INTERDISCIPLINARY MENTAL HEALTH TEAM

COLLABORATION

.
• AIDA I. BAUTISTA PhD. MAN. RN
LEARNING OBJECTIVES:

• Identify Mental Health Team Members

• Discuss core skill areas of a PHMN
• Understand team approach in psychiatric nursing
care
• Describe collaboration with inter-agency, intra-
agency, multidisciplinary sectoral teams to
improve delivery of health services
• Learn managing conflicts for a better working
relationships
• Explain interdisciplinary mental health team
collaboration
 INTERDISCIPLINARY MENTAL HEALTH TEAM
• An Interdisciplinary mental health team
comprises professionals from various
disciplines who work in collaboration to
address a patient with mental health needs.
They complement one another's expertise
and actively coordinate to work toward
shared treatment goals.
• Regardless of the treatment setting,
rehabilitation program, or population, an
interdisciplinary team approach is most
useful in dealing with the multifaceted
problems of clients with mental illness.
MEMBERS OF THE INTERDISCIPLINARY
MENTAL HEALTH TEAM
• 1. PSYCHIATRIST:
• The psychiatrist is a physician
certified in psychiatry by the
Philippine Board of Psychiatry and
Neurology, which requires residency
training program in their field of
specialization after passing the
licensure exam. They will undergo a
3-year residency, 2-year of clinical
practice, and completion of an
examination.
• The primary function of the
psychiatrist is to diagnose, treat and
rehabilitate mentally ill patients.
• 2. PSYCHOLOGIST:
• The clinical psychologist has a
bachelor’s degree and/or a master’s
degree plus a doctorate degree to
become a clinical psychologist or a
researcher. To be Psyc.D one must
pass practical work and examinations
rather than a dissertation
• Clinical psychologists identify
emotional, mental, and behavioral
problems. Through observation,
interviews, and tests, the
psychologist will diagnose any
existing or potential disorders.
MEMBERS OF THE INTERDISCIPLINARY TEAM
• 3. PHARMACIST:
• The pharmacist is a bachelor’s degree
graduate or/and a master in social work
that requires years of clinical experience
as a prerequisite to receive a license or
certification
• The registered pharmacist:
• Prepares / compounds, packages,
labels and dispenses medications
• Gives pharmacological information
to health care professionals, and
monitors patient drug therapies.
• 4. PSYCHIATRIC NURSE:
• The nurse has a solid foundation in
health promotion, illness prevention,
and rehabilitation in all areas,
allowing him/her to view the client
holistically. The nurse is also an
essential team member in evaluating
the effectiveness of nursing care and
medical treatment, particularly
medications.
MEMBERS OF THE INTERDISCIPLINARY TEAM
• 5. PSYCHIATRIC NURSING AIDE
• Psychiatric aides help with personal
hygiene, meals, recreation,
transportation, and socialization.
They also assist in medical care
under the supervision
of nurses or psychiatric technicians.
• 6. PSYCHIATRIC SOCIAL WORKER:
• Psychiatric social workers are a
bachelor’s degree or/and master’s
social work, and require years of
clinical experience as a prerequisite
to receive a license or certification.
• Social workers may practice therapy
and often have the primary
responsibility for working with
families, community support, and
referral.
• Responsible for patients’ anamnesis
MEMBERS OF THE INTERDISCIPLINARY TEAM
• 7. OCCUPATIONAL THERAPIST:
• Occupational therapists may have an
associate degree (certified
occupational therapy assistant) or a
baccalaureate degree (certified
occupational therapist).
◦ Occupational therapist assists
patient’s ability to perform useful
tasks that may contribute to
patients socializations and
recovery
◦ Focus on the client’s functional
abilities and ways to improve
functioning
• 8. RECREATIONAL THERAPIST:
• Recreational therapists complete a
bachelor’s degree in recreational
therapy or a related field. Some
may take associate’s degree in
therapeutic recreation or another
subject related to health care.
• The recreation therapist helps the
client to achieve a balance of work
and play in his/her life and
provides activities that promote
constructive use of leisure or
unstructured time.
MEMBERS OF THE INTERDISCIPLINARY TEAM
• 9. VOCATIONAL REHABILITATION
SPECIALIST:
• Vocational rehabilitation specialists
should have bachelor's degrees in
vocational rehabilitation, counseling, or a
related field. Typically, they may hold a
master’s degree in vocational or
rehabilitation counseling, psychology, or,
sometimes, social work.
• Vocational rehabilitation specialist work
may includes determining clients’
interests and abilities and matching them
with vocational choices. Clients are also
assisted in job-seeking and job-retention
skills as well as in pursuit of further
education, if that is needed and desired.
 10. EXPRESSIVE ART THERAPIST
 Expressive art therapist is normally
a bachelor's degree. They usually
study rehabilitation science,
psychology or fine arts. They may
also have masters or doctors degree
in a clinical mental health-related
field (e.g., counseling, marriage &
family therapy, social work,
psychology
 Assists patients in exploring
underlying feelings and emotional
conflicts that impair their physical,
cognitive, and emotional wellbeing
by using music, art, and movements
MEMBERS OF THE INTERDISCIPLINARY TEAM
 11. DIETITIAN
 Dietitians are a bachelor's
degree in dietetics, foods,
nutrition, food service systems
management, or a related area.
 Responsible for the nutritional
needs of the client
 12. CHAPLAIN
 Responsible for the spiritual
needs of the client.
 They are trained to assess the
patient’s spiritual and religious
needs
Psychiatric nurse as collaborative members of
the interdisciplinary team:

