To give an overview of our findings, some data from the interviews are presented by direct quotations. In addition, provides major findings from three focus group interviews by listing the participants’ profession, institutional affiliation, views of multidisciplinary work, and the priority of main working tasks, while illustrates data from the two in-depth interviews which were classified into categories.
Major findings from the validation process with two informants. Data are conceptualized within the main categories: procedures for teamwork, person involvement, family support, leadership, laws, and regulations
Most important working tasks and time spent
Concerning important working tasks and priority, there seems to be a great deal of unforeseen elements when working in mental health care. One of the participants in focus group 1 says: “When a person’s discharge is suddenly decided, I always think that a plan must be prepared in case of crisis. What shall the patient do when a crisis occur and what shall the network do?” When group 2 was asked about priority, all participants were silent and concluded after a while: “It is the need which decides; there is always a question about priority. You must be available. There are no standards; you must meet the unforeseen and take the challenge there and than. If the person refuses to collaborate, this may be a potential for development as we can return to previous decisions. It may be a growth for both partners.”
A major finding from the focus groups, when asked to describe their use of team work, was that different barriers existed. According to group 1, “It is difficult when we do not know each other … several unwanted situations may occur”. Among the men in the latter group, one respondent says: “… we are inclined to be frustrated when we do not reach consensus of opinion … (consequently) we often do not succeed in multidisciplinary work. I am thinking about all the time spent on team planning.” Another participant continues: “If we only had the capacity to follow-up our plans! That is the main drawback. The more team members involved, the more difficult it is.” One participant in group 3 says: “In all situations where I have experienced success, the reason has been good teamwork. In contrary, when we have failed to be coordinated or there was a lack of agreement, I tend to feel frustrated.” Another participant from group 1 explains why team work may often be neglected: “Shortage of time, often unexpected situations occur and must be given priority, and you easily lose view (of the total work situation)”. Informant 1 in the in-depth interviews says. “There are no guidelines telling us about what a multidisciplinary team should consist of.” Informant 2 in the in-depth interviews is a nurse working as a group leader usually together with one similar profession and states “I officially belong to a multidisciplinary team”. His concluding remark was however, “Actually I do not think in terms of multidisciplinarity during my daily work.”
As indicated through the process of thematic analysis of the two in-depth interviews regarding person involvement (), common examples from everyday life illustrated their frustrations. Informant 1 says: “The persons still ask for permission when they wish to have a meal … Although the person is allowed to participate in meetings about care planning, they leave the meeting after a short while.” Informant 2 explains: “Final reports are sent to the persons’ private practitioners or psychologists without their involvement.” A concluding remark from Informant 1 is that “The person needs help to find a new role.”
When asked to describe family support the family was not very visible, although their importance is described: “If the family members are engaged, this is a strength leading to inspiration in our work. They often need explanations and ventilation of their feelings even though the mental sick don’t want to be in contact with them.”
Leadership, laws, and regulations
Both of our informants express that leadership is not very visible and laws as well as regulations are not in focus. Informant 1 says: “Leaders in community administration established for mental health care are important supporters by given updated knowledge about laws and regulations. However, the leaders in the institution pay little attention to new laws and regulations and how they should be incorporated in daily life.” Informant 2 explains the situation in this way: “We work very independently and are isolated, I would say. There is little attention from the community or from the institutional leaders to guide us towards teamwork and more person involvement.”
provides major findings from the three focus group interviews, comprising a representative sample of 17 participants, by listing the participants’ profession, institutional affiliation, views of multidisciplinary work and priority of main working tasks. These findings indicate that neither multidisciplinary work, nor person and family involvement were considered a basic area of work. The participants’ priority of main working tasks revealed that four gave leadership first priority, three consultations, five individual therapies, two group therapy, while two listed milieu therapy. An interesting feature was that in group three, nurses described collaboration as an activity mainly in inpatient departments, while the social workers’ focus was mainly directed towards outpatient departments.
The authors conceptualized the statements from the two in-depth interviews within the main categories: procedures for teamwork, person and family involvement, leadership, laws, and regulations. outlines the thematic domains and their components, which indicated that teamwork, person involvement and family collaboration were often missing. Furthermore, leadership seemed almost absent, and guidelines from laws and regulations were given little priority.