strategies may contribute to improved work role performance in mental health care.
Highlights
Over the last two decades, most industrial countries have reformed their mental healthcare system[1,2,3]
The findings revealed that work role performance was associated almost exclusively with variables related to team attributes
The study design did not permit us to test for associations between work role performance and user-related outcomes, such as recovery, or quality of life. This exploratory study was innovative in assessing the perceptions of 79 mental health team managers in order to better understand the association between work role performance and a comprehensive range of variables related to team effectiveness, while examining their inter-relationships with exogenous variables in the model
Summary
Over the last two decades, most industrial countries have reformed their mental healthcare system[1,2,3]. There may be some differences regarding targeted mental disorders, structure, or clinical interventions, these reforms pursue similar objectives: a better response to the needs of persons with mental health disorders through enhanced accessibility, quality and continuity of care. Mental health reforms seek to widen access to care by prioritizing mental health services in primary care [4], which are less stigmatizing than specialized services. Concerning quality of care, the reforms promote evidence-based practices (e.g. strength model [5] for severe mental disorders, and stepped care [6] for depressive and anxiety disorders); these.
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