Cross-sector problems of collaboration in psychiatry

Some mental health service users need support from both hospital-based and community-based services. Treatment requires well-functioning collaboration practices between different mental health organizations and professions. However, serious cross-sector problems of collaboration have existed in Danish psychiatry since the 1980s when mental health service provisions were split into two psychiatric systems.

We report from two qualitative studies: STUDY#1 (n = 24) consisted of twenty-four individual, qualitative interviews with the staff and management of a psychiatric emergency unit, a closed psychiatric ward, and a community-based residential facility, respectively. STUDY#2 (n = 22) consisted of four individual interviews with service users and mental health staff, and three focus group interviews each including six staff members from both hospital- and community-based services.

Staff and management experiencing cross-sector problems of collaboration point to ineffective coordination of services between systems and lack of mutual understanding of how systems other than the staffs' own systems work. Solutions include specific procedural changes during service users' admission to and discharge from hospital and during hospitalization and measures to increase cross-sector knowledge about each system's practices and methods.

Improvement of cross-sector collaboration in psychiatry should take the form of a multi-faceted approach embracing measures to improve coordination of service users' treatment and care and to increase interaction, understanding and respect between the two systems.

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