Everyday work, working culture and patient care. A qualitative study on professionals’ perceptions of the establishment of a specialized brief therapy unit in a district psychiatric center.

Abstract

Background: Increasing mental health problems and a scarcity of treatment resources put pressure on service innovation in mental health services. Innovative efforts include providing brief or short-term treatment to patients who have moderate mental health problems. So far, there is limited knowledge on how implementing brief therapy approaches in mental health organizations influence the professionals and their work. The aim of this study was to explore the professionals’ perceptions on how the establishment of a specialized brief therapy unit in a district psychiatric center had affected the work in the outpatient clinics, specifically the everyday work, working culture and patient care. Methods: Eleven professionals, five men and six women, took part in semi-structured individual interviews. All participants were between 40 and 60 years old and had leading or coordinating positions in the organization. Their professional backgrounds were within psychology, nursing and medicine, most of them specialists in their field. Results: The professionals’ experiences represented four main themes: (1) The brief therapy unit was perceived as successful and celebrated. (2) The general outpatient clinics, on the other hand, were by some, perceived as “forgotten”. (3) The establishment process had elucidated different treatment cultures in the outpatient clinics and had set off (3) a discussion regarding the criteria for prioritizing in mental health services. Conclusion: Implementation of new services calls attention to the distribution of scarce resources and differences in professional cultures. A strong focus on efficiency might challenge professionals’ perceptions of autonomy. Focusing on patients with moderate mental health problems can raise questions concerning resource use and the appropriate level of treatment provision. Before implementing new services, it is important to ensure information and, if possible, understanding for the process in the organization.