Key dimensions of collaboration quality in mental health care service networks

ABSTRACT

Appropriate care delivery for patients with severe mental illness (SMI) requires a high level of collaboration quality between primary, mental health, and social care services. Few studies have addressed the interpersonal and inter-organizational components of collaboration within one unique study setting and it is unclear how these components contribute to overall collaboration quality. Using a comprehensive model that includes ten key indicators of collaboration in relation to both components, we evaluated how interpersonal and inter-organizational collaboration quality were associated in 19 networks that included 994 services across Belgium. Interpersonal collaboration was significantly higher than inter-organizational collaboration. Despite the internal consistency of the model, analysis showed that respondents perceived a conflict between client-centered care and leadership in the network. Our results reveal two approaches to collaborative service networks, one relying on interpersonal interactions and driven by client needs and another based on formalization and driven by governance procedures. The results reflect a lack of strategy on the part of network leaders for supporting client-centered care and hence, the persistence of the high level of fragmentation that networks were expected to address. Policy-makers should pay more attention to network formalization and governance mechanisms with a view to achieving effective client-centered outcomes.

KEYWORDS:

• Health care reform
• mental health services
• intersectoral collaboration
• deinstitutionalization
• delivery of health care
• integrated
• community health networks

Availability of data

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to the possibility of identifying specific services in small networks.

Declaration of interest

None

Ethics approval

The research protocol was reviewed and approved by the “Commissie Medische Ethiek” Ethical Committee, KULeuven, Leuven, Belgium, 12 October 2012, reference number B322201215206.

Additional information

Funding

The research was funded by a grant from the Federal Ministry of Health, Food Chain and Environment, 2011–2015;Belgian Federal Ministry of Health, Food Chain and Environment.

Notes on contributors

Pablo Nicaise

Pablo Nicaise,PhD in public health science, Qualified Researcher, Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium.

Adeline Grard

Adeline Grardis a PhD Student in public health science, Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium.

Mark Leys

Mark Leys is a Head of the Organization Policy and Inequalities in Health research group, Vrije Universiteit Brussel, Brussels, Belgium.

Chantal Van Audenhove

Chantal Van Audenhove  is a Head of LUCAS, Centre for Care Research and Consultancy, Katholiek Universiteit Leuven, Leuven, Belgium.

Vincent Lorant

Vincent Lorant is a Professor of Medical Sociology, Institute of Health and Society (IRSS), Université catholique de Louvain, Brussels, Belgium.