title: Assertive community treatment (ACT) case managers' professional identities: A focus group study.
abstract: Assertive community treatment (ACT) case managers provide healthcare services to people with severe and persistent mental illness. These case managers take on generic roles in multidisciplinary teams and provide all-around services in the clients' private homes. This focus group study aimed to gain insight into Danish ACT case managers' professional identity work by examining their discussions of ethical dilemmas and collaboration in their everyday practice. Data were collected during five focus groups at three ACT teams in the North Denmark Region and subjected to discourse analysis emphasizing how identity work was accomplished through talk. The findings indicated that the case managers constructed professional identities by actively positioning themselves and the particular ACT approach in relation to other mental healthcare professionals and clients. They represented themselves as achieving better client-related outcomes by being more assertive and persistent, and as responsible caregivers who provided the help that their clients needed when other services had failed to do so. They depicted their services as being focused on the clients' well-being, and their persistent efforts to establish and sustain interpersonal relationships with clients were an important part of their service. Basic nursing tasks were described as an important part of their everyday work, and even though such tasks were not distinctive for ACT case managers, the representations of their work seemed to give them a sense of worth as professionals and legitimized a unique role in the community mental healthcare services.
authors.affiliation: RN, MHS, Aalborg University Hospital, Psychiatric Hospital, Aalborg, Denmark.
authors.forename: Birgitte
authors.initials: B
authors.lastname: Lerbaek
authors.affiliation: Unit for Psychiatric Research and Department S, Aalborg University Hospital, Psychiatric Hospital, Aalborg, Denmark.|Unit for Psychiatric Research and Department M, Aarhus University Hospital, Risskov, Denmark.
authors.forename: Jørgen
authors.initials: J
authors.lastname: Aagaard
authors.affiliation: RN, MHS, Aalborg University Hospital, Psychiatric Hospital, Aalborg, Denmark.
authors.forename: Mette Braendstrup
authors.initials: MB
authors.lastname: Andersen
authors.affiliation: Faculty of Nursing and Midwifery, University of Sydney, Australia and St. Vincent's Private Hospital Sydney, Sydney.
authors.forename: Niels
authors.initials: N
authors.lastname: Buus
mesh_terms: D000328:Adult; D000071959:Case Managers; D003156:Community Mental Health Services / Q000379:methods*; D003718:Denmark; D005260:Female; D017144:Focus Groups; D006801:Humans; D033183:Interdisciplinary Communication; D008297:Male; D001523:Mental Disorders / Q000628:therapy; D008875:Middle Aged; D010348:Patient Care Team; D024382:Professional Role; D011369:Professional-Patient Relations
keywords: case management; community mental health services; focus groups; mental health nursing; qualitative research