There is scarce research studying healthcare professionals’ and users’ perceptions in relation to creating coherence in intersectoral collaboration between psychiatric centres and community mental healthcare. Drawing on the discourse analysis framework of Fairclough, this study aimed to explore how healthcare professionals and users could perceive coherence in intersectoral collaboration between psychiatric centres and community mental healthcare. But also to explore their perception of how coherence could be maintained through an intersectoral journey, and what discourses manifested themselves within the field of mental healthcare. Data were collected through 11 focus group interviews, five of which with healthcare professionals ( n = 20) and six with users ( n = 18). Fairclough’s three-dimensional model for the studying of discourse was used to analyse the transcribed texts. This study is reported in accordance with the COREQ checklist. Coherence in intersectoral collaboration was interpreted to exist in tension between being predominantly steered by the healthcare professionals while the users had a desire to be more involved in decisions regarding their own intersectoral journey. The users were subjected to a paternalistic steering, expressed by the power of the healthcare professionals to select the right efforts as well as the purpose of the users’ journeys. The findings showed that coherence in intersectoral collaboration in general was articulated from an overall discourse of neoliberal governance, with its embedded discourses of rationality and structure, and discourses of linearity, objectivity, paternalism, biomedicine and evidence have a controlling influence on how users should guide themselves based on the discourse of self-care.

Aim: To investigate how differences in types of professions and rationalities affect the management of inter-sectoral trajectories in psychiatric health care in the Capital Region of Denmark. Background: Some psychiatry users experience a lack of coherence between the mental health care treatment provided at hospitals and run by the regions, and that provided at residential psychiatric units run by municipalities. The literature points to various challenges in this field of research, related to transitions that need rethinking and further examination. Method: The approach is an eclectic use of theory and methods in a theory-governed analysis of empirical data built up from focus group interviews with professionals in mental health care centres and social psychiatric residencies. We classify the positions from the data using a theoretical framework based on Max Weber's theory of ideal types and from Pierre Bourdieu's concept of habitus. Our analysis outlines a theory about the practice of transitions in inter-sectoral trajectories in psychiatric health care.  Results: From the empirical material, we were able to construct different professional ideal types related to mental health care psychiatry and social psychiatry. The construction points to differences in the habitual basis of action that maintains institutional distinctions. Discussion: Differences in ideal types are connected to the prevailing positions of the two sectors, in which management in health care centres follows a dominant medical rationality, and management in residencies draws on a social and social educational legitimacy. Conclusion: We find differences between the rationalities and habitus of staff at regional hospitals and municipal residencies that enable us to explain how management contributes to trajectories in psychiatric health care. Choices concerning trajectory transitions relate to a combination of habitual professional inclinations and the management of trajectories streamlined through illness classification based on a neoliberal governance model. Future management must be aware of the different rationalities linked to professional and institutional logics when planning; and this requires reflexivity and awareness of the management of intersectoral collaboration.

This paper explores healthcare professionals’ and users’ experience of coherent intersectoral care between hospital mental healthcare and community mental healthcare. A total of 20 healthcare professionals, primarily nurses, and 14 users with a range of mental illnesses participated in nine focus group interviews (FGIs). Participants were encouraged in the FGIs to reflect upon their experience of coherency in intersectoral care. The analysis of FGIs was informed by a phenomenological-hermeneutic approach in a research group from 2016–2019. The Consolidated Criteria for Reporting Qualitative Research checklist was used as a guideline to ensure complete and accurate reporting of the study. The analysis led to the generation of several themes from a professional perspective and from a user perspective, addressed barriers to coherent intersectoral care. The healthcare professionals experienced barriers such as a lack of common language and knowledge of partners. The users did not feel involved and lacked coherence in their recovery processes and, as such, intersectoral care was often experienced as being lost in a maze.