Addressing organizational barriers to continuity of care in the Danish mental health system – a comparative analysis of 14 national intervention projects

Kristensen, Mette Marie; Sølvhøj, Ida Nielsen; Kusier, Amalie Oxholm; Folker, Anna Paldam

doi:10.1080/08039488.2018.1551929

Cited by 9 publications

(6 citation statements)

References 22 publications

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“…Several policy programs and new upcoming laws in the Netherlands will hopefully solve several of these problems. Although we specifically investigated the Dutch situation, the results seem in line with the scarce international literature (Haggerty et al, 2003;Kristensen et al, 2019;Nurjannah et al, 2013) and can possibly guide interventions or research on this topic internationally.…”

Section: Discussionsupporting

confidence: 70%

Improving continuity of forensic mental health care

Vogel

Schaftenaar²,

Clercx³

2019

JFP

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Purpose Continuity of forensic mental health care is important in building protective structures around a patient and has been shown to decrease risks of relapse. Realising continuity can be complicated due to restrictions from finances or legislation and difficulties in collaboration between settings. In the Netherlands, several programs have been developed to improve continuity of forensic care. It is unknown whether professionals and clients are sufficiently aware of these programs. The paper aims to discuss this issue. Design/methodology/approach The experienced difficulties and needs of professionals and patients regarding continuity of forensic care were explored by means of an online survey and focus groups. The survey was completed by 318 professionals. Two focus groups with professionals (15 participants), one focus group and one interview with patients (six participants) were conducted. Findings The overall majority (85.6 percent) reported to experience problems in continuity on a frequent basis. The three main problems are: first, limited capacity for discharge from inpatient to outpatient or sheltered living; second, collaboration between forensic and regular mental health care; and, third, limited capacity for long-term inpatient care. Only a quarter of the participants knew the existing programs. Actual implementation of these programs was even lower (3.9 percent). The top three of professionals’ needs are: better collaboration; higher capacity; more knowledge about rules and regulation. Participants of the focus groups emphasized the importance of transparent communication, timely discharge planning and education. Practical implications Gathering best practices about regional collaboration networks and developing a blueprint based on the best practices could be helpful in improving collaboration between setting in the forensic field. In addition, more use of systematic discharge planning is needed to improve continuity in forensic mental health care. It is important to communicate in an honest, transparent way to clients about their forensic mental health trajectories, even if there are setbacks or delays. More emphasis needs to be placed on communicating and implementing policy programs in daily practice and more education about legislation is needed Structured evaluations of programs aiming to improve continuity of forensic mental health care are highly needed. Originality/value Policy programs hardly reach professionals. Professionals see improvements in collaboration as top priority. Patients emphasize the human approach and transparent communication.

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Section: Discussionsupporting

confidence: 70%

Improving continuity of forensic mental health care

Vogel

Schaftenaar²,

Clercx³

2019

JFP

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“…Second, the (institutional) environment of networks is mentioned in ten articles (see Table 2 ). Networks experienced legislative or regulatory barriers such as delayed state approval for the network’s health plan ( Conrad et al, 2003 ) or different legislations and regulations across sectors, inhibiting collaboration, data sharing, and integrated initiatives ( Kristensen et al, 2019 ; Sharek et al, 2007 ). In addition, members in networks may cover different geographical areas and, as such, serve different populations, creating problems in implementing initiatives ( Harlock et al, 2020 ).…”

Section: Resultsmentioning

confidence: 99%

So Happy Together: A Review of the Literature on the Determinants of Effectiveness of Purpose-Oriented Networks in Health Care

et al. 2022

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While purpose-oriented networks are widely recognized as organizational forms to address wicked problems in health care such as increasing demands and expenditure, the associated literature is fragmented. We therefore reviewed empirical studies to identify the determinants of the effectiveness of these networks. Our search yielded 3,657 unique articles, of which 19 met our eligibility criteria. After backward snowballing and expert consultation, 33 articles were included. Results reveal no less than 283 determinants of effective health care networks. The majority of these determinants are processual and involving professionals from the operational level is particularly salient. In addition, most studies relate determinants to process outcomes (e.g., improved collaboration or sustainability of the network) and only a few to members’ perception of whether the network attains its goals. We urge future research to adopt configurational approaches to identify which sets of determinants are associated with networks’ ability to attain their goal of addressing wicked problems.

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“…The study was part of a larger study, which also included a thematic document analysis of external evaluations of 14 national projects on the improvement of continuity of routine mental health care in Denmark from 2009 to 2017. The results of this study will be published elsewhere (Kristensen et al, 2019).…”

Section: Methodsmentioning

confidence: 99%

“…A Danish structural reform in 2007 has resulted in the current centralization of specialized treatment in a few highly specialized psychiatric hospitals, a significant decline in hospital admission duration, and a decentralization of outpatient treatment into community mental health care divided between regional services focusing on medical and therapeutic treatment and municipal rehabilitation services focusing on social support and employment-centered initiatives (Kristensen, Sølvhøj, Kusier, & Folker, 2019). While the aim of the reform was to clarify the responsibility between sectors, it has, at the same time, made it difficult to navigate the system and increased the need to ensure continuity of care across sectors and professional disciplines (Kristensen et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

Exploring Perceptions of Continuity of Care Among People With Long-Term Mental Disorders in Denmark

et al. 2019

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Continuity of mental health care is central to improve the treatment and rehabilitation of people with mental disorders. While most studies on continuity of care fail to take the perspectives of service users into account, the aim of this study was to explore the perceived meanings of continuity of care among people with long-term mental disorders. Fifteen service users participated in semi-structured in-depth interviews. We used template analysis to guide the analysis. The main transversal themes of continuity were “Navigating the system” and “Connecting to people and everyday life.” While the first theme related to the participants’ experiences of their interaction with the mental health care system, the latter related to their hopes and perceived opportunities for a good life as desired outcomes of mental health care. We conclude that efforts to improve continuity of mental health care should be tailored to the priorities of service users.

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Addressing organizational barriers to continuity of care in the Danish mental health system – a comparative analysis of 14 national intervention projects

Cited by 9 publications

References 22 publications

Improving continuity of forensic mental health care

Improving continuity of forensic mental health care

So Happy Together: A Review of the Literature on the Determinants of Effectiveness of Purpose-Oriented Networks in Health Care

Exploring Perceptions of Continuity of Care Among People With Long-Term Mental Disorders in Denmark

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