Collective Competence as an Enabler for Service Integration in Health and Social Care Services

Figures & data

Table 1 The Municipalities from Which the Participants Were Recruited

Municipal Code	Municipal Characteristics
Municipality 1	3000 inhabitants 15 registered with concurrent mental health and substance abuse challenges Mental health and substance abuse services are organized and managed as one department
Municipality 2	30,000 inhabitants 100 registered with concurrent mental health and substance abuse challenges Mental health and substance abuse services are organized and managed as two different departments within a joint unit.
Municipality 3	52,000 inhabitants 300 registered with concurrent mental health and substance abuse challenges Mental health and substance abuse services are organized and managed as two different departments in separate units.

Table 2 Focus Group Interviews

Name of Group	Municipality	Participant Group	Number of Participants	Participant Characteristics (Gender, Age, Profession or Family Relations).
Focus group 1	Municipality 1	Service recipients	6	Male, between 40–49. Male, between 60–69. Male, between 50–59. Male between, 50–59. Male, between 60–69. Male, between 40–49.
Focus group 2	Municipality 1	Family caregivers	3	Female, between 50–59, ex-wife. Male, between 70–79, father. Female, between 70–79, mother.
Focus group 3	Municipality 1	Professionals/managers	5	Female, between 50–59, mental health nurse. Female, between 60–69, assistant nurse. Female, between 40–49, social worker. Female, between 50–59, nurse/substance abuse counsellor. Female, between 40–49, social educator.
Focus group 4	Municipality 2	Professional/managers	5	Female, between 30–39, social worker. Female, between 30–39, social worker. Female, between 50–59, assistant nurse. Male, between 20–29, social educator. Male, between 30–39, psychologist.
Focus group 5	Municipality 3	Service recipients	5	Female, between 30–39. Female, between 50–59. Male, between 30–39. Male, between 40–49. Male, between 60–69.
Focus group 6	Municipality 3	Professionals/managers	4	Male, between 40–49, mental health nurse. Female, between 20–29, psychologist. Female, between 40–49, social educator. Male, between 30–39, mental health nurse.

Table 3 Individual Telephone Interviews

Municipality	Participant Group	Number of Participants	Participant Characteristics (Gender, Age and Family Relations).
Municipality 2	Service recipients	3	Male, between 30–39. Female, between 40–49. Female, between 70–79.
Municipality 2	Family caregivers	2	Male, between 30–39, son. Female, between 60–69, mother.
Municipality 3	Family caregivers	1	Male, between 40–49, brother.

Table 4 Analysis Structure

Quotes That Support Analysis	Empirically Close Codes	Categories	Main Themes
“There is a lack of competence on addictions in mental health services” (professional).	Knowledge about substance abuse and mental health.	Human complexity competence.
“Service recipients often do not have knowledge about how to live an ordinary life. We must have information about their economic situation and living conditions” (professional).	Knowledge about social challenges.		Knowledge about individual life situations and organization and system.
“We have to see the whole person, also their physical challenges” (professional).	Knowledge about physical health.
“Also necessary is knowledge about the service recipients’ local environment and network” (family caregiver)	Knowledge about context
“I like when they show that they respect me” (service recipient).	Supportive attitudes.	Human qualities.
“In mapping we try to see the service recipient in their context, and we try to understand this context. Both the historical account and their current situation and goals are included. We let them tell their stories, and we are open to what they tell” (professional).	Listening and understanding.	Inquiry competence.	Investigation competence.
“Not everybody knows the important skill of being observant” (family caregiver).	Observation and mapping.
“The team talks with me and not about me and they involve me in the discussion. They listen to me, and we find solutions” (service recipient).	Involvement.	Empowerment Competence.
“They all have individual needs that need to be considered” (family caregiver).	Individual adjustments.
“Motivation is decisive. We can for example use motivational interviews” (professional).	Motivation.
“I need them to speak a language I can understand. Not this expert-language” (service recipient).	Understandable communication.
“I should not have to wait for months to get a substance abuse counsellor” (service recipient).	Handling waiting periods.	Resource management competence.	Person-centred collaboration competence.
“We must manage the gap between what the hospitals recommend for municipal follow-up and what we can offer (manager).	Handling hospital discharge challenges.
“Resources must be available, staff and housing. But sometimes, through collaboration, we can find solutions that otherwise would be inaccessible” (professional).	Sufficiency/robustness.
“The professionals are shaped by New Public Management thinking, which prevents us from getting attached to them” (service recipients).	Economic constraints shape the behavior of the professionals.
“One coordinator throughout the follow-up would be good. I have had to switch many times” (service recipient).	Coordination.	Organization and interaction competence.	Facilitating competence.
“This walk to Canossa is very oppressive, with many battles to fight” (service recipient”.	Continuity.
“When we do assessments, we should also discuss this inter-professionally” (professional).	Inter-professional collaboration
“Early intervention! Assess the situation and build a team around them with all relevant actors (family caregiver).	Team around service recipients.
“I think more of us would show up to meetings if there were possibilities for attending digitally” (service recipient).	Technology and information.
“Professionals should be able to think outside the box. To make things happen” (family caregiver).	Efficiency.
“Peer-expertise is as much for the professionals as it is for us” (service recipient).	Peer-expertise.
“We must talk about what we do, and there should be a mutual responsibility for health and social care professionals to guide and teach each other” (manager).	Knowledge transfer.