Integrated mental health care: practitioners' perspectives

Objective: Integrated mental health care (IMHC) is a community-based model that considers the patient and informal carers to be the major contributors to stable recovery from severe mental health problems. This study investigates the implementation of IMHC by 35 New Zealand practitioners 1 year after being trained in the model. It also explores their experiences and perceptions regarding the model. Method: Quantitative and qualitative data were gathered by combining a questionnaire survey with in-depth interviews. Results: Few of the trainees had been able to implement the model as much as they would have liked. A primary barrier to implementation was created by the resource constraints that impede most innovative community care initiatives even when demonstrated to be more cost-effective than traditional hospital-based approaches. Concerns particular to IMHC included issues relating to flexibility, time-intensiveness and applicability to New Zealand. Many practitioners found some of the specific intervention strategies and the clear overall structure of the model useful. Its psychosocial emphasis had a positive impact on many practitioners' beliefs about the causes and prognosis of severe mental health problems. Conclusions: Participants offer a range of recommendations as to how IMHC might be applied and adapted. Consultation with staff, consumers, families and Maori, as well as a strengthening of the psychosocial components, are recommended.