The different needs, concerns, and preferences of the professions constituting the multidisciplinary team (MDT), including medicine, psychology, nursing, and social work, reflect the hybrid nature of psychiatry and the knowledge and skills required for clinical practice.

Neuroscience has evolved at impressive speed over recent decades. Many of its findings have relevance to psychiatry but are rarely directly translatable into clinical practice. Improving understanding of the psychological dimension of mental illness has led to new treatments with similar efficacy to medications. Our current approach to treating mental illness has also benefited greatly from insights from sociology and anthropology. The value conflicts relating to liberty and personal autonomy versus the medical value of restoring health and societal values around managing risk have led to the development of legal frameworks to aid clinical decision-making. These are, however, far from perfect, and values-based practice (VBP) principles could meaningfully contribute to improving them.

Although traditionally medicine sat at the top of the hierarchy in the MDT, this hierarchy has become more horizontal in recent decades. Close working together with social care is key, but there are pros and cons for both integrated and separate services. Values-based practice can ease some of the tensions in MDT working.