Context of change in community mental health occupational therapy: Part one

Mental health services have experienced radical changes over the past 20 years. There has been a shift from institutional to community care and different professions have been brought together to work in teams. More recently, these teams have been aligned to geographical boundaries, not by profession, and have one manager from any professional background. The working relationships between the professional groups in the teams can be an area of difficulty and the individual clinician can experience role confusion and stress. This two-part study used focused ethnography to explore an occupational therapist's role in a community mental health team. It found that the occupational therapist was trying to develop her role both as a mental health worker and as an occupational therapist and that the context of organizational change was an important influence on these roles. This article describes the background literature, methodology and findings. Part two covers the data analysis, discussion and recommendations for further research and practice.