How do professionals collaborate in the face of uncertainty?: An investigation into the complexities of mental health care

Professional uncertainty is ubiquitous across health care settings, yet it may be managed by the sharing of information through effective interprofessional collaboration. Professional uncertainty is particularly prominent in mental health care; however, the literature lacks a consistent categorisation of the types of uncertainty in this context.The aim of this thesis was to identify the types of uncertainty experienced by professionals working in mental health, and evaluate how professionals collaborate in these situations. The research was conducted in two youth mental health 'headspace' centres in Australia. Two literature reviews and an exploratory two-stage mixed-methods design were employed. Study 1 used semi-structured interviews and Study 2, a social network survey. Statistical, thematic and social network analyses were employed to analyse the data. Findings revealed distinct types of professional uncertainty in mental health care related to: decisions, professional role, and external factors. In the face of these uncertainties, health care professionals collaborated across professional bounds, however, the degree of connectedness and who colleagues sought for support varied depending on the type of uncertainty. Specifically, collaboration during professional role uncertainty was sparse, indicating that the mere co-location of professionals may not always lead to cohesive interprofessional working. This suggests the need to do more to engender professional collaboration (rather than just co-location). Research must continue to identify situations of sparse collaborative patterns, such as role uncertainty, in order to develop interventions to improve interprofessional teams in navigating these complex situations. The findings of this research are directly applicable to headspace centres, and can be extrapolated to other services that aim for integrated, collaborative care.