• Collaboration implies a commitment • Seven characteristics of

to common goals, with shared effective collaboration
responsibility for the outcome of
care. includes:
• Trust
• Collaboration also implies helping to
facilitate the mental health of the • Respect
patient, family or community within • Commitment
the context of the treatment team. • Cooperation
• Nurses bring their own specialized • Coordination
knowledge and skills to the • Communication
treatment process. • Flexibility.
PHMN CORE SKILL AREAS: KSA

KNOWLEDGEABLE SKILLFUL ATTITUDE

- Concepts, theories, - Communication skills - Acceptance
principles, standard - Interpersonal skills - Empathy
practices in the care of
patients with mental - Decision making skills - Genuineness
disorders. - Technical psychiatric - Nonjudgmental
attitude
nursing skills
- Patient/Tolerant
- Risk assessment and
risk management skill - Consistent
- Assertiveness
The SOLER position (Egan, 2010)
S: Squarely face the patient
O: Open posture
L: Lean forward
E: Eye contact
R: Relaxed attending attitude
B. TEAM APPROACH IN NURSING CARE

• Team nursing approach is a care

model that uses a group of people
led by a knowledgeable nurse.
• It is a delivery approach that
provides care to a group of
clients by coordinating a team of
Registered Nurses (RNs), Licensed
Practical Nurses (LPNs), and
psychiatric nursing aides under
the supervision of a
TEAM LEADER (HEAD NURSE)
NURSING CARE DELIVERY SYSTEM

• Choosing the most appropriate • Four classic nursing care

organizational model to delivery models
deliver patient care for each unit
or organization depends on the ff: • (1) Functional nursing
• skills and expertise of the staff • (2) Team nursing
• the availability of registered • (3) Primary nursing
professional nurses
• the economic resources of the
• (4) Total patient care
organization
• the acuity of the patients,
• the complexity of the tasks to
be completed.
FUNCTIONAL NURSING

• Functional Nursing is a kind of nursing

modality, which is task-oriented where
a particular nursing function is
assigned to each nursing staff.
• The nurse identifies the tasks to be
done for a shift and the tasks will be
divided among the nursing staff
members who should focus on
completing the assigned task.
• Functional nursing has the advantage
of being efficient in handing a large
number of clients.
• The idea behind functional nursing is
that there is a specialist for each task.
FUNCTIONAL NURSING

ADVANTAGES & DISADVANTAGES

TEAM NURSING

• Team nursing is where groups of professional

and non-professional personnel work
together to identify, plan, implement and
evaluate comprehensive client-centered
care.
• The key concept is a group that works
together toward a common goal, providing
qualitative, comprehensive nursing care
(Wikipedia).
• The nurses are divided into a number of
teams. Each team has to provide care for a
fixed group of patients. Therefore, nurses
have a close relation with the patients they
have to take care. Team leader is
responsible for the performance for each
team members.
TEAM NURSING

ADVANTAGES & DISADVANTAGES

TOTAL PATIENT CARE.

