Within the general area of forensic health care, a multidisciplinary working environment will only be successful if the roles of each profession are clear to all members of the team, (Konrad, 2002).
Multidisciplinary working has neither been defined as a good or a bad model of preferred practice. It has in face been defined as, ‘an unavoidable social construction in mental health services where the contributions and professional expertise of each worker are called for it citizens are to obtain the services they need in a coordinated way’, Leiva (1994: 137). This is mainly to maintain a good standard of care for the client by implementing a holistic approach and to create a healthy working environment for professionals, (McGrath, 1991).
Sometimes the need to uphold professional standards is the main barrier to a multidisciplinary team being able to thrive. Being part of a profession means that your work encompasses a specific philosophy, largely due to specialist training courses, making it difficult to adapt to being part of a collaborative group, (Leiba (1996) quotes Strauss (1962). Furthermore, being professionally biased limits communication and can therefore hinder development.
To overcome this issue, forensic staff work alongside a ‘three level ethical code of reference, in the hope of being able to successfully meet the clients needs as part of a successful team, (Mason et al 2002). These were identified as:
Working within your professional beliefs
Working within your professional structure (in regards to the trust, company or service you belong too)
Working within your professional code of conduct (Health Professionals Council, British Psychological Society, General Medical Council etc)
It has been suggested that communication is a major factor that hinders multidisciplinary teams. Each profession has their own language, to which other professions would often find uninterruptable. Therefore, rather than trying to adopt the language of one specific team, the multidisciplinary team face the challenge of creating a new collaborative language, one which they all understand, (Pietroni, 1992).
Within a forensic setting, each profession occupies a different position within the multidisciplinary team, and unintentionally this creates a hierarchy. Doctors and those seen in more medical professions may place more of an emphasis on medicalising whereas those in social professions may focus on interventions and no medical treatment programmes. One way in which to ensure that this does not continue is to have regular practice meetings in which member of the multidisciplinary team can highlight any issues that arise, (Engstrom, 1986).
Furthermore, within a forensic setting these academic/ professional differences occur frequently, due to the wide range of disciplines, services, agencies and professions that are required to collaborate. For example when a prisoner is placed on remand or is sentenced, their journey into prison will involve them being dealt with various agencies such as the courts, the police service, the prison service, social services and the National Health Service (NHS). Especially when it comes to health care, a multidisciplinary team will certainly be involved, (United Kingdom central council for nursing, midwifery and health visiting, 1999). The need for a multidisciplinary approach is essential to support the growing number of prisoners with mental health disorders, (Fazel & Danesh, 2000; Singleton, Meltzer and Gatward, 1998). A positive association between these disciplines is crucial in meeting the clients needs, while not breaching any legal or ethical constraints, (Horny, 1993).
A great example of where ethical and legal boundaries have to be followed is with The Offender Assessment System (OASys). OASys seeks to assess the risk individuals pose to themselves and other upon release, as well as the probability of them reoffending. This system is only used within the Prison Service and
