https://orcid.org/0000-0003-1760-9130
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ABSTRACT
Integrated treatment is recommended for users with a comorbidity of mental illness and substance misuse. However, due to a divided support system, coordinated individual care planning (CIP) and user participation are emphasised to provide users with the necessary support. One way of increasing user participation is through shared decision making. However, the challenges are evident why coordination and user participation are not used in practice as intended. To contribute with knowledge to bridge the gap between the intended CIP process and practice, this study examined the problems and solutions perceived by staff. Future workshops were conducted with 17 staff members from social services and health care. Problems and solutions were identified within three main areas: organisation and staff knowledge, coordination among staff, and staff attitudes and user participation. The problems are in agreement with previous research, but this study contributes with knowledge regarding solutions. Overall, the solutions expressed relate to improving collaboration between providers and users and having more resources to conduct this work. However, the study also assents to the question if CIP is the best way to coordinate support or if integrated treatment should be the future.
ABSTRAKT
Samordnad behandling rekommenderas för brukare med psykisk sjukdom och missbruk. Men med det fragmentiserade vård- och stödsystem som erbjuds personer med samsjuklighet betonas en samordnad individuell vårdplanering (SIP) där brukaren själv medverkar för att erhålla nödvändigt stöd. Ett sätt att öka brukarmedverkan är genom delat beslutsfattande. Utmaningarna att förverkliga intentionerna om samordning av vård och stöd, samt att realisera brukarmedverkan i praktiken är dock väldokumenterat. För att bidra med kunskap om hur denna klyfta mellan intentioner och praktik kan överbryggas undersökte denna studie de problem och lösningar som personalen uppfattar. Framtidsverkstäder genomfördes med 17 anställda från socialtjänsten och hälso- och sjukvården. Problem och lösningar identifierades inom tre huvudområden: organisation och personalkunskap, samordning mellan personal och personalens attityder, samt brukarmedverkan. Resultaten identifierar problem som överensstämmer med tidigare forskning, men denna studie bidrar också med kunskap om lösningar till dessa problem. Lösningarna handlar om sätt att förbättra samarbetet mellan personal och brukare, samt resurser och förutsättningar för att genomföra detta arbete.
Acknowledgements
We are deeply grateful to all the staff for their time and commitment during the workshops and for sharing their indispensable knowledge and experiences.
Disclosure statement
No potential conflict of interest was reported by the author(s).
Additional information
Funding
Notes on contributors
Amanda Jones
Amanda Jones is a social worker and PhD-student in health and welfare. Her research interest regards users with a comorbidity of substance use and mental illness/neuropsychiatric disorders, and participation in social work encounters.
Ola Knutsson
Ola Knutsson has a Ph.D. in Human–Computer Interaction and is Associate Professor at Stockholm University. His research focuses on participatory design of learning and work environments, the use of design patterns, and research on digital literacy.
Ulla-Karin Schön
Ulla-Karin Schön is a social worker and Professor in social work. Her research interest lie in the field of disability, especially disabled people’s opportunities to participate in social life, in meetings with social services and health care, and in education.