• Also called Total Patient Care.

Commonly used in intensive care unit
(ICU) and post-anesthetic care unit
(PACU).
• The nurse is fully responsible for
organizing, planning, and performing
all aspects of nursing care.
• Total Patient Care provides a high
degree of autonomy, clear lines of
responsibility and accountability,
holistic patient care and
unfragmented care
TOTAL PATIENT CARE.

• ADVANTAGES & DISADVANTAGES • HISTORY

PRIMARY NURSING

• PRIMARY NURSING is a system

of nursing care delivery which
emphasizes continuity of care and
responsibility acceptance by having one
registered nurse (RN).
• Primary nursing focuses on the
therapeutic relationship between a
patient and a nurse who assumes
responsibility for a patient's plan of care
for their length of stay in a particular
institution. The patient is aware of who
their nurse is and can communicate to
the entire hospital staff through the
primary nurse.
PRIMARY NURSING

• ADVANTAGES & DISADVANTAGES • HISTORY

CO-PRIMARY NURSING

• ADVANTAGES & DISADVANTAGES

MODULAR NURSING

• Modular nursing is an ideal model of

care to improve the quality of care
and nurses' satisfaction, far from
being optimal with Functional
Nursing (FN).
• Patients are assigned to one unit,
thus the staff members know what is
their maximum workload, the
number of beds on that unit, etc. And
the staff quickly get to know all the
staff in that unit and develop
excellent working relationships.
MODULAR NURSING

• Advantages & Disadvantages

PATIENT-CENTERED CARE
PATIENT-CENTERED CARE

• ADVANTAGES • DISADVANTAGES
CASE MANAGEMENT
FUNCTIONS OF THE PMHN in COLLABORATION

• Functions of the PMHN • Current best practice in nursing is

collaboration with based on the principles of patient-
• 1. Interprofessionals centered care, shared decision-
making and multidisciplinary
• 2. Inter-agency teamwork.
• 3. Intra-agency • When applying these principles to
• 4. Multidisciplinary practice, psychiatric nurses engage in
intensive collaboration with
colleagues, patients and relatives.
• Collaboration is crucial in everyday
practice and should be considered a
core value of nursing.
FUNCTIONS OF THE PMHN in COLLABORATION

• INTERPROFESSIONAL
COLLABORATION
• This refers to the working
relationships between different
groups of professionals such as
psychiatrist, psychiatric nurse,
psychologist and other mental
health team members
• Each professional group should
bring their own perspective to the
collaborative process to improve
the standard of service and the
experiences of patients needing
mental health services and their
carers.
FUNCTIONS OF THE PMHN in COLLABORATION

• INTERAGENCY COLLABORATION
• Interagency collaboration in
systems of care is "the process of
agencies and families joining
together for the purpose of
interdependent problem solving
that focuses on improving services
to children and families" (Hodges,
Nesman, & Hernandez, 1999, p.8).
• The psychiatric nurse collaborate
within the organizations rather
than only professionals within them
for successful provision of care.
FUNCTIONS OF THE PMHN in COLLABORATION

• INTRA-AGENCY COLLABORATION
• Intra-agency collaboration are
agreements occurring between
or involving different
organizations working together
for the betterment of the
provision of care.
• Ex: Department of Health &
Human Services, Mental Health
Organizations. Mental /
Psychiatric Institutions
FUNCTIONS OF THE PMHN in COLLABORATION

