Psychiatric Bulletin (2005) 29: 398. doi: 10.1192/pb.29.10.398-a
© 2005 The Royal College of Psychiatrists
Psychiatric Bulletin (2005) 29: 398
© 2005 The Royal College of Psychiatrists
Community Mental Health Teams. A Guide to Current Practices
Frank Holloway, Clinical Director
Croydon Integrated Adult Mental Health Services, Bethlem Royal Hospital,
Monks Orchard Road, Beckenham, Kent BR3 3BX
Tom Burns Oxford: Oxford University Press, 2004, £29.95, 211 pp.
ISBN: 0-19-852999-6
Contemporary mental healthcare in the UK is based on an emerging service
model that requires a number of ‘functional’ mental health teams
to work together in providing comprehensive secondary mental healthcare to a
catchment area. This model replaces the painfully won dominance of the single
local community mental health team. At the time of writing, four teams are
mandatory: in the phraseology of the Department of Health these are
‘primary care liaison, assertive outreach, early intervention and crisis
resolution and home treatment’ teams (the logic of functional
differentiation suggests that ever more specialist teams will emerge). All
health economies have been required to develop these four teams, producing a
potentially complex and confusing service system.
A book that provides a map of this brave new world should be valuable both
for the experienced practitioner and the tyro. I cannot think of anyone better
placed to write such a book than Tom Burns, now Professor of Social Psychiatry
at Oxford, who has for many years been at the forefront of innovations in
service delivery. With a career stretching back to the high point of
traditional social psychiatry as practised at Dingleton Hospital, Burns has
undertaken important research into the primary/secondary care interface, the
workings of community mental health teams and intensive case
management/assertive outreach teams. In Community Mental Health Teams
he has supplemented his considerable personal experience and knowledge of the
literature with direct observation of mental health teams both in the UK and
North America. The structure of the book is simple and the writing is clear.
Two introductory chapters summarise, perhaps rather too briefly, the origins
of community psychiatry and some key issues in multidisciplinary team-working.
Chapters describing the four ‘functional’ teams provide the core
of the book: Burns underlines the commonalities between these teams as well as
describing their differences. Two short chapters allude to highly specialised
teams and the research agenda (which is very large). It provides all the
information that an examination candidate should know, but like all good books
this text raises more questions for the perceptive reader than it answers.
