Community-based Collaborative Care for Serious Mental Illness: A Rapid Qualitative Evidence Synthesis of Health Care...

Community-based collaborative care (CBCC) is an effective approach for addressing the needs of people with mental health conditions. However, even with the established components of CBCC in place, CBCCs effectiveness for serious mental illnesses (SMIs) remains unknown. This review aims to synthesize qualitative evidence of health care providers' experiences of CBCC in order to identify key factors that facilitate or hinder collaboration in the specific context of SMIs. We searched databases to identify 3368 studies. The eligibility criteria included qualitative studies focusing on health care providers' experiences in delivering a CBCC intervention for people with SMIs. Studies were included if they had at least 2 of 3 CBCC components: a multidisciplinary team, case management, and structured communication. Thematic analysis was used to synthesise the findings, and the Standards for Reporting Qualitative Research framework was used to assess the quality of included studies. The protocol is registered on Prospero. Of the 19 studies included in our review, 5 had achieved collaboration, which was driven by several key ingredients: the availability of on-site case managers and psychiatrists, or the psychiatrists' willingness to travel to the site; the psychiatrists' efforts in actively engaging and supporting the CBCC team; the primary care clinicians' willingness to collaborate with the team and reduce traditional hierarchical engagement; the team's understanding of CBCC; and case managers with strong interpersonal and professional skills. The inclusion of CBCC components do not guarantee collaboration. The findings emphasise the importance of on-site mental health specialists, clearly defined roles, and proactive providers in achieving collaboration.