Managers' experiences of collaboration and individual participation in integrated healthcare and social services for adults with complex needs: a focus group study.

Abstract

Background: Adults with long-term mental, cognitive, and physical conditions experience a substantial disease burden and have complex health needs. The co-occurrence of mental health problems, substance use, and social vulnerabilities further underscores the need for integrated and coordinated healthcare and social services. Such integration requires close collaboration among involved actors; however, this is often constrained by legislative barriers and challenges in coordinating complex care. Coordination adapted to complexity, individualised care planning, and interprofessional collaboration depend on effective leadership and governance to support the development and sustainability of integrated care. Therefore, this study aimed to explore managers' experiences of facilitators and barriers to collaboration and individual participation in managing healthcare and social services for adults with complex needs.

Methods: A descriptive qualitative design was employed using three focus group interviews with a total of 13 participants to explore managers' experiences. Data were analysed using qualitative content analysis.

Results: The analysis resulted in three categories: (1) organisational prerequisites for the sustainable improvement of integrated care, (2) prerequisites for interprofessional collaboration in addressing individuals' needs, and (3) supporting individual change through relational and needs-based approaches. These categories included eight subcategories.

Conclusions: Interprofessional collaboration in the care of adults with complex needs is influenced by relational, structural, and contextual factors. Although managers express awareness of and ambition towards person-centred and integrated care, a gap remains between intention and implementation. Addressing this gap may require strengthening trust, clarifying structures and governance, and supporting organisational continuity to enhance sustainable collaboration and individual participation.