Teamworking in Mental Health. Steve Onyett, Basingstoke: Palsgrave Macmillan, 2002, 269pp. £17.99 pb, ISBN 0-333-76375-0

I am a member of five formally constituted multidisciplinary teams. I also participate in numerous regular and ad hoc entities (e.g. committees and research groups), which come together to achieve a task. In common with most psychiatrists almost all my work takes place in the context of what might be called a team of one sort or another. However, I do not recall receiving any formal teaching or training about the theory and practice of working within teams apart from a team-building day a decade ago when we played games designed to show that teams do better than individuals. (Sadly, according to Onyett and my experience on the day that is not true: the team will do better than the average of its members’ individual performances, but worse than the best individual.)

There is a theory of team-working within mental health. Its doyen, John Ø vretveit, contributed an excellent brief chapter to Thornicroft and Szmukler’s Textbook of Community Psychiatry. In the book under review, Onyett draws on Øvretveit’s work, the rather scanty available empirical data, and recent developments in organisational and occupational psychology. Onyett has read widely and has drawn on his experience as a mental health team leader, and more latterly in research and consultation, to produce a valuable text that can be read with profit, if not a little irritation, by established consultants and senior trainees. He does not address important issues of operational management, such as dealing with difficult colleagues, performance and financial management and he is not, in my opinion, an entirely reliable guide to the history of mental health or the community care literature. He is surprisingly weak in his discussion about power: classically, professionals have ‘negative power’, in that we can screw up almost any managerial initiative if we choose to. Onyett’s negative view of the work of psychiatrists within teams is presumably an honest reflection of his experience and is a sobering reminder to new consultants that leadership roles need to be earned.