This paper reports the findings of a survey of 757 members of the British Association of Professional Music Therapists, conducted in January 7998, to investigate burnout and job satisfaction in relation to multidisciplinary team membership. Information on personal profile and employment characteristics was also sought, as music therapists are such a widely diverse group. Three aspects of burnout (emotional exhaustion, depersonalisation and personal accomplishment) were measured with the Maslach Burnout Inventory (Maslach & Jackson 7981). Factors influencing reward and dissatisfaction in the job were also assessed in relation to multidisciplinary team membership. Personal and team role clarity and team and professional identification were assessed in therapists who were members of multidisciplinary teams.Therapists who were members of multidisciplinary teams were found to have higher levels of personal accomplishment and similar levels ofemotional exhaustion and depersonalisation in comparison to those working independently. These results are discussed in relation to previous surveys of other health and social care professionals. Sources of pressure and reward differed between multidisciplinary team members and nonmembers. Music therapists who were members of multidisciplinary teams were found to have a moderate level of personal role clarity within their team and identified with their profession more than with their multidisciplinary team.

Mental health services in England, in common with many other European countries, have been the subject of sustained government attention during the 1990s. Since the election of the Labour administration in Britain in May 1997, mental health services have been discussed in most Department of Health documents on health and social care policy, and mental health services in England have a new national strategy. At the same time, the local provision of mental health services within NHS Trusts has been undergoing organisational change. This paper sets out the policy context and evidence base for the reorganisation of provider arrangements for mental health services. In addition, the results of a documentary analysis of unpublished reviews of provider arrangements in 10 localities are presented. The review identified three major themes: firstly, the reconfiguration of NHS Trusts is based around Specialist Mental Health Trusts and Community and Mental Health Trusts; secondly, the joint provision of services and/or the integration of services between health and social services is starting to appear and; thirdly, the delegation of responsibility to localities based on Primary Care Group/Social Services boundaries is being discussed. The paper discerns a number of trends and points to the need for further research, in particular into the relationship between organisational arrangements and effective service delivery.

This paper describes benchmarking research undertaken within one former National Health Service Executive region examining acute ward funded and actual staffing establishments and funded expenditure for mental health nursing staff. Staffing establishment data were obtained for all 73 acute wards within the region. Of the established posts for trained mental health nurses across these wards, it was identified that there were 12% vacancies (117.99 whole time equivalent) at the time of the study. While some of the shortfall was dealt with by recruiting untrained nursing staff above funded establishments, there remained an overall shortfall in the total nursing workforce across the system of acute wards in the region. Although most of the provider trusts in the region were in development or experiencing major organizational change at the time of the study, considerable variation existed within and between trusts. Variations were identified in funded and actual nursing establishments and cost per bed, raising significant issues for trusts and their local mental health economies. Variations based on mixed- and single-sex wards were also noted. Findings are discussed in respect of the issues raised for the development of wards, provider trusts and their local systems. The utility of the methodology developed in this work is also discussed.