The impact of organisational change on professionals working within a Community Mental Health Team (CMHT): A psychodynamic perspective.

The recent Francis Report (2013) emphasised how organisational culture within the NHS represents an important determinant of safe and effective health care systems. Therefore, it is crucial to inquire into the contexts and causes of dysfunctional organizational dynamics within the NHS. A review of the literature was undertaken, focusing on the relationships between professional role ambiguity, role conflict and team culture in community mental health. The review identified that role ambiguity and role conflict have detrimental consequences to services, creating tensions between staff members, adversely impacting on the continuity and appropriateness of workload. The need for further research into the impact on client care is also highlighted by this review. Finally, the review suggests that there is a need for role ambiguity and conflict to be managed more effectively, enabling staff to work within a stable and supportive context. The second part of this thesis comprises a research study using grounded theory methodology to explore the impact of organisational change on staff working within a community mental health team. The study revealed that staff experienced a sense of denigration of professional values and low morale in the face of austerity measures, incessant regulation and industrialising therapy. The analysis identified a number of social defences within the team. The findings of this study suggest increased consideration should be given to the way in which rapid change and restructuring of mental health services dismantle the containing aspects of the organisation. The practical implications include a need for better balance between work structures and systems, and the needs of individuals. The final part of this thesis is a reflective account of the author’s experience of undertaking the research, including reflections on the literature review, methodology and findings, implications of the study and possible areas for future research.