Inter-professional collaboration reduces the burden of caring for patients with mental illnesses in primary healthcare. A realist evaluation study

Background: The implementation of primary care for mental health is often insufficient, which leaves its mark on staff. A team-based approach of mental healthcare prevents poor staff morale. A community health centre (CHC), therefore, set up a project promoting interprofessional collaboration with a mental health team (MHT).
Objectives: This study aimed to understand how an MHT would influence staff morale in a primary care setting, aiming to formulate some recommendations for future projects.
Methods: In 2017, interviews and a focus group discussion were conducted among the staff of a CHC. Using a qualitative approach, we aimed to unravel contextual factors and mechanisms that determine the effect of an MHT on staff morale.
Results: The project relieved the burden of the patient encounters and staff members felt more valuable to patients. Underlying mechanisms were recognition, altered attitudes towards patients and role clarity. Facilitating factors were intercultural care mediators and a positive team atmosphere, whereas inhibiting factors were inefficient time management and communicative issues.
Conclusion: Our study elucidated mechanisms and the contextual factors by which an MHT in general practice improves staff morale.

KEY MESSAGES
An MHT improves staff morale in a CHC, through nurturing recognition, through altering staff members' attitudes and through ensuring role clarity.
Pitfalls are inefficient time management and poor communication.
Policymakers should stimulate interprofessional collaboration in primary mental health.

KEY MESSAGES
An MHT improves staff morale in a CHC, through nurturing recognition, through altering staff members' attitudes and through ensuring role clarity.
Pitfalls are inefficient time management and poor communication.
Policymakers should stimulate interprofessional collaboration in primary mental health.

背景：心理健康基层医疗的实施往往存在不足，常对工作人员造成负面影响。基于团队的心理健康照护模式可避免医护人员士气低落。因此，某社区卫生服务中心（Community Health Centre, CHC）开展了一项旨在推动与心理健康团队（Mental Health Team, MHT）开展跨专业协作的项目。
研究目标：本研究旨在探究心理健康团队（MHT）对基层医疗场景中医护人员士气的影响机制，并为后续相关项目制定可行建议。
研究方法：2017年，研究团队对某社区卫生服务中心（CHC）的工作人员开展了访谈与焦点小组讨论。本研究采用质性研究方法，旨在厘清影响心理健康团队（MHT）对工作人员士气发挥作用的情境因素与内在机制。
研究结果：该项目减轻了工作人员处理患者接诊事务的负担，医护人员也更能感受到自身对患者的价值。其内在作用机制包括：获得认可、转变对患者的态度以及明确角色职责。助力项目推进的因素包括跨文化照护协调员与积极正向的团队氛围，而阻碍因素则为低效的时间管理与沟通不畅问题。
研究结论：本研究阐明了基层医疗场景中，心理健康团队（MHT）改善医护人员士气的内在机制与情境影响因素。

核心要点
心理健康团队（MHT）可通过强化工作人员的被认可感、转变其对患者的态度以及明确角色职责，提升社区卫生服务中心（CHC）内医护人员的士气。
该项目存在的短板包括低效的时间管理与沟通不畅问题。
政策制定者应推动基层心理健康照护领域的跨专业协作。

核心要点
心理健康团队（MHT）可通过强化工作人员的被认可感、转变其对患者的态度以及明确角色职责，提升社区卫生服务中心（CHC）内医护人员的士气。
该项目存在的短板包括低效的时间管理与沟通不畅问题。
政策制定者应推动基层心理健康照护领域的跨专业协作。