Perspectives on Coordinating Health Services for Individuals with Serious Mental Illness – A Qualitative Study

Abstract

Purpose

Individuals with serious mental illness (SMI) might require coordinated health services to meet their healthcare needs. The overall aim of this study was to describe the perspectives of professionals (registered nurses, medical doctors, social educators, and social workers) on care coordination and measures to ensure proper and coordinated follow-up of the healthcare needs of individuals with SMI. More specifically, we investigated which measures are taken by employees in municipal health and care services to prevent the deterioration of health conditions and which measures are taken in cases where deterioration occurs despite preventive efforts.

Method

The study comprised individual qualitative interviews with professionals employed in municipal health and care services in two Norwegian municipalities. The interview material was analyzed using systematic text condensation.

Results

Three categories and seven subcategories were created in the data analysis: 1) Maintain a stable and meaningful home life, including ensuring proper housing and access to services and assistance in receiving healthcare; 2) Measures to prevent deterioration of the health condition, including close monitoring of symptoms, emergency psychiatric care plans and emergency room calls and visits; and 3) Inpatient care to stabilize acute and severe symptoms, including municipal inpatient care, returning home after inpatient care and a need for shared responsibility for treatment and care.

Conclusion

Professionals employed in municipal health and care services coordinate health services to ensure proper and coordinated follow-up of the healthcare needs of individuals with SMI by ensuring housing services and access to the required healthcare. Measures taken when deterioration occurs include monitoring symptoms, use of emergency psychiatric care plans, emergency room contacts, or inpatient care.

Keywords:

• care coordination
• service integration
• qualitative interviews
• chronic medical condition
• physical health

Authors’ Information

Jorunn Nærland Skjærpe is a PhD candidate in health and medicine at the University of Stavanger. Her research interests include care coordination, digital health, peer support, social innovation, and service user involvement.

Inge Joa, PhD is a researcher at TIPS –Centre for Clinical Research in Psychosis at Stavanger University Hospital. He holds an associate professor II position at the University of Stavanger. His research interests include psychosis, ultra-high risk states, early intervention, and information campaigns targeting vulnerable groups

Elisabeth Willumsen, Dr. PH is a professor emerita in social work at the University of Stavanger. Her research interests include interprofessional collaboration in health and welfare services, social innovation, and co-creation in the public sector.

Wenche ten Velden Hegelstad, PhD is a specialist in clinical psychology holding an associate professor II position at the University of Stavanger. She is a principal investigator at TIPS – Centre for Clinical Research in Psychosis at Stavanger University Hospital. Her research interests mainly focus on psychosis and ultra-high risk states, including early intervention and information campaigns.

Tatiana AleksandrovnaIakovleva, PhD holds a Professor of Entrepreneurship at Stavanger Business School, University of Stavanger. Her research interests include responsible innovation in health and welfare services, entrepreneurial intentions, gender issues in innovation management, and ethical usage of digital technology.

Marianne Storm, PhD is a professor in Health Sciences at the University of Stavanger and holds a professor II position at Molde University College. She leads the interprofessional research group PARTAKE: Participation in school, working life and treatment. Her research interests include patient participation and user involvement, care coordination, eHealth, social innovation, and health promotion.

Abbreviation

SMI, serious mental illness.

Consent for Publication

Interview participants have been shown the article content to be published. The authors are prepared to provide copies of signed consent forms to the journal editorial office if requested.

Data Sharing Statement

The interview material reported in this study is available from the corresponding author on reasonable request.

Acknowledgments

The authors thank the interview participants for their time and feedback and the municipalities for supporting the interviews. The authors would also like to thank Povl Munk-Jørgensen for his generous input and comments.

Author Contributions

All authors contributed significantly to this study, in its conception, study design, execution, data collection, or analysis and interpretation, or in all these areas. The authors took part in drafting, revising, or critically reviewing the article and gave final approval for this version to be published. The authors have agreed to submit the article to this journal and take responsibility for the content of the article.

Disclosure

The authors report no conflicts of interest in this work and declares that the study was conducted without any commercial or financial relationships that could be construed as a potential conflict of interest.

Additional information

Funding

This study was funded by the University of Stavanger, Norway.