Organisational i ssues surrounding the m erger of two acute p sychiatric s ervices in the s outh-east of Irelan

1. Organisational issues surrounding the merger of two acute psychiatric services in the south-east of Ireland By Claire Hayes BSc; RPN Supervisors: Dr. Michael Bergin Professor John Wells

2. Presentation Outline Acute psychiatric services in Ireland-background Current study and research design Findings Conclusion and significance of this study

3. Acute Mental Health Services Reform Mental health policy A Vision for Change (2006) Organisational issues emerging as a significant concern

4. Literature Gap Minimal research on psychiatric services in Ireland No ‘how to’ guides Mergersin a recession

5. Aim of Study To explore and analyse the ‘how’ and ‘why’ issues, which may arise during the merger of two acute psychiatric services in the south-east of Ireland

6. Objectives • To identify and analyse the organisational issues, which arise during the merger of two acute psychiatric services • To examine how the change process affects the viewpoints of individuals involved in merging into a single service

7. Methodology • Acute MentalSemi-structured Acute Mental • Health ServiceInterviews Health Service • AB • Data Collection • 15 Key Stakeholders n=30 15 Key Stakeholders • Purposive Sample • Analysis • Thematic Analysis • Nvivo9 Case Study Approach

8. Findings • (1) Communication with senior management (SM) and health professionals (HPs) • (2) Merger Reactions • (3) Conflict between HPs and SM

9. (1) Communication Senior management Health professionals

10. (2)Merger Reactions “I think it’s a short-sighted decision, which ultimately will have to be reversed” “I was annoyed. The main reason, very simply would be that 82% of the staff that were involved in the merger were not consulted” “I felt I had a duty to the people of [county X] to try and find an alternative” “People were very sad at the loss of the admission unit” “I’m fully supportive of Vision for Change, so it wasn’t a disappointment for me” Denial Anger Bargaining Reactions of sadness Acceptance

11. (3)Conflict between HPs & SM Health professionals Senior management Merger Motive Merger Motive “Policy” “Economics” Consultation Consultation “If management listen to what employees are saying and get their advice, but they won’t, but that’s what they should do” “You are never going to get everyone to agree” “In the ideal world, you would like to leave four or five months for consultation. We didn’t have that luxury” “I know there’s managers in offices who have to make decisions and they have to make them but I really think that they’re not in tune with working on the ground” Challenges “Getting people to accept the change”

12. Morale Senior management MORALE Health Professionals “The morale level among the staff is at an all time low” “Morale is very good, positive, full of enthusiasm”

13. Conclusion Unequal Vision Policy vs Economics Separate agendas Good Communication

14. Significance of this study To Merge Acute Mental Health Services in Ireland Economics -Conflict -Cost-effectiveness Educational Future acute mental health service mergers

16. References Alaranta M. and Viljanen M. (2004) Integrating the IS Personnel After a Merger-Managing Challenges and Opportunities. ECIS 2004 Proceedings. Paper 23. Boone L. E. & Kurtz D. L. (2009) Contemporary Business, 13thedn. John Wiley and Sons, New York. Department of Health & Children (2006) ‘A Vision for Change’ Report of the Expert Group on Mental Health Policy. Stationary Office, Dublin. Department of Health (1984) Planning for the Future. Stationary Office, Dublin. Landy F. J. & Conte J. M. (2009) Work in the 21st Century: An Introduction to Industrial and Organizational Psychology, 3rdedn. John Wiley and Sons, New York. Rukholm E., Lemonde M., Bailey P., Kaminski V., McLellan B., McGirr M., Palkovits J., Pong R. & St Onge R. (2003) Hospital System Assessment & Redesign for a New Millennium. Canadian Health Services Research Foundation, Canada.