Improving Collaboration Between Primary and Secondary Mental Healthcare via Boundary Spanning: Evaluation of a New Joined-Up Community Mental Healthcare Model in England.
Lida Efstathopoulou, Jules Mackenzie, Rory Cameron, Adam P Wagner, Julia Jones, Jesus Perez
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Abstract
Objectives: Community mental healthcare requires the collaboration of multiple services to meet the needs of local populations. Accessing mental health care in England often involves the collaboration of primary and secondary healthcare services. This paper presents the findings from an evaluation of 'boundary spanning' processes and practitioner roles aiming to reduce service fragmentation and improve access to mental healthcare.
Methods: Forty-one qualitative interviews with professionals across local healthcare providers were conducted in Peterborough (East England) to assess the impact of boundary spanning processes and practitioner roles and were analysed thematically.
Results: Structured boundary spanning processes and professional roles were found to facilitate communication and knowledge exchange between primary and secondary mental healthcare services, leading to optimisation of GPs' decisions about individuals' treatment pathways, and to improvements in service accessibility. Yet, effectiveness was reported as conditional on GPs' engagement, as well as the decentralised structure of primary care settings.
Conclusion: Community mental healthcare organisations could utilise boundary spanning interventions to flex organisational barriers between primary and mental healthcare and optimise accessibility of service users to mental health services. Boundary spanning processes and professional roles can be used to inform national and local care integration strategies.
期刊介绍：
Policy making and implementation, planning and management are widely recognized as central to effective health systems and services and to better health. Globalization, and the economic circumstances facing groups of countries worldwide, meanwhile present a great challenge for health planning and management. The aim of this quarterly journal is to offer a forum for publications which direct attention to major issues in health policy, planning and management. The intention is to maintain a balance between theory and practice, from a variety of disciplines, fields and perspectives. The Journal is explicitly international and multidisciplinary in scope and appeal: articles about policy, planning and management in countries at various stages of political, social, cultural and economic development are welcomed, as are those directed at the different levels (national, regional, local) of the health sector. Manuscripts are invited from a spectrum of different disciplines e.g., (the social sciences, management and medicine) as long as they advance our knowledge and understanding of the health sector. The Journal is therefore global, and eclectic.
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