Understanding mental health care as a landscape of different professions – and what to do about it to improve its delivery

New research by the University of Bristol Business School and Curtin University (Australia) academics explores how to respond to today’s grand challenges, such as mental health, by working together across different types of organisations and professions.

The study Mobilising Landscapes of Practice to Address Grand Challenges shows that mental health is not a unified practice but a collection of different types of professionals, such as psychiatrists, psychologists, GPs, and dieticians, among other professions. This means that it is fundamental for improving mental health care delivery to work across these professions, develop meaningful learning partnerships, and thereby piece the puzzles of the complex landscape of mental health practice.

Dr Igor Pyrko, Senior Lecturer in Strategy and Organisation, was involved in this project in which he applied his expertise in practice theory, communities of practice, and organisational knowledge. The article he co-authored, published in the Tavistock Institute’s flagship FT50 journal Human Relations, aims to provide practical guidelines and new insights into the need to deploy ‘participatory architectures’ when developing and implementing responses to grand challenges.

The research was based on a series of 10 half-day workshops and 39 interviews with mental health hospital directors, senior leaders, healthcare professionals, and carers in 5 out of 6 states in Australia. The research revealed four main ‘pillars’ for mobilising the landscapes of practice to address grand challenges, with a focus on mental health. These pillars are expected to inform managers, facilitators, and community leaders who work on multi-stakeholder initiatives targeting grand challenges such as mental health care.

The first pillar is concerned with determining and legitimising the purpose of mobilising the landscape of practice – that is, the constellation of different professionals who possess the expertise and hold a stake in working against the grand challenge in question and its ramification. Such purpose must be negotiated within the network and in relation to the public policy which the multi-stakeholder initiative wants to influence.

The second pillar is to deploy landscape-based administration, roles, and processes for improved coordination of activities. Thus, while much of the learning across the landscape of practice is informal, there is still a need for more formal coordinating structures. This also means that pockets of expertise relevant to mental health care improvement have to be integrated while working across the boundaries of existing institutions and jurisdictions.

The third pillar is to do with motivating and connecting membership across the landscape so that the ‘right people’ are targeted with the ‘right’ problems, and new forms of collaboration can be developed. Here the important consideration is ensuring equality of membership, psychological safety, and the silenced voices are heard.

And finally, as part of the fourth pillar, it is essential to demonstrate the value of the multi-stakeholder initiative. Therefore, the initiative’s leaders should regularly communicate to participants a sense of progression against the agreed objectives and test for ‘small wins’.

While these four pillars offer a practical point of reference, the implementation is not easy and requires good judgment – we comment in more detail on such tensions, difficulties, and possible courses of action in the full paper, which is now available to read on the Human Relations’ website.

Find out more about the University of Bristol Business School Research.

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