Care coordination for persons with mental health challenges: a scoping review.

Abstract

Background: Care coordination is commonly employed to assist individuals with mental health challenges [MHCs]. However, its implementation in mental health contexts is inconsistent. The term, 'care coordination' is also used interchangeably with integrated care and case management. This review aims to (1) consolidate the literature on how, and in what contexts, care coordination has been used to help adults with MHCs access care from more than one service and (2) describe the challenges and benefits of implementing care coordination for adults with MHCs from the perspective of service providers, care coordinators and service users.

Methods: This is a scoping review that adopted methodological aspects of Arksey and O'Malley and those proposed by the Joanna Briggs Institute.

Results: Care coordination has been employed in a range of clinical and non-clinical settings. Eligibility for care coordination was predominantly restricted to individuals at high risk of deterioration or those unable to access multiple services independently. Care coordinators worked individually or as part of a team and were mostly mental health nurses or social workers. Care coordination was reported to include both clinical and non-clinical tasks. Clinical tasks included medication management, preparing coordinated treatment plans and implementing crisis triage. Non-clinical tasks included acceptance of referrals, identification of service user needs, developing a plan for service involvement, implementation of the said plan, and monitoring of outcomes. Benefits of care coordination included improved access to services, reduced consumer distress, and self-harming behaviour, a team approach to care, decrease in psychiatric hospitalisations, emergency room visits and arrests, and better interservice collaboration. Challenges to care coordination included continuing unmet needs, lack of service availability and health insurance, unclear processes causing confusion, difficulties in engaging with some service users, administrative complications, large consumer load and staff shortages, incompatibility of technology between systems, insufficient funding and limited community support agencies.

Conclusion: A better understanding of care coordination is needed that includes indications, eligibility criteria, coordination tasks, expected outcomes, as well as organizational and service system requirements.