Addressing organizational barriers to continuity of care in the Danish mental health system - a comparative analysis of 14 national intervention projects

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Resumé

BACKGROUND: Continuity of mental health care is central to improve the conditions of people with enduring mental disorders. In Denmark, several government-funded projects on the improvement of continuity of mental health care have been initiated since 2009.

AIM: The aim of this study was to investigate how national intervention projects on continuity of mental health care have addressed major barriers for continuity of care and extract general learning points from the projects on the improvement of continuity of care.

METHOD: The study was designed as a thematic document analysis of external evaluations of 14 major national projects on the improvement of continuity of routine mental health care from 2009 to 2017. The data material was processed through thematic coding and comparative analysis.

RESULTS: The analysis was organized around four main barriers for continuity: Lack of models for collaboration, different professional cultures and methods, lack of channels of communication, and intersectoral differences in management, economy, and legislation. The first three barriers were addressed in a predominant part of the projects through development of collaborative models, common tools and communication systems. The latter structural barrier was not addressed in any of the projects.

CONCLUSION: There is an ongoing need to address barriers for continuity of mental health care. So far, there has been a much larger focus on organizational, cultural and communicational aspects of continuity than on structural aspects. The study calls for an increased focus on how changes in existing managerial, economic and legislative structures can improve continuity of care.

OriginalsprogEngelsk
TidsskriftNordic Journal of Psychiatry
Vol/bind73
Udgave nummer1
Sider (fra-til)36-43
ISSN0803-9488
DOI
StatusUdgivet - 2019

Fingeraftryk

Mental Health
Delivery of Health Care
Communication
Denmark
Legislation

Citer dette

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title = "Addressing organizational barriers to continuity of care in the Danish mental health system - a comparative analysis of 14 national intervention projects",
abstract = "BACKGROUND: Continuity of mental health care is central to improve the conditions of people with enduring mental disorders. In Denmark, several government-funded projects on the improvement of continuity of mental health care have been initiated since 2009.AIM: The aim of this study was to investigate how national intervention projects on continuity of mental health care have addressed major barriers for continuity of care and extract general learning points from the projects on the improvement of continuity of care.METHOD: The study was designed as a thematic document analysis of external evaluations of 14 major national projects on the improvement of continuity of routine mental health care from 2009 to 2017. The data material was processed through thematic coding and comparative analysis.RESULTS: The analysis was organized around four main barriers for continuity: Lack of models for collaboration, different professional cultures and methods, lack of channels of communication, and intersectoral differences in management, economy, and legislation. The first three barriers were addressed in a predominant part of the projects through development of collaborative models, common tools and communication systems. The latter structural barrier was not addressed in any of the projects.CONCLUSION: There is an ongoing need to address barriers for continuity of mental health care. So far, there has been a much larger focus on organizational, cultural and communicational aspects of continuity than on structural aspects. The study calls for an increased focus on how changes in existing managerial, economic and legislative structures can improve continuity of care.",
keywords = "Continuity of care, intersectoral collaboration, mental health care, mental health rehabilitation, psychiatry, Health Services Accessibility/organization & administration, Humans, Intersectoral Collaboration, Mental Disorders/therapy, Continuity of Patient Care/organization & administration, Organizational Culture, Adolescent, Denmark, Adult, Mental Health Services/organization & administration, Child, Communication",
author = "Kristensen, {Mette Marie} and S{\o}lvh{\o}j, {Ida Nielsen} and Kusier, {Amalie Oxholm} and Folker, {Anna Paldam}",
year = "2019",
doi = "10.1080/08039488.2018.1551929",
language = "English",
volume = "73",
pages = "36--43",
journal = "Nordic Journal of Psychiatry",
issn = "0803-9488",
publisher = "Taylor & Francis",
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TY - JOUR

T1 - Addressing organizational barriers to continuity of care in the Danish mental health system - a comparative analysis of 14 national intervention projects

AU - Kristensen, Mette Marie

AU - Sølvhøj, Ida Nielsen

AU - Kusier, Amalie Oxholm

AU - Folker, Anna Paldam

PY - 2019

Y1 - 2019

N2 - BACKGROUND: Continuity of mental health care is central to improve the conditions of people with enduring mental disorders. In Denmark, several government-funded projects on the improvement of continuity of mental health care have been initiated since 2009.AIM: The aim of this study was to investigate how national intervention projects on continuity of mental health care have addressed major barriers for continuity of care and extract general learning points from the projects on the improvement of continuity of care.METHOD: The study was designed as a thematic document analysis of external evaluations of 14 major national projects on the improvement of continuity of routine mental health care from 2009 to 2017. The data material was processed through thematic coding and comparative analysis.RESULTS: The analysis was organized around four main barriers for continuity: Lack of models for collaboration, different professional cultures and methods, lack of channels of communication, and intersectoral differences in management, economy, and legislation. The first three barriers were addressed in a predominant part of the projects through development of collaborative models, common tools and communication systems. The latter structural barrier was not addressed in any of the projects.CONCLUSION: There is an ongoing need to address barriers for continuity of mental health care. So far, there has been a much larger focus on organizational, cultural and communicational aspects of continuity than on structural aspects. The study calls for an increased focus on how changes in existing managerial, economic and legislative structures can improve continuity of care.

AB - BACKGROUND: Continuity of mental health care is central to improve the conditions of people with enduring mental disorders. In Denmark, several government-funded projects on the improvement of continuity of mental health care have been initiated since 2009.AIM: The aim of this study was to investigate how national intervention projects on continuity of mental health care have addressed major barriers for continuity of care and extract general learning points from the projects on the improvement of continuity of care.METHOD: The study was designed as a thematic document analysis of external evaluations of 14 major national projects on the improvement of continuity of routine mental health care from 2009 to 2017. The data material was processed through thematic coding and comparative analysis.RESULTS: The analysis was organized around four main barriers for continuity: Lack of models for collaboration, different professional cultures and methods, lack of channels of communication, and intersectoral differences in management, economy, and legislation. The first three barriers were addressed in a predominant part of the projects through development of collaborative models, common tools and communication systems. The latter structural barrier was not addressed in any of the projects.CONCLUSION: There is an ongoing need to address barriers for continuity of mental health care. So far, there has been a much larger focus on organizational, cultural and communicational aspects of continuity than on structural aspects. The study calls for an increased focus on how changes in existing managerial, economic and legislative structures can improve continuity of care.

KW - Continuity of care

KW - intersectoral collaboration

KW - mental health care

KW - mental health rehabilitation

KW - psychiatry

KW - Health Services Accessibility/organization & administration

KW - Humans

KW - Intersectoral Collaboration

KW - Mental Disorders/therapy

KW - Continuity of Patient Care/organization & administration

KW - Organizational Culture

KW - Adolescent

KW - Denmark

KW - Adult

KW - Mental Health Services/organization & administration

KW - Child

KW - Communication

U2 - 10.1080/08039488.2018.1551929

DO - 10.1080/08039488.2018.1551929

M3 - Journal article

VL - 73

SP - 36

EP - 43

JO - Nordic Journal of Psychiatry

JF - Nordic Journal of Psychiatry

SN - 0803-9488

IS - 1

ER -