Assessing and improving the mental health outreach team service.

Abstract

In a similar way to other countries, the mental health system in Malta is being optimised by the introduction of community care as an adjunct, or sometimes as an alternative to inpatient psychiatric care. Oftentimes, professionals working within this innovative sector in psychiatry, exhibit a transdisciplinary effort in an attempt to address the diverse needs of the target population. This role blurring, as well as the less controlled work environment where the professional functions, may render a challenge in assessing and measuring the work performance and hence the service outcome of a community team. This challenge cannot be ignored in the light that it is individual and team effectiveness that dictate the level of financial and human resources that are dedicated by management towards the team. It is this concern that led to the birth of this study, where a local community mental health team, namely the Outreach Team is explored in terms of the daily work carried out by each individual member and its contribution to the synergistic team performance. The already existing minimalist documentation system, known as the Weekly Work Schedule (WWS) was used as a baseline to measure interventions carried out. Through the cycle of the study, a New Weekly Work Schedule (NWWS) was formed. In order to meet the aim of the study, the researcher opted for an action research approach. This action research project involved a number of consecutive phases until the issue that prompted action research was resolved. The researcher commenced by

diagnosing the problem through analyses of the weekly work schedules and became evident that a NWWS was needed. Since there was no standardised documentation system, prior to auditing the interventions, content analysis was carried out and seven categories were formed. As part of the action research, after analysing and auditing two episodes of data collection the first nominal group technique was carried out. All the participants took part in the discussion and mutually formulated the sub-themes. The researcher designed the new weekly work schedule herself including all that was decided during the NOT and after carrying out an extensive review of the literature. The NWWS was piloted and after one month, the data was collected and audited. The findings from the audit reinforced the need of the NWWS as a more detailed audit was collected. The second NOT was carried out after four months of using the NWWS and the perception of the participants in relation to the use of the NWWS was also received as well as suggestions for improvement. This NWWS became the formal means to collect data individually and collectively to determine the workload and caseload of each worker and encourage and lead the way to further research in this field of study such as standardised assessment to measure the performance of the interventions.