Organisational Issues surrounding the Merger of Two Acute Mental Health Services: An Exploratory Study

Healthcare services have engaged in domestic and international mergers in recent years in order to match the macroeconomic trends operating worldwide and to cope with the current global financial crisis. ‘Vision for Change’ (Department of Health and Children 2006) highlights the importance of closing all psychiatric institutions in an effort to enhance a community-based model of care and to modernise mental health service infrastructure. Therefore, considering acute mental health services will continue to merge in the near future to facilitate the closure of institutions, the views of individuals involved in a merger process are significant. This study explored the ‘how’ and ‘why’ issues that occurred during the merger of two acute mental health services in the south-east of Ireland.\ud A case study approach was employed, whereby service providers (n=30) involved in the merger of two acute mental health services were purposively recruited. Participants were interviewed using a semi-structured framework to gain an in-depth understanding of the ‘how’ and ‘why’ issues. Interview data was entered into computer aided qualitative data analysis software, ‘NVivo 9’ and analysed using Braun & Clarke’s (2006) guide to thematic analysis.\ud ‘How’ and ‘why’ issues were identified as they related to: (1) uncertainty and communication, (2) loss of familiarity, and (3) cultural differences between health professionals and senior management. Uncertainty emerged as a key finding and appeared to be exacerbated as a result of ‘how’ information was communicated during the initial stages of the merger. The loss of familiarity emerged throughout the merger process, as participants faced uncertain futures and desired the ‘old’ mental health service. The findings also indicated cultural differences between health professionals and senior management in terms of an occupational divide. Overall, the findings suggest that health professionals assume a significant role during the early stages of a merger process, and that this role can impact the pace of the merger process.\ud \ud Keywords: organisational issues, psychiatric service, amalgamation, mergers, policy, organisational change, organisational culture