Interagency collaboration in primary mental health care: lessons from the Partners in Recovery program

Abstract

Background Collaborative care is a means of improving outcomes particularly for people with complex needs. The Partners in Recovery (PIR) program, established in Australia in 2012, provides care coordination to facilitate access to health and social support services for people with severe and persistent mental illness. Of the 48 PIR programs across Australia, 35 were led by Medicare Locals, the previous Australian regional primary health care organisation and nine involved Medicare Locals as partner organisations. Aims To identify features which enabled and hindered collaboration in PIR programs involving Medicare Locals and determine what can be learnt about delivering care to this population. Methods Data were collected from 50 interviews with senior staff at Medicare Locals and from eight focus groups with 51 mental health stakeholders in different Australian jurisdictions. Results Successful PIR programs were based upon effective collaboration. Collaboration was facilitated by dedicated funding, a shared understanding of PIR aims, joint planning, effective network management, mutual respect and effective communication. Collaboration was also enhanced by the local knowledge and population health planning functions of Medicare Locals. Jurisdictional boundaries and funding discontinuity were the primary barriers to collaboration.

The impact of a needs‐based model of care on accessibility and quality of care within children's mental health services: A qualitative investigation of the UK i‐THRIVE Programme

“…The use of signposting to redirect CYP referred into CAMHS to services that would better meet their needs was seen by participants as more equitable, and increased CYP and their families' awareness of other sources of support. This finding is consistent with literature highlighting the use of information sharing and mapping in increasing service visibility (Champine et al, 2019; Henderson et al, 2019).…”

“…In the current study, projects focused on multi‐agency working were seen by some CAMHS staff to be met by resistance from other sectors and to inhibit programme impact. This finding is consistent with existing literature that highlights the challenges of promoting cross‐collaboration, in particular, if there is an absence of shared protocols, joint leadership and when change is perceived to be forced upon staff by outside agencies (Auschra, 2018; Cooper et al, 2016; Henderson et al, 2019). In the present study, the i‐THRIVE programme was perceived as a CAMHS‐focused transformation and CAMHS staff felt they had limited ability to influence other sectors towards a THRIVE‐like approach.…”

Responding to Complexity in the Context of the National Disability Insurance Scheme

“…For example, PIR funded support facilitators, who worked directly with clients to identify their needs and broker required services, but also formed relationships within the broader service sector including through participation in existing inter-organisational forums and developing local ad hoc networks (Smith-Merry et al, 2015). Furthermore, PIR also had provision for a dedicated coordination 'boundary spanner' (Brophy et al, 2014) or network manager (Henderson et al, 2019) role separate from the support facilitator. This role was aligned with the need to generate system level change and was a key feature of the success of PIR.…”

“…Under the funding model of PIR, involvement in the consortium enabled access to flexible funding for the support of clients and broader systems capacity building (Hancock et al, 2016). This funding was central to successful collaboration (Henderson et al, 2019). However, within the personalisation framework of the NDIS, there is little specific funding for collaboration: as collaboration is not funded under client NDIS plans.…”

Interdisciplinary behavioral health provider perceptions of implementing the Collaborative Chronic Care Model: an i-PARIHS-guided qualitative study

“…Third, we found that relationships with external services in the community (e.g., homelessness programs) were considered to be a helpful context for providing comprehensive care. Services needed by individuals with mental illness are often not limited to mental health care and rather include a range of other health and social supports that are essential for their well-being [ 31 – 33 ]. These supports may include housing, employment, or legal services [ 34 ], which may be available within (e.g., [ 35 , 36 ]) or outside of VA.…”