Experiences and challenges faced by community mental health workers when providing care to people with mental health conditions: A qualitative descriptive study

Abstract

The global prevalence of mental health conditions and the associated wide treatment gaps have led to increased demand for quality mental healthcare services. In Singapore, despite a shift towards a joint provision of mental healthcare in hospitals and the community, experiences of mental healthcare teams in such hospital‐community partnerships have remained unclear. Through a qualitative descriptive approach, this study explored community mental health workers’ experiences and perceptions of working with partners from tertiary hospitals and other community organisations. Eighteen participants were individually interviewed with a semi‐structured question guide through video conferencing. This study was guided by the 32‐item checklist from the Consolidated Criteria for Reporting Qualitative Research. Data were subjected to Braun and Clark’s six‐step thematic analysis. Three themes emerged: (i) the need for supportive partners, due to institutional and legal challenges faced in the participants’ liaison with hospital partners and other community organisations; (ii) the need for a supportive organisation, whose presence and importance were revealed by the interviews; and (iii) the necessity of advanced training, identified by the participants as a contributor to their professional growth. The findings highlighted the importance of inter‐sectoral communication and positive effects of a robust organisational support system. Accordingly, hospitals and community mental healthcare organisations should consider strengthening networking and boosting case discussions through regular inter‐sectoral meetings that would prioritise the clients’ continuity of care. Furthermore, opportunities for advanced trainings should be created for community‐based mental healthcare workers.

Experiences and challenges faced by community mental health workers when providing care to people with mental illness: a qualitative study

“…This feeling of powerlessness is associated with burnout and negative job outcomes, which can drive more turnover [48]. These aspects eventually lead to early termination or delay of CMHS [49]. A study by Karkkola et al found that role clarity through higher autonomy and higher competence can impact subjective dynamics at work [50].…”

“…The CMHWs often find it difficult to obtain complete patient information and need to spend their time piecing it together. This is also the difficulty faced by CMHS in Singapore [49]. The lack of effective communication and cooperation makes the patient's information cannot be shared in time and become fragmented.…”

Effectiveness of Illness Management and Recovery program on people with severe mental illnesses: a systematic review and meta-analysis

“…Progressive decentralization of mental healthcare over recent decades might have partly been responsible for a fragmented medical system. This system not only relies on coordination between healthcare organizations, but also obliges individuals to establish and maintain contact with a multiplicity of such organizations ( 7 , 9 ). The fragmentation is further confounded by existing challenges in the treatment for people with psychiatric-somatic comorbidities ( 10 ) and by difficulties faced by people with SMIs in establishing a point of contact with medical professionals ( 11 ).…”