Skip to main content Accessibility help

The Teamworking Challenges of Care Planning

  • Patrick McHugh (a1) and Micheal Byrne (a2)


Background: Care planning is a multidisciplinary process used to develop an individualised recovery plan for each service user. The success of this process will depend on the extent to which members of mental health teams can work with one another, with service users, and with other service providers in developing a coordinated plan that meets service user needs across multiple domains.

Aims: This paper examined the teamworking challenges that Community Mental Health Teams (CMHTs) face during the care planning process and how such challenges may be managed.

Method: A narrative review of published articles and policy documents relevant to teamworking and recovery-focused care planning within mental health teams.

Findings: Teamworking challenges include the provision of integrated rather than fragmented care, the empowerment of the service user, and development of a distributed model of leadership, responsibility and decision making.

Conclusions: CMHTs face a range of substantial but manageable challenges in attempting to implement recovery-focused care planning. Recommendations include the need to integrate recovery-orientated skills and values into professional training, the need for greater multidisciplinary training opportunities, and the need to evaluate CMHTs based on recovery-orientated criteria.


Corresponding author

*Correspondence E-mail:


Hide All
1.Department of Health and Children. A Vision for Change: Report of the Expert Group on Mental Health Policy. Dublin: Stationery Office; 2006: 81.
2.Anthony, WA. A recovery-oriented service system: Setting some system level standards. Psychiatr Rehabil J 2000; 24(2): 159–68.
3.Jacobson, N, Curtis, L. Recovery as policy in mental health services: Strategies emerging from the states. Psychiatr Rehabil J 2000; 23(4): 333–41. Burca, S, Armstrong, C, Bronson, P. Community Mental Health Teams: Determinants of Effectiveness in an Irish Context. Limerick: Health Systems Research Centre; 2010.
5.Singh, SP. Running an effective mental health team. Adv in Psychiatric Treatment 2000; 6: 414–22.
6.Mental Health Commission. The Recovery Approach within the Irish Mental Health Services: A Framework for Development. Dublin: Mental Health Commission; 2008.
7.Begley, CM. Developing inter-professional learning: Tactics, teamwork and talk. Nurse Educ Today 2009; 29(3): 276–83.
8.Warne, T, Stark, S. Service users, metaphors and teamworking in mental health. J Psychiatr Ment Health Nurs 2004; 11(6): 654–61.
9.Rosen, A, Callaly, T. Interdisciplinary teamwork and leadership: issues for psychiatrists. Aust Psychiatry 2005; 13(3): 234–40.
10.Byrne, M, Onyett, S. Teamwork within Mental Health Services in Ireland. Dublin: Mental Health Commission; 2010.
11.Jones, A. Multidisciplinary team working: collaboration and conflict. Int J Ment Health Nurs 2006; 15: 1928.
12.Belling, R, Whittock, M, McLaren, S, Burns, T, Catty, J, Jones, IR, et al.Achieving Continuity of Care: Facilitators and Barriers in Community Mental Health Teams. Implementation Sci 2011; 6.
13.Norman, IJ, Peck, E. Working together in adult community mental health services: An interprofessional dialogue. J Ment Health 1999; 8(3): 217–30.
14.Rapaport, J, Manthorpe, J. Family matters: developments concerning the role of the nearest relative and social worker under mental health law in England and Wales. Br J Social Work 2008; 38: 1115–31.
15.Collins, P, Byrne, M. A call to co-ordinate mental health teams. The Ir Psychol 2011; 37(8): 212–6.
16.Ovretveit, J. Planning and managing teams. Health & Social Care in the Community 1997; 5(4): 269–76.
17.Rosen, A. New roles for old: the role of the psychiatrist in the interdisciplinary team. Aust Psychiatry 2001; 9(2): 133–7.
18.Mathisen, G, Einarsen, S, Jørstad, K, Brønnick, S. Climate for work group creativity and innovation: Norwegian validation of the team climate inventory (TCI). Scand J of Psych 2004; 45: 383–92.
