Collaborating for children's mental health : a study of the experiences of health and social care practitioners and managers working within different models of service integration

摘要

The fragmented history of collaboration across health and social care is an acknowledged problem in public services in the United Kingdom. For several decades Government policy documents have recommended improved collaboration to tackle problems associated with people's satisfaction with the quality of public services, the perceived lack of communication across agencies and service inefficiency as a result of the duplication of activities.Too often the establishment of collaborative structures and processes are mistaken for the realisation of collaborative activity, overlooking the need to nurture identity, relationships and interdependence. This thesis adopts a qualitative methodology to explore the experiences of health and social care practitioners and managers working within interagency and inter-professional teams providing family support and guidance in relation to children's mental health and emotional well being.There is limited knowledge of the complexity of interagency and inter-professional relationships and the conceptual frameworks that could improve our understanding of the behaviours of people working within, and across, health and social care. This research focuses upon understanding how collaboration is organised at the level of teams, concentrating on models and levels of team integration. Such an approach allows the study of how interagency and inter-professional teams are structured and any impact upon the nature and development of relationships between the people working within such environments. In so doing, this research connects conceptual frameworks located within both organisational and social theories.This thesis identified many of the benefits and challenges of integrated team working and concluded that higher levels of satisfaction were experienced by people working within more integrated team structures. The relevance of social identity theory is discussed as managers' and practitioners' experiences were explained as an expression of their need to belong to something which could take the form of an agency, a team and/or a profession. This suggests that, if the public policy goals of collaboration are to be realised, there is a need for practical strategies that pay attention to nurturing relationships, interdependence and building positive social identities within the workplace. Indeed the history of failed collaboration might be explained by a neglect of the people issues.