Collaboration for drug prevention: Is it possible in a “siloed” governmental structure?

Abstract

Summary Purpose Norwegian municipalities report that drug misuse is the most important public health challenge. The municipalities play a unique role in drug prevention aimed at youth, since young people rely on several services in their daily lives that are organized by different municipal departments. However, the municipal structure is described as siloed, and the policy areas as differentiated. This situation has led to a need for integration between different policy sectors to prevent drug use and promote health. The following study explores how policymakers describe the structures for integration within local government in practice with regard to drug prevention aimed at youth, contributing to the ongoing debate on collaboration and integration in response to public health challenges. Methods A single case study design was used to investigate the accounts of policymakers from different municipal departments in a Norwegian municipality following Axelsson and Axelsson's conceptual scheme of integration. Findings Collaboration between departments was viewed as important to successfully address drug prevention; however, the policymakers recognized problems with integration. The participants described confusion regarding ownership between the departments and a perceived lack of a mandate for collaboration. Conclusions The findings and discussion illustrate that integration of drug prevention in a siloed structure relies on departments appreciating their respective roles in drug prevention and advisers experiencing a mandate to manage the siloes that exist in the organization. By gaining a better understanding of the siloed structures, we can provide valuable information needed to navigate them.

“At the end of the day, it is Council’s decision”: Integration of health and equity into urban design and urban planning decisions and policies in Regina Saskatchewan

“…For instance, Williams et al ( 2023) not only argued that an intersectional lens should be applied in urban planning for health equity, but also outlined four strategies for accomplishing this: challenging assumptions, fostering cross-sectoral collaboration, co-designing strategies, and looking to established tools and resources. 62 Also, in a case study of a Norwegian city, Oldeide et al 63 identified siloing as one of the biggest hurdles to successfully managing youth drug prevention. Siloing often created confusion regarding the jurisdictional ownership of drug prevention mandates, resulting in uncertainty over which departments are and are not responsible for addressing youth drug prevention.…”

“…Siloing often created confusion regarding the jurisdictional ownership of drug prevention mandates, resulting in uncertainty over which departments are and are not responsible for addressing youth drug prevention. 63 This was exacerbated by the lack of meaningful opportunities for cross-sectoral collaboration, preventing policy-makers from different departments from effectively pooling together their knowledge and resources. 63 Lowe et al (2022) similarly acknowledged the limitations posed by siloing in municipal policy-and decision-making, stating that the creation of healthy and sustainable cities could not occur without integrated urban planning.…”

“…63 This was exacerbated by the lack of meaningful opportunities for cross-sectoral collaboration, preventing policy-makers from different departments from effectively pooling together their knowledge and resources. 63 Lowe et al (2022) similarly acknowledged the limitations posed by siloing in municipal policy-and decision-making, stating that the creation of healthy and sustainable cities could not occur without integrated urban planning. They argued that this integration must occur both vertically -between different levels of government -and horizontally -between different organizations at the same level of government.…”

Local drug prevention strategies through the eyes of policy makers and outreach social workers in Norway

“…This perceived lack of collaboration may potentially lead to fragmented services as a result of an unclear mandate for collaboration throughout the municipal organisation. Previous research has highlighted the importance of advisers receiving a clear mandate to collaborate in order to effectively address drug prevention in a siloed governmental structure (Oldeide, Fosse, & Holsen, 2019).…”

Lessons Learned from an Intersectoral Collaboration between the Public Sector, NGOs, and Sports Clubs to Meet the Needs of Vulnerable Youths

“…Most of the research literature on local health promotion and collaboration has been devoted to describing how municipalities face the challenges associated with intersectoral collaboration [10][11][12][13][14]. Previous research has demonstrated that the sports sector has successfully been used as a tool for promoting health through reaching vulnerable groups, creating social inclusion, integrating refugees, preventing crime, and addressing other complex public health challenges [15][16][17][18].…”