Searby Adam, Burr Dianna, Carolin Renae, Hutchinson Alison
Monash University School of Nursing and Midwifery, Melbourne, Australia.
Centre for Quality and Patient Safety Research, School of Nursing and Midwifery, Deakin University, Geelong, Australia.
Int J Ment Health Nurs. 2025 Feb;34(1):e13449. doi: 10.1111/inm.13449. Epub 2024 Oct 9.
Mental health service integration currently has no consensus definition and exists in a variety of settings, including primary care, addiction treatment and chronic disease management, and mental health nurses have often experienced efforts at service integration with varying degrees of success. The intent of mental health service integration is to enable collaboration between mental health services and other healthcare providers to improve service access and the care provided to individuals with mental health issues or mental illness. This scoping review aimed to explore service integration between mental health services and with a specific focus on those evaluated in peer-reviewed, primary literature, to determine facilitators and barriers to service integration. Using the Arksey and O'Malley's framework for scoping reviews, we located 3148 studies, with screening narrowing final papers for inclusion to 18. Facilitators to service integration included clinician education, adequate resourcing and an interdisciplinary approach, while barriers included staff factors such as a reluctance to work with individuals with mental illness, consumer level barriers such as poor mental health literacy, 'territorialism' among staff and organisational climate. Research indicates that service integration is an effective means to detect and treat mental health issues in settings that do not traditionally provide mental health care, lowering the costs of providing healthcare and providing improved care for mental health needs; however, there are several barriers to be addressed to achieve full implementation of integration models.
目前，心理健康服务整合尚无统一的定义，且存在于多种环境中，包括初级保健、成瘾治疗和慢性病管理，心理健康护士在服务整合方面常常经历过不同程度的成功尝试。心理健康服务整合的目的是促使心理健康服务机构与其他医疗服务提供者开展合作，以改善心理健康问题或精神疾病患者的服务可及性及所提供的护理。本范围综述旨在探讨心理健康服务之间的服务整合，尤其关注同行评审的原始文献中所评估的整合情况，以确定服务整合的促进因素和障碍。利用阿克斯和奥马利的范围综述框架，我们找到了3148项研究，经筛选后最终纳入的论文缩减至18篇。服务整合的促进因素包括临床医生教育、充足的资源配置和跨学科方法，而障碍包括工作人员因素，如不愿与精神疾病患者合作、消费者层面的障碍，如心理健康素养低、工作人员中的“地盘主义”以及组织氛围等。研究表明，服务整合是在传统上不提供心理健康护理的环境中发现和治疗心理健康问题的有效手段，可降低医疗保健成本，并改善对心理健康需求的护理；然而，要全面实施整合模式，还需克服若干障碍。
