Accessing the Teams and Developing Relationships

While I was waiting for ethical approval from the Research Ethics Committee (REC), I attempted to make connections with the teams so that I could begin the field work as soon as the ethical approval was granted. I understood that this initial induction would otherwise be time consuming and prolong the research time frame.

Access and entry issues always play a major role in the field work process, as the first step in collecting data. In approaching the teams the best approach I identified from the literature (Fetterman, 2010, Schwartzman, 1993) was an introduction to the team members by somebody who is close, accepted and trusted within the teams. Fetterman (2010:36) demonstrates this as the „best ticket into the community‟ because this ticket can „open doors otherwise locked to outsiders‟. As Fetterman goes on to explain:

This facilitator should have some credibility with the group either as a member or as a friend or associate and in return the ethnographer benefits from this. The trust the group places in the intermediary will approximate the trust it extends to the ethnographer at the beginning of the study. Ethnographers thus benefit from a halo effect if they are introduced by the right person (Fetterman, 2010:36).

In qualitative research the person who introduces the researcher into the field is called the “gatekeeper” (Schwartzman, 1993:3-4). From the initial discussions with the senior manager in the MHT, I understood the team managers were the “gate keepers” and could introduce me to the teams‟ environment. Schwartzman (1993:4) further describes „The importance of how one presents oneself to gate keepers in an organisation is also crucial for setting up particular expectations about one‟s research, and even for gaining entry into a setting‟. In accordance with Schwatzman, I prepared myself for this first meeting by organising the necessary documents, such as the research proposal, information sheets, flyers and also the draft questionnaires and consent forms, which I could present for discussion. I also prepared myself by thoroughly studying the research proposal to answer any questions they might ask during the meeting and dressed accordingly on the day, as I understood how important this first encounter would be for the success of the whole field work process.

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During this meeting this manager also introduced my supervisor and me to the manager of the other team, and we allowed time to explain the study plan to her as well. This meeting progressed very well and helped me to build my confidence in approaching the two managers again to start the fieldwork, once I had gain the necessary ethical approval.

Before starting the field work, I decided to meet the members of the two teams, to introduce myself and to share information about the study. I felt this was very important for the smooth running of the research as I am from a very different culture with no experience in working in a similar system. As Schwartzman (1993:53) describes:

First encounters are also the first time that informants and researchers have to observe each other. No matter what role one tries to adopt in the field work situation, in the beginning informants will make sense of the researcher in the way that they make sense of all other strangers who appear to begin to ask questions. For this reason organisational ethnographers have been seen as evaluators, consultants, federal investigators, spies from other companies or agencies and journalists.

Given this, I understood the importance of properly presenting myself to the team members so as not to arouse any suspicions about the role I would play within the teams.

Despite a few cancellations of appointments with one team at the start of the research, the team manager was very cooperative and helpful and provided me with all the facilities I needed to continue my fieldwork. I had the opportunity to address the team members in a short lunch time meeting; I explained the research to them and handed over the flyers and information sheets. After this successful meeting, I met the other team manager and set up the initial steps for my stay with that team. In both teams I was assigned a staff member from the Administration Staff that I mainly liaised during my time with the teams. On a separate day, I had the opportunity to introduce myself and the research to the staff members of this second team during an Allocation Meeting. According to Schwartzman (1993:48-49) access issues and first encounters provide researchers with a rich source if data.

It is in these encounters that the most dramatic differences between the ethnographer‟s culture and the informant‟s culture will be apparent. The surprises, differences, misunderstandings, and such that occur in these

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encounters may foreshadow major research concerns and issues; however, in the beginning, researchers may not know how to interpret what these

differences reveal about themselves and their informants. This is why it is extremely important to take detailed field notes in the beginning of one‟s field- work.

In agreeing with Schwartzman, during these few initial meetings I wrote down lengthy field notes which provided me with an opportunity to retrieve a very rich understanding of the functioning of the teams and their staff members. This in turn helped me in the data analysis process. As the data analysis was started during the very first week of field work this helped me to revise and redesign some aspects of the research. I considered this flexibility as a major advantage of doing an ethnographic study.

To complete the fieldwork, my initial plan was to spend first three months with one team and the next three months with the other team. This basic plan was changed after discussing the time constraints with the staff members. During the very first days I observed the duty schedules of the staff members and I understood that, as a part of their care coordination work, they must spend a considerable time outside the office and, once they return from the home visits, they are required to complete all the data on PARIS, which is the computer system newly introduced to NHS. Also they must sometimes cancel other commitments, to respond to crisis situations related to their clients. In this sense, I understood that three months with each team would not allow me to have sufficient contact with the members and to schedule the interviews. With this understanding, I changed my initial plan to spend two to three days a week with each team for up to six months. This decision gave me the opportunity to plan the interviews more than five months ahead, which suited with staff‟s extremely busy time tables. It also gave me the opportunity to become a familiar figure within the teams, which in turn helped me to participate in more of the team events, including team meetings and home visits.

Heeding advice from Schwartzman (Schwartzman, 1993), during these six months I made a conscious effort to develop relationships in the field, which helped me to appreciate why the team members think, act and feel in the way they do. This in turn helped me to change some of my presumptions about team working in CMHTs, which I gained through studying the literature. For example the prevailing literature (Goodwin, 1997) reports professional rivalry in multidisciplinary working and a lower

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perceived status of certain professions, which I very rarely observed during these six months. I started to see things for myself as a part of these teams and not as an outsider. This helped me to clearly observe the stresses experienced inside the real working environment.

During the field work period I gathered primary data through observation, participation in meetings and other team activities, home visits and semi structured interviews. In addition to the primary data, some secondary data pertaining to the role and function of mental health social work was gathered, which is described further in section 4.3.