Perceptions towards integrated care through the narrative of practicing social workers and psychologists in PHC: a cross-case analysis

Abstract

PurposeIn a collective effort to build a patient-centered and coordinated health care system, social workers and psychologists are being progressively introduced to primary health care (PHC) settings worldwide. The present study aims to explore the current status of integration through the narrative of social workers and psychologists in PHC settings in Kazakhstan.Design/methodology/approachIn this paper purposive snowball sampling was utilized to recruit social workers and psychologists who work, or used to work, in PHC settings since the onset of integration in Nur-Sultan for participation in an in-depth interview. A semistructured interview guide was based on normalization process theory (NPT). Interviews were conducted via video conference, in Russian language, lasted no more than 50 min, and transcribed verbatim. Cross-case analysis of eight cases was performed using NPT constructs.FindingsCross-case analysis included findings from the interviews from five social workers and three psychologists. Four major constructs of implementation process from NPT were reflected in the findings: coherence (believes integration improves patient care, functions within integrated care), cognitive participation (individual changes to role performance, mechanisms of work), collective action (status of support from stakeholders, cooperation within a multidisciplinary team) and reflective monitoring (existing mechanisms for monitoring the integration).Research limitations/implicationsDespite organizational integration, there is a lack of successful clinical integration of social workers and psychologists in PHC settings of Kazakhstan, which is manifested by a lack of understanding of responsibilities and functions of these mental health care specialists. Consensus was reached by all participants that both social workers and psychologists are valuable assets in a multidisciplinary team.Originality/valueThe present study contributes to the current knowledge of integrated PHC service delivery by addressing the status of integrated care in Kazakhstan from interviews with key stakeholders in social work and mental health. Moving forward, improvements are needed to (1) establish the monitoring mechanism to evaluate the status of integration, (2) enhance effective collaboration within multidisciplinary teams in PHC settings and (3) increase awareness among medical workers and community members on mental health issues and the available support offered by social workers and psychologists to promote quality of life in a holistic, integrated manner.