Coordination in networks for improved mental health service.

INTRODUCTION

Well-organised clinical cooperation between health and social services has been difficult to achieve in Sweden as in other countries. This paper presents an empirical study of a mental health coordination network in one area in Stockholm. The aim was to describe the development and nature of coordination within a mental health and social care consortium and to assess the impact on care processes and client outcomes.

METHOD

Data was gathered through interviews with 'joint coordinators' (n=6) from three rehabilitation units. The interviews focused on coordination activities aimed at supporting the clients' needs and investigated how the joint coordinators acted according to the consortium's holistic approach. Data on The Camberwell Assessment of Need (CAN-S) showing clients' satisfaction was used to assess on set of outcomes (n=1262).

RESULTS

The findings revealed different coordination activities and factors both helping and hindering the network coordination activities. One helpful factor was the history of local and personal informal cooperation and shared responsibilities evident. Unclear roles and routines hindered cooperation.

CONCLUSIONS

This contribution is an empirical example and a model for organisations establishing structures for network coordination. One lesson for current policy about integrated health care is to adapt and implement joint coordinators where full structural integration is not possible. Another lesson, based on the idea of patient quality by coordinated care, is specifically to adapt the work of the local addiction treatment and preventive team (ATPT)-an independent special team in the psychiatric outpatient care that provides consultation and support to the units and serves psychotic clients with addictive problems.