Internal vs. external care management in severe mental illness: Randomized controlled trial and qualitative study

Developments In Managing Mental Health Care: A Review Of The Literature

“…This is often referred to as the brokerage model of case management where there is an absence of clinical or therapeutic intervention by the case manager. Rutter et al (2004) compared brokerage services provided by a case manager outside of (external to) the multidisciplinary team providing therapeutic interventions, to internal brokerage (case management provided by a member of the team giving care) in a small randomised controlled trial and qualitative study. No significant differences were found in costs and outcomes, although qualitative assertions were that there were duplications and inefficiencies with brokerage external to the team.…”

What have we learnt about joint working between health and social care?

“…Several studies reporting evaluations of integrated care noted that patients experienced improvements in quality of life, health, and coping with everyday living (Asthana andHalliday, 2003, Clarkson et al, 2011;Kaambwa et al, 2008). Although in studies using more robust study designs, for example comparing different types of integrated and non-integrated care, only marginal differences in outcomes were reported (Carpenter 2004, Rutter et al, 2004. Evaluations of intermediate care services , such as rapid response teams, that were designed to support people to remain in their homes rather than be admitted to residential care or hospital, found that these outcomes could be achieved (Brooks 2002, Beech et al, 2004Kaambwa et al, 2008).…”

“…When effective communication and information sharing processes were established studies reported improvements, including speedier and timelier assessments (Brown et al, 2003, Brooks 2002, Rutter et al, 2004. In both reviews the co-location of staff was regarded as facilitating improvements in understanding (Rutter et al, 2004) and communication (Gibb et al, 2002).…”

“…However, while the first review noted that poor communication was often compounded by complex and inappropriate documentation as well as a lack of adequate or compatible IT systems (Higgins et al 1993 Ross andTissier 1997) the second emphasised concerns about the appropriateness of electronic information sharing (Drennan et al, 2005. When effective communication and information sharing processes were established studies reported improvements, including speedier and timelier assessments (Brown et al, 2003, Brooks 2002, Rutter et al, 2004. In both reviews the co-location of staff was regarded as facilitating improvements in understanding (Rutter et al, 2004) and communication (Gibb et al, 2002).…”

“…Such problems led to inappropriate referrals and delays in treatment (McCormack et al, 2008) as well as confusion and protectionism amongst staff (Dickinson 2006). Importantly the second review identified the importance of role flexibility in supporting the aims of intermediate care, ensuring that services were more responsive to the needs of service users (Regen et al, 2008, Rutter et al, 2004.…”