Health Professionals on Cross-Sectoral Collaboration Between Mental Health Hospitals and Municipalities: A Critical Discourse Analysis.

Abstract

This study investigates the role of language in cross-sector collaboration between mental health hospitals and municipalities, focusing on the challenges of maintaining continuity of care and integrating patient-centered approaches. Using Fairclough's framework for critical discourse analysis, we examined focus group interviews with 21 healthcare professionals, including nurses, social workers, and psychiatrists, to identify key themes and patterns in how cross-sector collaboration is discussed. The analysis revealed a dominant medicalized discourse in hospital settings, which often emphasized structured care processes like treatment plans and medication management, overshadowing more flexible, patient-centered approaches common in community-based services. Power dynamics were evident, with hospital professionals frequently positioned as active agents, while patients and community-based workers were portrayed in more passive roles. Although efforts to involve patients in decision-making were noted, these were often controlled by professionals, reflecting a mediated approach to patient empowerment. The findings highlight the cultural and structural divides between hospital and community services and suggest the need for improved communication strategies, integrated care pathways, and a shift toward more inclusive, patient-centered care models. Addressing these discursive barriers is crucial for achieving more effective, integrated, and patient-centered care, ultimately improving outcomes for patients.