Steps towards effective teamworking in Community Mental Health Teams C. Twomey 1 , M. Byrne 1 * and T. Leahy 2 1 Roscommon Service Area, Health Service Executive (HSE) West, Ireland 2 HSE Mental Health Services, Swords Business Campus, Co. Dublin, Ireland Objectives. This paper aims to show how effective teamworking can be achieved in Community Mental Health Teams (CMHTs), in the context of recovery-focused care. Methods. A narrative review of various governmental policy documents and selected papers relevant to teamworking and recovery-focused care within mental health services, in an Irish context. Findings. Effective teamworking within CMHTs is a prerequisite to the provision of quality, recovery-focused care. It requires the management of various environmental (e.g. adopting a ‘recovery’ model of mental health), structural (e.g. sharing of responsibilities and capabilities) and process (e.g. utilising a clear referral pathway) factors that influence teamworking, as CMHTs develop over time. Conclusions. Completion by CMHT members of teamworking and other evaluative measures can assist teams in highlighting potential interventions that may improve recovery-focused team functioning and effectiveness. Received 14 June 2012; Revised 7 August 2012; Accepted 25 June 2013; First published online 5 December 2013 Key words: Community mental health teams, recovery, teamworking. Introduction Recent publications by the Mental Health Commission (2005, 2008) highlight the need for our mental health services to provide recovery-focused care that empowers service users to ‘take control’ of their own recovery. In this person-centred approach, working with their assigned care co-ordinator (or key worker), service users are proactively empowered to define what recovery means to them as individuals, and to accordingly formu- late and drive the implementation of their needs-based care plan (Mental Health Commission 2008). Moreover, the role of mental health services is to support service users in fulfilling their potential in all life domains – from their well-being to their participation in social and com- munity activities, education and employment (Mental Health Commission 2008; Byrne & Onyett 2010). A Vision for Change (Department of Health and Children 2006) recommends the provision of inte- grated, recovery-focused care that is delivered in the community, primarily by multi-disciplinary Commu- nity Mental Health Teams (CMHTs). As detailed in the guidance papers from the Health Service Executive (HSE) National Vision for Change Working Group (HSE National Vision for Change Working Group 2012), this can be achieved by providing a continuum of integrated services (see Fig. 1). Moreover, the Mental Health Commission has developed the evidence- based Quality Framework for Mental Health Services in Ireland (Mental Health Commission 2007). This non- prescriptive framework has eight themes, 24 standards and 163 criteria that can be applied to all mental health services, and it aims to place service users at the centre of care through quality, recovery-focused service delivery (Mental Health Commission 2007). A prerequisite for such integrated, recovery-focused care is effective teamworking within CMHTs. How- ever, achieving this is dependent on environmental, structural and process factors that interact with each other as teams develop over time (Byrne & Onyett 2010). Building on guidelines from the Mental Health Commission’s Teamwork in Mental Health Services in Ireland (Byrne & Onyett 2010), this paper aims to highlight how to best manage these factors in order to facilitate effective teamworking and recovery-based care in CMHTs. First the stages of team development are outlined. It then considers the factors that influence teamworking and some potential interventions that may realise effective teamworking. Finally, it explores ways to evaluate if teams are working effectively. * Address for correspondence: M. Byrne, Principal Psychologist Manager, Roscommon Service Area, Health Service Executive West, Primary Care Centre, Golf Links Road, Roscommon, Ireland. (E-mail: michaelj.byrne@hse.ie) Irish Journal of Psychological Medicine (2014), 31, 51–59. © College of Psychiatrists of Ireland 2013 REVIEW PAPER doi:10.1017/ipm.2013.62