• MULTIDISCIPLINARY COLLABORATION
• Multidisciplinary care team model brings
together different providers such as
physicians, nurses, social workers, and
other specialists to reduce potential for
errors and improve health care outcomes.
• Service users, such as clients of mental
health services, have specific needs which
require a multidisciplinary team approach to
care planning and delivery (Couchman
1995).
• Example, within mental health care,
specialties such as community care, elderly
care, child, adolescent and family services,
parent and baby services, substance abuse,
rehabilitation etc., require a range of
specialist services with dedicated resources.
 CONFLICTS AND CONFLICT RESOLUTION FOR BETTER
WORKING RELATIONSHIPS
• Conflict is simply defined as a
disagreement or opposition of
interests or ideas.
• There are broadly two kinds of
workplace conflict:
• when people’s ideas, decisions or
actions relating directly to the
job are in opposition
• when two people just don’t get
along
• Workplace conflict may tend
to:
• 1. lower the team morale,
• 2. increase absenteeism
• 3. decrease cooperation and
participation to meet the
organization vision and mission
• 4. decrease productivity.
 CONFLICTS AND CONFLICT RESOLUTION FOR BETTER
WORKING RELATIONSHIPS

• CONFLICT RESOLUTION
• Conflict resolution is a
process where a given
disagreement between
parties is mediated to reach a
proper solution.
• It is a way to work out certain
differences that arise
between parties.
 EXAMPLE OF CONFLICT IN WORKPLACE
• 1. LEADERSHIP CONFLICT
• Sometimes conflict is caused by leadership
weakness, poor communication style, favoritism .
• SOLUTION:
• Clearly communicate goals, the corporate
vision, mission and other directives.
• Provide opportunity for employees to
contribute to corporate goals and objectives.
• Listen attentively to subordinates’ grievances
• Help employees to address their conflict
efficiently and effectively between
themselves, with their oversight.
• 2. EMPLOYEE DIVERSITY
• This can lead to miscommunication and
differences in the way employees relate to one
another
• SOLUTION:
• Holds diversity trainings
• Corporate morale boosting events like
picnics or brown bag lunches, and other
programs to help employees interact with
one another and share similarities in a
positive setting will help resolve conflict.
• Focus on the goal and mission of the
company to help find commonalities rather
than focus on differences.
EXAMPLE OF CONFLICT IN WORKPLACE
• 3. GROWTH & DEVELOPMENT
• Conflict maybe the result of employees
thinking that they are not recognized
or employees being bored with the
company.
• SOLUTION:
• Motivates employees by rewards
and or recognition/ appreciations
• Provide trainings for their growth
& development
• Engage employees in team building
events
• 4. INDIDUALISM
• Conflict may be the result of “dog eat
dog” mindset that puts personal growth
and success above co-workers and at
times, even the company.
• SOLUTION:
• Mangers should offer trainings that
show how harmony and
collaboration in the office actually
helps everyone reach their
individual goals. When employees
see the connection between their
own success and their co-workers’
and company’s success,
collectivism will occur naturally.
 STEPS IN RESOLVING A CONFLICT IN THE
WORKPLACE (Indeed Editorial Team, 2021))
• Nine steps in resolving a conflict in • 2. EXPLORE ALTERNATIVES
the workplace (Indeed Editorial
Team)
• 1. UNDERSTAND THE CONFLICT
• Fully understand your position
in the conflict and the position
of the other party.
• Clarify your own interests and
those of the other person.
• Think through what agreements
you might be able to reach.
• In some cases, the parties are
not able to reach an agreeable
solution in a conflict.
• Brainstorm possible resolutions
to the conflict
• Compare each of those
solutions that you have already
decided upon and determine if
the new solution is better.
 STEPS IN RESOLVING A CONFLICT IN THE
WORKPLACE (Indeed Editorial Team, 2021))
• 3. FIND A PRIVATE, NEUTRAL PLACE
• It’s important to find a quiet and
neutral location where you can
discuss the conflict in private.
• 4. COMMUNICATE BOTH SIDES
• Be an active listener.
• Let everyone participate
• Avoid forming assumptions
• Remain calm
• 5. BE AWARE OF BODY LANGUAGE
• Maintaining eye contact
• Being conscious of your
expression
• Relaxing your neck and shoulders
• Using a neutral tone with a
moderate speed and volume
• Avoiding the use of words that
imply an absolute such as
“always” or “never”
 STEPS IN RESOLVING A CONFLICT IN THE
WORKPLACE (Indeed Editorial Team, 2021))
• 6. IDENTIFY A COMMON GOAL • 7. USE A THIRD-PARTY MEDIATOR
• In this step, both parties agree
on the desired outcome for the
conflict
• Both parties may realize they
have the same goal, they just
have different opinions on how
to reach that goal
• Once the common goal is
identified, you can start
working towards a resolution.
• In some cases, it may be useful
to use a neutral third party
whom everyone trusts to be
fair.
• This can help ensure both
parties understand one another
fully and, if necessary,
continually remind everyone of
the ultimate goal so that the
conversation and brainstorming
session remains productive
 STEPS IN RESOLVING A CONFLICT IN THE
WORKPLACE (Indeed Editorial Team, 2021))
• 8. BRAINSTORM SOLUTIONS • 9. AGREE ON A PLAN OF ACTION
• Look for win-win solutions or
compromises that all parties can
agree upon.
• If the conflict is between you
and someone who works under
you, use their ideas first to
increase the personal
commitment on their part and
make them feel heard.
• Identify different solutions that
both you and the other party can
accept and see where there is
common ground.
• Ideally, you would identify a
solution that’s a win-win for
everyone involved. However, if
this isn’t possible, look for an
idea that everyone can agree
with and be committed on it.
 INTERDISCIPLINARY MENTAL HEALTH TEAM COLLABORATION
TEAM MODEL CHARACTERISTICS
Multidisciplinary • Doctor controls team
team • Team meets to coordinate client care
• Clients are not included in decision making
processes.
Interdisciplinary • The team is not necessarily led by the doctor.
team They work within their areas of expertise and
coordinate the work of others. Leadership is
provided by the person with the most
expertise in the given situation.
• Reports of functional progress, decision
making and care plans are informed by case
conferences
• The client is the center of the team’s focus
and plays an important role in goal setting
• Ideas are exchanged that lead to changes in
clients’ treatments
LIMITATIONS
• Clients not involved
• Services may be omitted,
fragmented or duplicated
• Team members expertise may
not be used effectively.
• Team meetings require time
• Team members may need to be
trained in team processes
• Individual team members need
to cede some control to the
team so that client care is
driven by the team processes
• The doctor needs to allow team
decision making yet take
medico-legal responsibility for
outcomes.
 BENEFITS OF INTERDISCIPLINARY TEAM CARE
PATIENT
Improves care by increasing coordination of Can serve clients of diverse cultural
services, especially for complex problems background

