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

<b>Background:</b> 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). <b>Objectives:</b> 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. <b>Methods:</b> 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. <b>Results:</b> 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. <b>Conclusion:</b> Our study elucidated mechanisms and the contextual factors by which an MHT in general practice improves staff morale. KEY MESSAGESAn 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.

<b>研究背景：</b> 心理健康基层医疗服务的落实往往存在不足，这会对工作人员产生负面影响。采用基于团队的心理健康照护模式，可避免工作人员士气低落。因此，某社区卫生服务中心（CHC）开展了一项项目，以推动其与心理健康团队（MHT）开展跨专业协作。
<b>研究目标：</b> 本研究旨在明晰心理健康团队（MHT）对基层医疗场景工作人员士气的影响机制，并为后续相关项目制定可行建议。
<b>研究方法：</b> 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。本研究采用定性研究方法，旨在厘清影响心理健康团队（MHT）对工作人员士气产生作用的情境因素与内在机制。
<b>研究结果：</b> 该项目减轻了工作人员接诊患者的工作负担，同时让员工感受到自身对患者而言更具价值。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岗位职责。促进项目实施的因素为跨文化照护协调员与积极的团队氛围，而阻碍因素则包括低效的时间管理与沟通问题。
<b>研究结论：</b> 本研究阐明了基层医疗场景中，心理健康团队（MHT）提升工作人员士气的作用机制与情境影响因素。
核心要点：
心理健康团队（MHT）可通过强化员工认同感、转变工作人员的服务态度以及明确岗位职责，提升社区卫生服务中心（CHC）的员工士气。
需注意的潜在风险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服务领域的跨专业协作。
核心要点：
心理健康团队（MHT）可通过强化员工认同感、转变工作人员的服务态度以及明确岗位职责，提升社区卫生服务中心（CHC）的员工士气。
需注意的潜在风险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服务领域的跨专业协作。