Relationships Among Structures, Team Processes, and Outcomes for Service Users in Quebec Mental Health Service Networks

Abstract

Background: Few studies have identified and compared profiles of mental health service networks (MHSN) in terms of structures, processes, and outcomes, based on cluster analyses and perceptions of team managers, MH professionals and service users. This study assessed these associations in Quebec metropolitan, urban and semi-urban MHSN. Methods: A framework adapted from the Donabedian model guided data management, and cluster analyses were used to identify categories. Study participants included team managers (n = 45), MH professionals (n = 311) and service users (n = 327). Results: For all three MHSN, a common outcome category emerged: service users with complex MH problems and negative outcomes. The Metropolitan network reported two categories for structures (specialized MH teams, primary care MH teams) and processes (senior medical professional, psychosocial professionals), and outcomes (middle-age men with positive outcomes, older women with few MH problems). The Urban and Semi-urban networks revealed one category for structures (all teams) and service user (young service users with drug disorders), but two for processes (psychosocial professionals: urban, all professionals: semi-urban). Conclusion: The Metropolitan MHSN showed greater heterogeneity regarding structures and team processes than the other two MHSN. Service user outcomes were largely associated with clinical characteristics, regardless of network configurations for structures and team processes.

Developing Relational Coordination: A Qualitative Study of Outpatient Mental Health Teams

“…This finding is consistent with literature suggesting that dimensions of Relational Coordination increased shared accountability and support among team members across numerous business sectors and settings (Bolton et al, 2021). Feeling supported is essential in mental health teams because the work can often be challenging (Fleury et al, 2020). Moreover, participants noted that having mutual respect and shared goals of prioritizing patient care enabled team members to cover for one another within their scope of practice, which in turn, improved provider job satisfaction.…”

“…Healthcare is interdisciplinary, requiring professionals from different training backgrounds and specialties to work alongside one another. Ample research has shown that team functioning in integrated healthcare teams affects the quality and safety of patient care and reduces healthcare service fragmentation (Fleury et al, 2020;Manser, 2009;Schmutz & Manser, 2013). Teamwork is an especially important component of mental health services, as many patients present with complex medical and psychosocial needs, which may require providers from psychiatry, psychology, social work, nursing, and pharmacology, among others (Kinnair, Anderson, van Diepen, & Poysey, 2014).…”

“…Teamwork is an especially important component of mental health services, as many patients present with complex medical and psychosocial needs, which may require providers from psychiatry, psychology, social work, nursing, and pharmacology, among others (Kinnair, Anderson, van Diepen, & Poysey, 2014). Integrated healthcare teams improve job satisfaction among healthcare professionals, which is especially important for mental health providers as they experience elevated rates of burnout and occupational stress (Fleury et al, 2017(Fleury et al, , 2020Onyett, 2011). In turn, job satisfaction also contributes to enhanced patient safety and higher quality of health care services (Wallace et al, 2009).…”

Deployment of the consultation-liaison model in adult and child-adolescent psychiatry and its impact on improving mental health treatment

“…Wait times to access MH-PCT and psychiatric care are also quite long, varying from several months to more than a year especially for psychiatric care in some Quebec territories [67,82]. Benchmarks originally set for access to treatment were 1-month for MH-PCT and evaluations within 7-days were promoted for the one-stop MH service teams [65], yet these standards have to be met due to organizational issues and high patient demand [67,68,83].…”