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Working in mental health services has always been recognised as a stressful occupation and many studies have attested to the high levels of stress and burnout. This study examined comparative levels of stress among inpatient and community mental health staff across five European countries.Using a quasi experimental pre‐test post‐test design, data was collected from staff at baseline, six months and 12 months. This paper examines data from the baseline period. Staff working in acute inpatient wards and community mental health teams in Denmark (Aarhus, Storstrøm), Finland (Tampere), Norway (Bodo), Poland (Warsaw) and the UK (Cambridge), were asked to complete the Maslach Burnout Inventory (MBI) (Maslach, & Jackson, 1986), the Mental Health Professional Stress Scale (Cushway, Tyler & Nolan, 1996) and a demographic questionnaire designed for this study. Results on the MBI are reported in this article. Both community and inpatient teams reported high levels of burnout. There was evidence to suggest that burnout differed by site but not by team type. The English teams scored highest in emotional exhaustion and depersonalisation. Relatively high levels of work‐related personal accomplishment were reported across all of the sites.

The paper aims to describe and discuss the development of a new and innovative community based mental health service.

The paper demonstrates how a team developed its ethos, formed links and provided leadership in establishing a socially inclusive community model of mental health care provision in a suburban area of Cork City, Ireland. Key factors which influenced and facilitated the development and implementation of the initiative will be highlighted, including demographic details of the local area, the results of the internal audit, the resource implications, and the collaborative style of the team. The change model used by the team used will be briefly outlined. The key processes and outcomes will be described, discussed and reflected upon.

Flexible, creative and collaborative leadership qualities, together with a good appreciation of knowledge of local communities, can create positive synergies in establishing effective relationships across diverse groups in developing a socially inclusive community mental health service.

This paper adds value to appreciating and understanding the wealth of social capital in local communities in fostering community mental health care integration across diverse groups.

Prisoners are at greater risk of developing mental health problems compared with people of a similar age and gender in the community. They are less likely to have their mental health needs recognised, are less likely to receive psychiatric help or treatment, and are at an increased risk of suicide. Prison mental health in‐reach services have been developed in the UK to address these problems. An organisational case study method was used to generate theory about the links between the aims, processes and impacts of the introduction of mental health in‐reach teams to prison contexts. Case studies were undertaken on six sites and included interviews and focus groups with in‐reach team staff, prison healthcare staff, and discipline staff. The aims of prison mental health in‐reach were related to providing an equivalent service to a Community Mental Health Team, with a primary focus on serious mental illness, but a widening role. Achievement of these aims was mediated by the organisational context, active relationship development and leadership. Overall effects were positively reported by all stakeholders. Successful development was not just a function of time in post, but also a function of the effectiveness of leadership within the in‐reach teams. The more effective teams were having a wide impact on the response to mental health problems in the prison setting

This study of community mental health teams (CMHTs) in Knowsley aimed to provide information about changes to the service user group and the nature of work undertaken in the teams following the implementation of the national service framework for mental health. Clear changes in the balance of work undertaken were identified, reflecting successful implementation of the new policies and appropriate selection of cases. Issues raised by such developments are summarised in view of their relevance to other localities.

This paper gives an overview of the development and pilot implementation of a tool to evaluate socially inclusive practice. There are strong links between social inclusion and better mental health outcomes for people who access services, yet a very limited amount of research exists concerning ways to evaluate socially inclusive practice within mental health services. The paper describes the creation of a tripartite tool to access the views of mental health teams who work with service users, and the service users themselves. As part of the movement towards recovery and social inclusion, the Department of Health requires that social and occupational needs become embedded in care plans alongside health needs (DoH, 1999), and so an analysis of care plan documentation completed the evaluation tool. A pilot evaluation was conducted with three mental health teams in Sussex and found issues with engagement and response rate. Lessons learned and future implications are discussed.

A tool was created to evaluate the socially inclusive practice of mental health teams. The tool was based on the 2007 Department of Health best practice guide for the workforce, Capabilities for Inclusive Practice (CfIP), itself based on The 10 Essential Shared Capabilities (Hope, 2004). The tool comprised three parts, a team questionnaire, a service user questionnaire, and a Care Programme Approach (CPA) care plan documentation analysis (see previous paper on pp31‐41). This paper focuses on piloting the tool with mental health teams within Sussex Partnership NHS Foundation Trust as a means of showcasing the evaluation tool. Detailed findings are reported from one assertive outreach team (AOT). The findings suggest that although the team professed limited knowledge of CfIP, they endorsed all capabilities in their practice, although a low response rate limits the extent to which the current findings are generalisable. The triangulation of data provided by the tool facilitates an exploration of the variance of capabilities across team, service user, and care planning perspectives, meaning that specific areas for the improvement of the delivery of inclusive practice can be easily identified.

Various attempts have been made to understand and resolve the enduring lack of cohesiveness of multidisciplinary teams (MDTs), their dysfunctional service delivery and the feelings of distress among some of the professionals who work in them. Distortions in forensic MDTs have sometimes compromised service delivery and effective risk management. Several public inquiries relating to high‐profile incidents in forensic mental health have noted the role of dysfunctional MDTs. This paper describes the philosophy, structure, functions and achievements of a forensic community MDT in Wellington, New Zealand. It explains a model of care that is adaptable, comprehensive, effective and evidence‐based. It highlights the role of the extended MDT and embedded cultural units from which care professionals work together, share a common philosophy of care and tailor their care to the needs of the individuals or populations they serve.

This paper gives a picture of the development of four new roles in mental health over a two‐year period. It draws on data from the national mapping project to provide a unique perspective on the emergence of the roles of support, time and recovery workers, gateway workers, carer support workers and community development workers for black and minority ethnic communities. The tracking of such roles on a national level reveals a number of issues, in particular the need for clarity of terms if there is to be an undisputed understanding of what mental health services are provided and by whom.

There are high rates of emotional, behavioural and psychiatric problems (Cooper et al, 2007) in the learning disability population. This paper describes the Mental Health in Learning Disabilities (MHiLD) service for adults with learning disabilities in four South London boroughs. This service has been in operation in two South East London boroughs from 1982, and was extended to a third in 1999 and a fourth in 2006.

STEPS is a primary care mental health team that has attempted to develop a very high volume multi‐level, multi‐purpose service for those with mild to moderate problems. The service attempts to overcome many of the limitations of more traditional services. This paper describes the services contained within the six level model.