Following the closure of the last Victorian asylum in Somerset, the health authority and county council undertook a review of mental health services. A major outcome of this review was the creation of an integrated mental health and social care provider. The current paper explores the impact of this integration on the morale of staff members involved, using a conceptual model derived from the literature on organizational behaviour. During the year immediately following integration, the average ratings on all measures of role clarity and job satisfaction reduced. For staff members involved in the integration, by far the largest group of whom were mental health nurses, job satisfaction was related to team role clarity, team identification, emotional exhaustion and gender. These effects of the integration on staff morale are discussed in light of the wider research into the determinants of job satisfaction and the conditions for success in merging organizations. The study has significant implications for managerial and professional leadership during organizational change.
Despite their prevalence and longevity in many forms of social organization, most research on formal meetings suggests that they do not fulfil the instrumental purposes (e.g. setting strategy) that their constitutions propose. A three-year study of the Joint Commissioning Board for mental health in Somerset, UK, revealed that it was no exception. However, many of the participants on the Board suggested that it fulfilled important purposes that drew attention to its role as ritual. This paper examines the role of the Board in the light of the literature on ritual--in particular the work of the neo-Durkheimian tradition flowing from the work of Douglas--and locates the importance of the meeting in the formation of social solidarity. This theoretical perspective illuminates issues around classification and language which explain the disempowerment felt by some members of the Board. Finally, this paper identifies the challenges in engaging a broader range of stakeholders (including users and carers) in these rituals.
The overcoming of professional boundaries to collaboration in patient care has become one of the goals of mental health service policy in England over the past 25 years, predominantly through the creation of community mental health teams. However, research has shown that these boundaries have been slow to come down, and some commentators have pointed to the benefits of appropriate boundaries. This paper introduces a theoretical framework, which seeks to categorise boundary activity in organisations and then examines the boundary activity of professional groups and community teams during the integration of mental health and social care service provision in one locality in the southwest of England. The paper identifies the ways in which this integration impacted on boundary activity and draws out the messages for mental health policy and practice that emerge.
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About Emerald www.emeraldinsight.comEmerald is a global publisher linking research and practice to the benefit of society. The company manages a portfolio of more than 290 journals and over 2,350 books and book series volumes, as well as providing an extensive range of online products and additional customer resources and services.Emerald is both COUNTER 4 and TRANSFER compliant. The organization is a partner of the Committee on Publication Ethics (COPE) and also works with Portico and the LOCKSS initiative for digital archive preservation. This paper presents the second set of results from the evaluation of the implementation of joint commissioning and combined provision of mental health services in Somerset. Comparisons with baseline data are made and key emerging questions are identified.
This paper is the first of two discussing the evaluation of the implementation of joint commissioning and integrated provision of mental health services in Somerset. The paper presents the methods of evaluation, and explores the potential limitations and environmental factors impacting on the effectiveness of data‐collection methods.
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