Integrates health care for a wide range of Uses time more efficiently
problems and needs.

Empowers clients as active partners in care and

enhances satisfaction and outcomes

FOR CARERS AND FAMILIES

Provides the best possible outcome for the
physical and psychosocial carers
Addresses the needs of carers, siblings and the
children of those with mental health problems
Assists with broader social, cultural and health
issues experienced by families
Involves carers with a range of professionals
in the process of developing a mental health
plan
Considers everyone’s concerns and identifies
resources for supporting someone with mental
health issues
 Benefits of Interdisciplinary Team Care
FOR HEALTH CARE PROFESSIONALS
Increases professional satisfaction Encourages innovation in the practice of
their profession and provision of patient
care
Facilitates shift in emphasis from acute, Allows providers to focus on individual areas
episodic care to long-term preventive care of expertise
Enables the practitioner to learn new skills
and approaches FOR EDUCATORS AND STUDENTS
Offers multiple health care approaches to Promotes student participation
study
Fosters appreciation and understanding of Challenges norms and values of each
other disciplines discipline

Models strategies for future practice Develops an understanding of the reality of

working in a collaborative interdisciplinary
team
 Benefits of Interdisciplinary Team Care

FOR THE HEALTH CARE DELIVERY SYSTEM

Holds potential for more efficient delivery Facilitates continuous quality

of care improvement efforts

Maximizes resources and facilities Reduces health expenditure

Decreases burden on acute care facilities as Facilitates seamless transition between

a result of increased preventive care care sectors (such as acute and community
care)
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