Interprofessional Communication in Psychiatric Units: Barriers, Prerequisites, and Its Role in Shaping Person-Centered Practices - A Vignette Study.

Abstract

Interprofessional communication is fundamental in healthcare, particularly where patient needs demand coordination and shared understanding. It fosters role clarity, care coordination, and team cohesion. However, unclear hierarchies, heavy workloads, and interpersonal conflicts can disrupt collaboration, affecting professional relationships and patient outcomes. This study explores experiences of and reflections on prerequisites for and barriers to interprofessional communication in psychiatric outpatient settings. While previous research has described barriers, few studies have examined how communication itself constitutes professional roles, boundaries, and collaborative practices. To address this gap, the study applies the Four Flows framework-membership negotiation, self-structuring, activity coordination, and institutional positioning-as an interpretive lens. Using vignettes and semi-structured interviews with 11 clinicians in psychiatric outpatient units, the study analyzed how communication shapes and is shaped by interprofessional collaboration. Analysis identified four key categories: systemic barriers and organizational challenges; social dynamics and interprofessional relationships; supportive leadership and team culture; and patient focus and involvement. These categories intersect across the Four Flows, illustrating how communication acts as a structuring process rather than a neutral tool. The overarching theme," From Separate Paths to Shared Care," highlights how clinicians enact person-centered collaboration through communicative practice in psychiatric outpatient settings.