19.Wilson, V, Pirrie, A. Multidisciplinary Teamwork Indicators of Good Practice. Edinburgh: Scottish Council for Research in Education, 2000.
20.Anthony, P, Crawford, P. Service user involvement in care planning: the mental health nurse's perspective. J Psychiatric Ment Health Nurs 2000; 7(5): 425–34.
21.Mickan, SM, Rodger, S. Effective health care teams: A shared model of six characteristics developed from shared perceptions. J Interprof Care 2005; 19(4): 358–70.
22.Lankshear, AJ. Coping with conflict and confusing agendas in multidisciplinary community mental health teams. J Psychiatric Ment Health Nurs 2003; 10: 457–64.
23.Clark, J. On the Bounce: Understanding Mental Health Systems in the North West. NHS North West: Commission on Mental Health Services; 2008.
24.Borrill, C, West, M, Shapiro, D, Rees, A. Team working and effectiveness in health care. Br J of Health Care Manag 2000; 6(8): 354371.
25.Department of Health and Children. Building a Culture of Patient Safety: Report on the Commission on Patient Safety and Quality Assurance. Dublin: Stationery Office; 2008.
26.Mental Health Commission. Quality Framework: Mental Health Services in Ireland. Dublin: Mental Health Commission; 2007.
27.Coulter, A. The NHS revolution: health care in the market place - What do patients and the public want from primary care? Br Med J 2005; 331(7526): 11991201.
28.Simpson, A. The impact of team processes on psychiatric case management. J of Adv Nurs 2007; 60(4): 409–18.
29.Janis, IL, Victims of Groupthink. Boston: Houghton-Mifflin, 1982.
30.Ovretveit, J. Team decision-making. J of Interprof Care 1995; 9: 4151.
31.Elstad, TA, Eide, AH. User participation in community mental health services: exploring the experiences of users and professionals. Scand J of Caring Sci 2009; 23(4): 674681.
32.Davidson, L, O'Connell, M, Tondora, J, Styron, T, Kangas, K. The top ten concerns about recovery encountered in mental health system transformation. Psychiatric Serv 2006; 57(5): 640–5.
33.Hamann, J, Leucht, S, Kissling, W. Shared decision making in psychiatry. Acta Psychiatrica Scand 2003; 107: 403–9.
34.Deegan, PE. Recovering our sense of value after being labelled mentally ill. J of Psychosoc Nurs 1993; 31: 711.
35.Perkins, RE, Repper, JM. Compliance or informed choice. J of Ment Health 1999; 8(2): 117–29.
36.Schwartz, B. The Paradox of Choice. New York: Ecco/Harper Collins; 2004.
37.Pelled, LH. Demographic diversity, conflict, and work group outcomes: An intervening process theory. Organ Sci 1996; 7(6): 615–31.
38.Onyett, S, Standen, R, Peck, E. The challenge of managing community mental health teams. Health and Social Care in the Community 1997; 5: 40–7.
39.Higgins, A, Maguire, G, Watts, M, Creaner, M, McCann, E, Rani, S, et al.Service user involvement in mental health practitioner education in Ireland. J Psychiatric Ment Health Nurs 2011; 18(6): 519–25.
40.Herrman, H, Trauer, T, Warnock, J, Professional Liaison Committee. The roles and relationships of psychiatrists and other service providers in mental health. Aust N Z J Psychiatry 2002; 36(1): 7580.
41.Cooper, H, Carlisle, C, Gibbs, T, Watkins, C. Developing an evidence base for interdisciplinary learning: a systematic review. J of Adv Nurs 2001; 35(2): 228–37.
42.Irish College of General Practitioners. Team-based approaches to supporting mental health in primary care settings. [serial online] 2011; Available from
43.Reeves, S, Freeth, D. Re-examining the evaluation of interprofessional education for community mental health teams with a different lens: understanding presage, process and product factors. J of Psychiatric and Ment Health Nurs 2006; 13(6): 765–70.
44.Roncalli, S, Byrne, M, Onyett, S. Psychometric properties of a Mental Health Team Development Audit Tool. J of Ment Health (submitted).
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Irish Journal of Psychological Medicine
  • ISSN: 0790-9667
  • EISSN: 2051-6967
  • URL: /core/journals/irish-journal-of-psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed