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Ruttmann K, Albaladejo-Fuertes S, Lindenberg N, Kunst C, Mehrl A, Kindl V, Gülow K, Schlosser-Hupf S, Schmid S, Müller M. Relationship between interprofessional collaboration and psychological distress experienced by healthcare professionals during COVID-19: a monocentric cross-sectional study. Front Med (Lausanne) 2024; 11:1292608. [PMID: 38660424 PMCID: PMC11039835 DOI: 10.3389/fmed.2024.1292608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 03/18/2024] [Indexed: 04/26/2024] Open
Abstract
Background Since the onset of the COVID-19 pandemic, global healthcare systems have faced unprecedented challenges, leading to significant psychological distress among healthcare professionals. Recognizing the importance of enhanced interprofessional collaboration in alleviating this burden, as emphasized by the World Health Organization in 2020, we investigated whether such collaboration could mitigate staff psychological distress during crises. To our knowledge, no study has yet explored the role of interprofessional collaboration as a resilience factor in crises. Methods For this monocentric cross-sectional study at a German university hospital, we examined the relationship between the quality of interprofessional collaboration and the psychological distress of healthcare professionals during the initial pandemic wave. We employed validated mental health instruments, such as the GAD-7 and PHQ-2, to assess anxiety and depressive symptoms. Additionally, custom-designed questionnaires evaluated "Pandemic-Associated Burden and Anxiety (PAB; PAA)" and interprofessional crisis management experiences. A novel "Interprofessional collaboration and communication (IPC)" assessment tool was developed based on international competency frameworks, demonstrating strong reliability. Results The study involved 299 healthcare professionals (78.6% in direct contact with COVID-19 patients). Moderate levels of PAB/PAA were reported. However, a significant proportion experienced clinically relevant anxiety, as indicated by GAD-7. Negative IPC perceptions correlated with higher levels of psychological distress. Linear regression analysis showed associations between interprofessional collaboration and anxious and depressive symptoms, and pandemic-related burden. Conclusion Our findings highlight the vital role of enhanced interprofessional collaboration in strengthening the psychological well-being of healthcare professionals during crises. The study underscores the need to foster a collaborative environment and integrate interprofessional education for resilience.
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Affiliation(s)
- Kirstin Ruttmann
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
- Nursing Development Department of the Care Management Head Office, University Hospital Regensburg, Regensburg, Germany
| | - Sheila Albaladejo-Fuertes
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Nicole Lindenberg
- Department of Anaesthesiology, University Hospital of Regensburg, Regensburg, Germany
| | - Claudia Kunst
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Alexander Mehrl
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Vera Kindl
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Karsten Gülow
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Sophie Schlosser-Hupf
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Stephan Schmid
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Martina Müller
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology, Rheumatology, and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
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Wang F, Gao J, Hao S, Tsang KT, Wong JPH, Fung K, Li ATW, Jia C, Cheng S. Empowering Chinese university health service providers to become mental health champions: insights from the ACE-LYNX intervention. Front Psychiatry 2024; 15:1349476. [PMID: 38585479 PMCID: PMC10995288 DOI: 10.3389/fpsyt.2024.1349476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/28/2024] [Indexed: 04/09/2024] Open
Abstract
Background Evidence shows that there is a high prevalence of mental health challenges including depression and anxiety, among Chinese university students. Providing mental health care providers with professional training is crucial to implementing effective mental health promotion initiatives in university settings. Globally, the focus of the mental health system is shifting to recovery and the importance of empowerment is increasingly being emphasized. There is a call to integrate empowerment education into professional training programs for health service providers with the goal of mobilizing them to become mental health champions capable of advancing mental health care. Method The ACE-LYNX (Acceptance and Commitment to Empowerment-Linking Youth and Xin i.e., "heart(s)" in Chinese) intervention took place at six universities in Jinan, Shandong Province, China. It aimed to promote mental health literacy and build capacity among mental health service providers (MHSPs) to enable them to become mental health champions at their universities and beyond. A total of 139 university MHSPs participated. We collected pre-, immediate post- and three-month-post-surveys. In addition, we recruited forty-five participants to take part in three-month- post-intervention focus group interviews to explore their experiences taking part in ACE-LYNX and applying the knowledge, skills, and insights they gained from the intervention. Result This paper reports on the effects of empowerment education, which is a key component of ACE-LYNX, on the MHSPs. Four themes were identified: 1) conscious awareness and behavioral change through psychological empowerment users; 2) professional insights and motivation for organizational empowerment; 3) non-self in the continuum of collective empowerment; and 4) interdisciplinary challenges and divergences in empowerment action. Discussion We found that it is critical to integrate empowerment education into professional training. The process of MHSPs developing their empowerment practice is characterized by their moving from individual to collective empowerment along a continuum, with organizational and collective empowerment taking place in a longer time frame. Experiential learning, empathy education, and critical reflection accelerated the continuous iterative transformative process of empowerment practices. To advance the integration of empowerment into mental health care, the engagement of organizational decision-makers and policy makers in empowerment training is critical to ensure alignment of empowerment values and competence at all levels of service provision.
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Affiliation(s)
- Fenghua Wang
- Department of Social Work, School of Philosophy and Social Development, Shandong University, Jinan, Shandong, China
| | - Jianguo Gao
- Department of Social Work, School of Philosophy and Social Development, Shandong University, Jinan, Shandong, China
| | - Suyu Hao
- Department of Social Work, Law School, Qingdao University of Science and Technology, Qingdao, Shandong, China
| | - Ka Tat Tsang
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada
| | | | - Kenneth Fung
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Alan Tai-Wai Li
- Primary Care, Regent Park Community Health Centre, Toronto, ON, Canada
| | - Cunxian Jia
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, Shandong, China
| | - Shengli Cheng
- Department of Social Work, School of Philosophy and Social Development, Shandong University, Jinan, Shandong, China
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Boylan P, Knisley J, Wiskur B, Nguyen J, Lam K, Hong J, Caballero J. Pharmacist-social worker interprofessional relations and education in mental health: a scoping review. PeerJ 2024; 12:e16977. [PMID: 38410797 PMCID: PMC10896088 DOI: 10.7717/peerj.16977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 01/29/2024] [Indexed: 02/28/2024] Open
Abstract
Background One in eight patients is affected by a mental health condition, and interprofessional mental health teams collaborate to improve patient care. While pharmacists and social workers are recognized as mental health team members, there is a lack of literature describing interprofessional relations and education between these professions, especially as it pertains to mental health. The purpose of this review was to identify and characterize reports describing pharmacist-social worker interprofessional relations and education within mental health. Methodology To address this knowledge gap, this scoping review was conducted to collect and characterize reports published between January 1, 1960 and August 18, 2023 describing pharmacist-social worker interprofessional relations and education within the field of mental health. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines were followed. Ovid MEDLINE, CINAHL, and Social Work Abstracts were searched using keywords "pharmacy student," "pharmacist," "social work student," "social worker," and "social work." Reports were included if they were published in English and interprofessional relations or education occurred directly between (student) pharmacists and social workers. Results Three hundred twenty records were identified and three records were included: one cross sectional study, one qualitative educational project, and one case report. Each record suggested positive patient and/or educational outcomes developing from pharmacist-social worker interprofessional relations and education. In clinical practice, pharmacist-social work teams identified mental health risk factors, reduced 30-day readmissions, and improved post-discharge telehealth care. In the classroom, a social worker improved pharmacy students' confidence assessing patient suicidal ideations. Conclusions This scoping review identified needs and areas for future research: pharmacist interprofessional education with Master of Social Work and Doctor of Social Work degree students, transitional care and mental health outcome measure reporting using evidence-based outcomes, and development of scholarly teaching projects utilizing higher-level educational frameworks beyond learner reactions.
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Affiliation(s)
- Paul Boylan
- College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
| | | | - Brandt Wiskur
- Office of the Vice Provost for Academic Affairs and Faculty Development, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
| | - Jessica Nguyen
- College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
| | - Kristine Lam
- College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
| | - Jisoo Hong
- College of Pharmacy, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, United States
| | - Joshua Caballero
- College of Pharmacy, University of Georgia, Athens, Georgia, United States
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Clibbens N, Booth A, Sharda L, Baker J, Thompson J, Ashman M, Berzins K, Weich S, Kendal S. Explaining context, mechanism and outcome in adult community mental health crisis care: A realist evidence synthesis. Int J Ment Health Nurs 2023; 32:1636-1653. [PMID: 37574714 DOI: 10.1111/inm.13204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 07/25/2023] [Accepted: 08/01/2023] [Indexed: 08/15/2023]
Abstract
Mental health crises cause significant distress and disruption to the lives of individuals and their families. Community crisis care systems are complex, often hard to navigate and poorly understood. This realist evidence synthesis aimed to explain how, for whom and in what circumstances community mental health crisis services for adults work to resolve crises and is reported according to RAMESES guidelines. Using realist methodology, initial programme theories were identified and then tested through iterative evidence searching across 10 electronic databases, four expert stakeholder consultations and n = 20 individual interviews. 45 relevant records informed the three initial programme theories, and 77 documents, were included in programme theory testing. 39 context, mechanism, outcome configurations were meta-synthesized into three themes: (1) The gateway to urgent support; (2) Values based crisis interventions and (3) Leadership and organizational values. Fragmented cross-agency responses exacerbated staff stress and created barriers to access. Services should focus on evaluating interagency working to improve staff role clarity and ensure boundaries between services are planned for. Organizations experienced as compassionate contributed positively to perceived accessibility but relied on compassionate leadership. Attending to the support needs of staff and the proximity of leaders to the front line of crisis care are key. Designing interventions that are easy to navigate, prioritize shared decision-making and reduce the risk of re-traumatizing people is a priority.
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Affiliation(s)
| | - Andrew Booth
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Leila Sharda
- School of Healthcare, University of Leeds, Leeds, UK
| | - John Baker
- School of Healthcare, University of Leeds, Leeds, UK
| | - Jill Thompson
- Health Sciences School, University of Sheffield, Sheffield, UK
| | | | | | - Scott Weich
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Sarah Kendal
- School of Healthcare, University of Leeds, Leeds, UK
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Clibbens N, Baker J, Booth A, Berzins K, Ashman MC, Sharda L, Thompson J, Kendal S, Weich S. Explanation of context, mechanisms and outcomes in adult community mental health crisis care: the MH-CREST realist evidence synthesis. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2023; 11:1-161. [PMID: 37837344 DOI: 10.3310/twkk5110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/16/2023]
Abstract
Background Mental health crises cause significant disruption to individuals and families and can be life-threatening. The large number of community crisis services operating in an inter-agency landscape complicates access to help. It is unclear which underpinning mechanisms of crisis care work, for whom and in which circumstances. Aim The aim was to identify mechanisms to explain how, for whom and in what circumstances adult community crisis services work. Objectives The objectives were to develop, test and synthesise programme theories via (1) stakeholder expertise and current evidence; (2) a context, intervention, mechanism and outcome framework; (3) consultation with experts; (4) development of pen portraits; (5) synthesis and refinement of programme theories, including mid-range theory; and (6) identification and dissemination of mechanisms needed to trigger desired context-specific crisis outcomes. Design This study is a realist evidence synthesis, comprising (1) identification of initial programme theories; (2) prioritisation, testing and refinement of programme theories; (3) focused realist reviews of prioritised initial programme theories; and (4) synthesis to mid-range theory. Main outcome The main outcome was to explain context, mechanisms and outcomes in adult community mental health crisis care. Data sources Data were sourced via academic and grey literature searches, expert stakeholder group consultations and 20 individual realist interviews with experts. Review methods A realist evidence synthesis with primary data was conducted to test and refine three initial programme theories: (1) urgent and accessible crisis care, (2) compassionate and therapeutic crisis care and (3) inter-agency working. Results Community crisis services operate best within an inter-agency system. This requires compassionate leadership and shared values that enable staff to be supported; retain their compassion; and, in turn, facilitate compassionate interventions for people in crisis. The complex interface between agencies is best managed through greater clarity at the boundaries of services, making referral and transition seamless and timely. This would facilitate ease of access and guaranteed responses that are trusted by the communities they serve. Strengths and limitations Strengths include the identification of mechanisms for effective inter-agency community crisis care and meaningful stakeholder consultation that grounded the theories in real-life experience. Limitations include the evidence being heavily weighted towards England and the review scope excluding full analysis of ethnic and cultural diversity. Conclusions Multiple interpretations of crises and diverse population needs present challenges for improving the complex pathways to help in a crisis. Inter-agency working requires clear policy guidance with local commissioning. Seamless transitions between services generate trust through guaranteed responses and ease of navigation. This is best achieved where there is inter-agency affiliation that supports co-production. Compassionate leaders engender staff trust, and outcomes for people in crisis improve when staff are supported to retain their compassion. Future work Further work might explore inter-agency models of crisis delivery, particularly in rural communities. Future work could focus on evaluating outcomes across crisis care provider agencies and include evaluation of individual, as well as service-level, outcomes. The implementation and effect of mental health triage could be explored further, including via telehealth. Barriers to access for marginalised populations warrant a specific focus in future research. Study registration The study is registered as PROSPERO CRD42019141680. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme and will be published in full in Health and Social Care Delivery Research; Vol. 11, No. 15. See the NIHR Journals Library website for further project information.
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Affiliation(s)
| | - John Baker
- School of Healthcare, University of Leeds, Leeds, UK
| | - Andrew Booth
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | | | | | - Leila Sharda
- School of Healthcare, University of Leeds, Leeds, UK
| | - Jill Thompson
- Health Sciences School, University of Sheffield, Sheffield, UK
| | - Sarah Kendal
- School of Healthcare, University of Leeds, Leeds, UK
| | - Scott Weich
- Sheffield Health and Social Care NHS Foundation Trust, Sheffield, UK
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A M, K LBC, E S, S C, P F. A protocol for a multi-site cohort study to evaluate child and adolescent mental health service transformation in England using the i-THRIVE model. PLoS One 2023; 18:e0265782. [PMID: 37155627 PMCID: PMC10166497 DOI: 10.1371/journal.pone.0265782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 03/14/2023] [Indexed: 05/10/2023] Open
Abstract
The National i-THRIVE Programme seeks to evaluate the impact of the NHS England-funded whole system transformation on child and adolescent mental health services (CAMHS). This article reports on the design for a model of implementation that has been applied in CAMHS across over 70 areas in England using the 'THRIVE' needs-based principles of care. The implementation protocol in which this model, 'i-THRIVE' (implementing-THRIVE), will be used to evaluate the effectiveness of the THRIVE intervention is reported, together with the evaluation protocol for the process of implementation. To evaluate the effectiveness of i-THRIVE to improve care for children and young people's mental health, a cohort study design will be conducted. N = 10 CAMHS sites that adopt the i-THRIVE model from the start of the NHS England-funded CAMHS transformation will be compared to N = 10 'comparator sites' that choose to use different transformation approaches within the same timeframe. Sites will be matched on population size, urbanicity, funding, level of deprivation and expected prevalence of mental health care needs. To evaluate the process of implementation, a mixed-methods approach will be conducted to explore the moderating effects of context, fidelity, dose, pathway structure and reach on clinical and service level outcomes. This study addresses a unique opportunity to inform the ongoing national transformation of CAMHS with evidence about a popular new model for delivering children and young people's mental health care, as well as a new implementation approach to support whole system transformation. If the outcomes reflect benefit from i-THRIVE, this study has the potential to guide significant improvements in CAMHS by providing a more integrated, needs-led service model that increases access and involvement of patients with services and in the care they receive.
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Affiliation(s)
- Moore A
- The Anna Freud National Centre for Children and Families, London, United Kingdom
- Psychoanalysis Unit, Division of Psychology and Language Sciences, University College London, London, United Kingdom
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Lindley Baron-Cohen K
- Psychoanalysis Unit, Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Simes E
- The Anna Freud National Centre for Children and Families, London, United Kingdom
- Psychoanalysis Unit, Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Chen S
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
| | - Fonagy P
- The Anna Freud National Centre for Children and Families, London, United Kingdom
- Psychoanalysis Unit, Division of Psychology and Language Sciences, University College London, London, United Kingdom
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Hasselberg N, Klevan TG, Weimand B, Uverud GM, Holgersen KH, Siqveland J, Ruud T. Similarities and differences between service users' and carers' experiences of crisis resolution teams in Norway: a survey. BMC Psychiatry 2022; 22:266. [PMID: 35421950 PMCID: PMC9011940 DOI: 10.1186/s12888-022-03928-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 04/05/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Crisis resolution team (CRT) care in adult mental health services is intended to provide accessible and flexible short-term, intensive crisis intervention to service users experiencing a mental health crisis and involve their carers (next of kin). Research on users' and especially carers' experiences with CRT care is scarce and is mostly qualitative in nature. METHODS Altogether, 111 service users and 86 carers from 28 Norwegian CRTs were interviewed with The Service User and Carer Structured Interviews of the CORE Crisis Resolution Team Fidelity Scale Version 2. Their experiences with different aspects of CRT care were reported with descriptive statistics, and differences between service users' and carers' experiences were analyzed with the Mann-Whitney U Test. RESULTS The service users and carers reported that the CRT care mostly reflected their needs and what they wanted. The experiences of service users and carers were mostly similar, except for significant differences in received information and how the termination of CRT care appeared. Both groups experienced the organization of the CRT care as accessible, with continuity, reliability, and flexibility, but without a high intensity of care. Both groups found the content of the CRT care supportive, sensitive, with a choice of treatment type and a range of interventions beyond medication, but a lack of written treatment plans and discharge plans. Carers were rarely involved in discharge meetings. Regarding the role of CRTs within the care system, both groups agreed upon the lack of facilitation of early discharge from inpatient wards and lack of home treatment, but both groups confirmed some collaboration with other mental health services. CONCLUSION Service users and carers found that the CRTs were accessible, reliable, flexible, supportive, sensitive, and provided a range of interventions beyond medication. Limitations were lack of a high intensity of care, limited written treatment and discharge plans, limited provision of home treatment, and lack of gatekeeping of acute beds. Both groups experienced the CRT care as mostly similar, but with significant differences regarding involvement in care planning and discharge preparation.
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Affiliation(s)
- Nina Hasselberg
- grid.411279.80000 0000 9637 455XDivision of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
| | - Trude Gøril Klevan
- grid.463530.70000 0004 7417 509XFaculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Bente Weimand
- grid.411279.80000 0000 9637 455XDivision of Mental Health Services, Akershus University Hospital, Lørenskog, Norway ,grid.463530.70000 0004 7417 509XFaculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
| | - Gunn-Marit Uverud
- grid.463530.70000 0004 7417 509XUniversity of South-Eastern Norway, Notodden, Vestfold Norway
| | - Katrine Høyer Holgersen
- grid.52522.320000 0004 0627 3560Nidelv Community Mental Health Center, Clinic of Mental Health, St Olavs hospital, Trondheim, Norway ,grid.5947.f0000 0001 1516 2393Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Johan Siqveland
- grid.411279.80000 0000 9637 455XDivision of Mental Health Services, Akershus University Hospital, Lørenskog, Norway ,grid.5510.10000 0004 1936 8921National Center for Suicide Research and Prevention, University of Oslo, Oslo, Norway
| | - Torleif Ruud
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway. .,Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
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Xanthopoulou P, Thomas C, Dooley J. Subjective experiences of the first response to mental health crises in the community: a qualitative systematic review. BMJ Open 2022; 12:e055393. [PMID: 35115355 PMCID: PMC8814746 DOI: 10.1136/bmjopen-2021-055393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE To review and synthesise qualitative studies that have explored subjective experiences of people with lived experience of mental health-related illness/crisis (MHC), their families and first responders. DESIGN A systematic review of qualitative evidence was conducted. English-language articles exploring the content of interactions and participants' experiences were included. DATA SOURCES MEDLINE, PsycINFO, EMBASE, CINAHL; Google Scholar, SAGE journals, Science Direct and PubMed. DATA EXTRACTION AND SYNTHESIS Two reviewers read and systematically extracted data from the included papers. Papers were appraised for methodological rigour using the Critical Appraisal Skills Programme Qualitative Checklist. Data were thematically analysed. RESULTS We identified 3483 unique records, 404 full-texts were assessed against the inclusion criteria and 79 studies were included in the qualitative synthesis. First responders (FRs) identified in studies were police and ambulance staff. Main factors influencing response are persistent stigmatised attitudes among FRs, arbitrary training and the triadic interactions between FRs, people with mental illness and third parties present at the crisis. In addition, FR personal experience of mental illness and focused training can help create a more empathetic response, however lack of resources in mental health services continues to be a barrier where 'frequent attenders' are repeatedly let down by mental health services. CONCLUSION Lack of resources in mental healthcare and rise in mental illness suggest that FR response to MHC is inevitable. Inconsistent training, complexity of procedures and persistent stigmatisation make this a very challenging task. Improving communication with family carers and colleagues could make a difference. Broader issues of legitimacy and procedural barriers should be considered in order to reduce criminalisation and ensure an empathetic response.
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Affiliation(s)
| | - Ciara Thomas
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Jemima Dooley
- Mood Disorders Centre, University of Exeter, Exeter, UK
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Yeary KHCK, Ounpraseuth S, Wan F, Graetz I, Fagan P, Huff-Davis A, Kaplan C, Johnson K, Hutchins E. Assessing the Feasibility of an Online Training Designed to Enable Community Health Workers to Deliver a Comprehensive, Evidence-Based Weight Loss Intervention for Rural African Americans of Faith. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2021; 36:1277-1284. [PMID: 32441002 PMCID: PMC7679277 DOI: 10.1007/s13187-020-01764-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Obesity is a critical modifiable risk factor in cancer prevention, control, and survivorship. Comprehensive weight loss interventions (e.g., Diabetes Prevention Program (DPP)) have been recommended by governmental agencies to treat obesity. However, their high implementation costs limit their reach, especially in underserved African American (AA) communities. Community health workers (CHWs) or trusted community members can help increase access to obesity interventions in underserved regions facing provider shortages. CHW-led interventions have increased weight loss. However, in-person CHW training can be costly to deliver and often requires extensive travel to implement. Web-based trainings have become common to increase reach at reduced cost. However, the feasibility of an online CHW training to deliver the DPP in AAs is unknown. The feasibility of an online CHW training to deliver the DPP adapted for AAs was assessed. The online training was compared to an in-person DPP training with established effectiveness. CHW effectiveness and satisfaction were assessed at baseline and 6 weeks. Nineteen participants (in-person n = 10; online n = 9) were recruited. At post-training, all scored higher than the 80% on a knowledge test required to deliver the intervention. All participants reported high levels of training satisfaction (88.9% of online participants and 90% of in-person participants rated the training as at least 6 on a 1-7 scale) and comfort to complete intervention tasks (78% of online participants and 60% of in-person participants scored at least 6 on a 1-7 scale). There were no significant differences in outcomes by arm. An online CHW training to deliver the DPP adapted for AAs faith communities produced comparable effectiveness and satisfaction to an evidence-based in-person CHW training. Further research is needed to assess the cost-effectiveness of different CHW training modalities to reduce obesity.
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Affiliation(s)
- Karen Hye-Cheon Kim Yeary
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Elm and Carton Streets, Buffalo, NY, 14263, USA.
| | - Songthip Ounpraseuth
- Department of Biostatistics, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - Fei Wan
- Department of Surgery, Washington University School of Medicine in St. Louis, 660 Euclid Avenue, St. Louis, MO, 63110, USA
| | - Ilana Graetz
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Suite 636, Atlanta, GA, 30322, USA
| | - Pebbles Fagan
- Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - Anna Huff-Davis
- Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - Cameron Kaplan
- The Gehr Center for Health Systems Science & Innovation, Keck School of Medicine of USC, 2020 Zonal Ave., Los Angeles, CA, 90033, USA
| | - Kemmian Johnson
- Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
| | - Ellen Hutchins
- Department of Health Behavior and Health Education, University of Arkansas for Medical Sciences, 4301 West Markham, Little Rock, AR, 72205, USA
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Alderwick H, Hutchings A, Briggs A, Mays N. The impacts of collaboration between local health care and non-health care organizations and factors shaping how they work: a systematic review of reviews. BMC Public Health 2021; 21:753. [PMID: 33874927 PMCID: PMC8054696 DOI: 10.1186/s12889-021-10630-1] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/11/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Policymakers in many countries promote collaboration between health care organizations and other sectors as a route to improving population health. Local collaborations have been developed for decades. Yet little is known about the impact of cross-sector collaboration on health and health equity. METHODS We carried out a systematic review of reviews to synthesize evidence on the health impacts of collaboration between local health care and non-health care organizations, and to understand the factors affecting how these partnerships functioned. We searched four databases and included 36 studies (reviews) in our review. We extracted data from these studies and used Nvivo 12 to help categorize the data. We assessed risk of bias in the studies using standardized tools. We used a narrative approach to synthesizing and reporting the data. RESULTS The 36 studies we reviewed included evidence on varying forms of collaboration in diverse contexts. Some studies included data on collaborations with broad population health goals, such as preventing disease and reducing health inequalities. Others focused on collaborations with a narrower focus, such as better integration between health care and social services. Overall, there is little convincing evidence to suggest that collaboration between local health care and non-health care organizations improves health outcomes. Evidence of impact on health services is mixed. And evidence of impact on resource use and spending are limited and mixed. Despite this, many studies report on factors associated with better or worse collaboration. We grouped these into five domains: motivation and purpose, relationships and cultures, resources and capabilities, governance and leadership, and external factors. But data linking factors in these domains to collaboration outcomes is sparse. CONCLUSIONS In theory, collaboration between local health care and non-health care organizations might contribute to better population health. But we know little about which kinds of collaborations work, for whom, and in what contexts. The benefits of collaboration may be hard to deliver, hard to measure, and overestimated by policymakers. Ultimately, local collaborations should be understood within their macro-level political and economic context, and as one component within a wider system of factors and interventions interacting to shape population health.
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Affiliation(s)
- Hugh Alderwick
- Health Foundation, 8 Salisbury Square, London, EC4Y 8AP UK
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH UK
| | - Andrew Hutchings
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH UK
| | - Adam Briggs
- Health Foundation, 8 Salisbury Square, London, EC4Y 8AP UK
- University of Warwick, Coventry, CV4 7AL UK
| | - Nicholas Mays
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH UK
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11
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Klevan T, Karlsson B, Hasselberg N, Ruud T. 'No service is an island': experiences of collaboration with crisis resolution teams in Norway. J Interprof Care 2021; 36:195-201. [PMID: 33853485 DOI: 10.1080/13561820.2021.1888900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Crisis resolution teams (CRTs) are a community-based service targeting adults experiencing acute mental health crises. The rationale for the development of CRTs is both value and efficacy based, suggesting that CRTs should contribute to the humanizing of mental health services and replace some acute hospital-based services with services in the community. Despite the collaborative nature of CRT work, how professionals from health and social services experience collaboration with CRTs is scantly explored. In the current study, semi-structured focus group interviews with eight different groups of 44 clinicians collaborating with CRTs in Norway were conducted. Data were analyzed using thematic analysis and categorized into four themes: (1) 'The accessible experts', (2) 'A broad and deep expertise', (3) 'Doing it together' and (4) 'Toward a new culture?'. The themes elaborate on issues related to the content and organization of CRT services, emphasizing the need for CRTs to be able to contribute their professional expertise in accessible, flexible and collaborative ways. A diversity in the knowledge base and in how services are organized may pose a challenge in interprofessional mental health crisis collaboration and mutual expectations. The study suggests that a shift toward a value-based and coherent mental health and social system could be a purposeful direction.
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Affiliation(s)
- Trude Klevan
- Center for Mental Health and Substance Abuse, Faculty of Health and Social Sciences, Department of Health, Social and Welfare Studies, University of South-Eastern Norway, Drammen, Norway.,Mental Health Services, Akershus University Hospital, Lillestrøm, Lørenskog, Norway
| | - Bengt Karlsson
- Center for Mental Health and Substance Abuse, Faculty of Health and Social Sciences, Department of Health, Social and Welfare Studies, University of South-Eastern Norway, Drammen, Norway
| | - Nina Hasselberg
- Mental Health Services, Akershus University Hospital, Lillestrøm, Lørenskog, Norway
| | - Torleif Ruud
- Mental Health Services, Akershus University Hospital, Lillestrøm, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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12
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Durand F, Fleury MJ. A multilevel study of patient-centered care perceptions in mental health teams. BMC Health Serv Res 2021; 21:44. [PMID: 33413371 PMCID: PMC7792020 DOI: 10.1186/s12913-020-06054-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 12/29/2020] [Indexed: 11/30/2022] Open
Abstract
Background The successful combination of interprofessional collaboration in multidisciplinary teams with patient-centered care is necessary when it comes to delivering complex mental health services. Yet collaboration is challenging and patient-centered care is intricate to manage. This study examines correlates of patient-centered care such as team adaptivity and proactivity, collaboration, belief in interprofessional collaboration and informational role self-efficacy in multidisciplinary mental health teams. Method A cross-sectional multilevel survey design was used, based on self-administered bilingual validated questionnaires. Participants (N=314) were mental health professionals and managers working in public primary care or specialized mental health services, in inpatient or outpatient settings. Results This study showed that belief in interprofessional collaboration’s relationship with patient-centered perceptions is increased in teams with high collaboration. Collaboration is also found as a mediator, representing a process by which team adaptive and proactive behaviors are transformed into positive patient-centered perceptions. Conclusions Our results were in line with recent studies on team processes establishing that collaboration is a key component in multilevel examinations of predictors of patient-centered care. In terms of practice, our study showed that multidisciplinary teams should know that working hard on collaboration is an answer to the complexity of patient-centered care. Collaboration is related to the teams’ ability to respond to its challenges. It is also related to individuals’ beliefs central to the delivery of interprofessional care.
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Affiliation(s)
- François Durand
- Montfort Research Chair in Organization of Health Services, Telfer School of Management, University of Ottawa, 55 Laurier Avenue East, Ottawa, On, K1N 6N5, Canada.
| | - Marie-Josée Fleury
- Douglas Mental Health University Institute, McGill University, 6875 LaSalle Blvd, Montreal, Qc, H4H 1R3, Canada
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13
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Ortega Vega M, Williams L, Saunders A, Iannelli H, Cross S, Attoe C. Simulation training programme to improve the integrated response of teams in
mental health crisis care. BMJ SIMULATION & TECHNOLOGY ENHANCED LEARNING 2020; 7:116-118. [DOI: 10.1136/bmjstel-2020-000641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/19/2020] [Accepted: 07/25/2020] [Indexed: 11/03/2022]
Abstract
Background
This report presents the findings of a simulation programme to improve the
integrated response of teams working in mental health crisis (MHC) care. The
programme consisted of the delivery of five interprofessional training courses
that aimed to improve the core skills of teams working in MHC care.
Methods
Questionnaires were conducted pre-training and post-training, measuring
participants’ human factors using the Human Factors SKills for Healthcare
Instrument, as well as self-reported learning experience using free text
questions.
Results
The results found a significant change in human factors scores across all
courses. Additionally, thematic analysis of the free text questions showed that
participants identified improvements in communication, teamwork and clinical
knowledge across all courses, with improvements in other skills in specific
courses.
Conclusion
Overall, the findings suggest a positive impact of the simulation
programme across a range of personal and clinical skills, developing further
the case for including simulation training in routine mental healthcare
education programmes. Future research should consider the long-term impact of
interprofessional simulation training in MHC teams to gain further insight into
the efficacy of this training modality.
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Fleury MJ, Grenier G, Farand L, Ferland F. Use of Emergency Rooms for Mental Health Reasons in Quebec: Barriers and Facilitators. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2020; 46:18-33. [PMID: 30074113 DOI: 10.1007/s10488-018-0889-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This study explored barriers and facilitators in mental health (MH) patient management in four Quebec (Canada) emergency rooms (ERs) that used different operational models. Forty-nine stakeholders (managers, physicians, ER and addiction liaison team members) completed semi-structured interviews. Barriers and facilitators affecting patient management emanated from health systems, patients, organizations, and from professionals themselves. Effective management of MH patients requires ER access to a rich network of outpatient, community-based MH services; integration of general and psychiatric ERs; on-site addiction liaison teams; round-the-clock ER staffing, including psychiatrists; ER staff training in MH; and adaptation to frequent and challenging ER users.
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Affiliation(s)
- Marie-Josée Fleury
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC, H3A 1A1, Canada. .,Douglas Mental Health University Institute Research Centre, 6875 LaSalle Blvd., Montreal, QC, H4H 1R3, Canada.
| | - Guy Grenier
- Douglas Mental Health University Institute Research Centre, 6875 LaSalle Blvd., Montreal, QC, H4H 1R3, Canada
| | - Lambert Farand
- Department of Health Administration, Policy and Evaluation School of Public Health, University of Montreal, Montreal, QC, Canada
| | - Francine Ferland
- School of Social Work, Laval University, Quebec City, QC, Canada
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Greidanus E, Warren C, Harris GE, Umetsubo Y. Collaborative practice in counselling: a scoping review. J Interprof Care 2019; 34:353-361. [DOI: 10.1080/13561820.2019.1637334] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Elaine Greidanus
- Faculty of Education, University of Lethbridge, Lethbridge, Canada
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Rodgers M, Thomas S, Dalton J, Harden M, Eastwood A. Police-related triage interventions for mental health-related incidents: a rapid evidence synthesis. HEALTH SERVICES AND DELIVERY RESEARCH 2019. [DOI: 10.3310/hsdr07200] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background
Police officers are often the first responders to mental health-related incidents and, consequently, can become a common gateway to care. The volume of such calls is an increasing challenge.
Objective
What is the evidence base for models of police-related mental health triage (often referred to as ‘street triage’) interventions?
Design
Rapid evidence synthesis.
Participants
Individuals perceived to be experiencing mental ill health or in a mental health crisis.
Interventions
Police officers responding to calls involving individuals experiencing perceived mental ill health or a mental health crisis, in the absence of suspected criminality or a criminal charge.
Main outcome measures
Inclusion was not restricted by outcome.
Data sources
Eleven bibliographic databases (i.e. Applied Social Sciences Index and Abstracts, Criminal Justice Abstracts, EMBASE, MEDLINE, PAIS® Index, PsycINFO, Scopus, Social Care Online, Social Policy & Practice, Social Sciences Citation Index and Social Services Abstracts) and multiple online sources were searched for relevant systematic reviews and qualitative studies from inception to November 2017. Additional primary studies reporting quantitative data published from January 2016 were also sought.
Review methods
The three-part rapid evidence synthesis incorporated metasynthesis of the effects of street triage-type intervention models, rapid synthesis of UK-relevant qualitative evidence on implementation and the overall synthesis.
Results
Five systematic reviews, eight primary studies reporting quantitative data and eight primary studies reporting qualitative data were included. Most interventions involved police officers working in partnership with mental health professionals. These interventions were generally valued by staff and showed some positive effects on procedures (such as rates of detention) and resources, although these results were not entirely consistent and not all important outcomes were measured. Most of the evidence was at risk of multiple biases caused by design flaws and/or a lack of reporting of methods, which might affect the results.
Limitations
All primary research was conducted in England, so may not be generalisable to the whole of the UK. Discussion of health equity issues was largely absent from the evidence.
Conclusions
Most published evidence that aims to describe and evaluate various models of street triage interventions is limited in scope and methodologically weak. Several systematic reviews and recent studies have called for a prospective, comprehensive and streamlined collection of a wider variety of data to evaluate the impact of these interventions. This rapid evidence synthesis expands on these recommendations to outline detailed implications for research, which includes clearer articulation of the intervention’s objectives, measurement of quantitative outcomes beyond section 136 of the Mental Health Act 1983 [Great Britain. Mental Health Act 1983. Section 136. London: The Stationery Office; 1983 URL: www.legislation.gov.uk/ukpga/1983/20/section/136 (accessed October 2017)] (i.e. rates, places of safety and processing data) and outcomes that are most important to the police, mental health and social care services and service users. Evaluations should take into consideration shorter-, medium- and longer-term effects. Whenever possible, study designs should have an appropriate concurrent comparator, for example by comparing the pragmatic implementation of collaborative street triage models with models that emphasise specialist training of police officers. The collection of qualitative data should capture dissenting views as well as the views of advocates. Any future cost-effectiveness analysis of these interventions should evaluate the impact across police, health and social services.
Funding
The National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Mark Rodgers
- Centre for Reviews and Dissemination (CRD), University of York, York, UK
| | - Sian Thomas
- Centre for Reviews and Dissemination (CRD), University of York, York, UK
| | - Jane Dalton
- Centre for Reviews and Dissemination (CRD), University of York, York, UK
| | - Melissa Harden
- Centre for Reviews and Dissemination (CRD), University of York, York, UK
| | - Alison Eastwood
- Centre for Reviews and Dissemination (CRD), University of York, York, UK
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Abstract
OBJECTIVES Many police officers receive medical training for limited assessments and interventions. In most situations where medical issues arise, however, emergency medical services (EMS) are called for evaluation, treatment, and transport. Given the limited amount of information about such encounters we examined officer calls for EMS help in a single system to better describe these encounters. METHODS Requests for medical help from a fire-based EMS system by police in a moderate-sized city in 2014 and 2015 were identified. In this system, fire department resources are requested for initial evaluations of any medical complaint. Data were extracted from fire records including disposition, transportation from scene, type of injury or illness, and vital signs. Data analysis used descriptive statistics. RESULTS 4,792 calls were made, representing 2.2% of all police-citizen interactions and 4.2% of all EMS calls. A total of 61.2% of calls resulted in transport to hospital. Of those, 5.6% required fire-based advanced life support; the remainder were transported by private basic life support ambulance or non-medical means. Most requests were for trauma (51.4%), followed by medical (24.7%), drug/alcohol use (17.1%), and psychiatric (6.7%). Vital signs tended to be within normal limits including 72.7% of pulses, 65.1% of systolic blood pressures, and 90.5% of respiratory rates. CONCLUSION Requests for EMS assistance from police were common. Most calls involved patients with normal vital signs who did not require advanced life support transport. Further research is needed to identify situations where increased officer training and change in protocols could potentially change EMS response models and improve efficiency of the system.
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Parker A, Scantlebury A, Booth A, MacBryde JC, Scott WJ, Wright K, McDaid C. Interagency collaboration models for people with mental ill health in contact with the police: a systematic scoping review. BMJ Open 2018; 8:e019312. [PMID: 29588323 PMCID: PMC5875664 DOI: 10.1136/bmjopen-2017-019312] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To identify existing evidence on interagency collaboration between law enforcement, emergency services, statutory services and third sector agencies regarding people with mental ill health. DESIGN Systematic scoping review. Scoping reviews map particular research areas to identify research gaps. DATA SOURCES AND ELIGIBILITY ASSIA, CENTRAL, the Cochrane Library databases, Criminal Justice Abstracts, ERIC, Embase, MEDLINE, PsycINFO, PROSPERO and Social Care Online and Social Sciences Citation Index were searched up to 2017, as were grey literature and hand searches. Eligible articles were empirical evaluations or descriptions of models of interagency collaboration between the police and other agencies. STUDY APPRAISAL AND SYNTHESIS Screening and data extraction were undertaken independently by two researchers. Arksey's framework was used to collate and map included studies. RESULTS One hundred and twenty-five studies were included. The majority of articles were of descriptions of models (28%), mixed methods evaluations of models (18%) and single service evaluations (14%). The most frequently reported outcomes (52%) were 'organisational or service level outcomes' (eg, arrest rates). Most articles (53%) focused on adults with mental ill health, whereas others focused on adult offenders with mental ill health (17.4%). Thirteen models of interagency collaboration were described, each involving between 2 and 13 agencies. Frequently reported models were 'prearrest diversion' of people with mental ill health (34%), 'coresponse' involving joint response by police officers paired with mental health professionals (28.6%) and 'jail diversion' following arrest (23.8%). CONCLUSIONS We identified 13 different interagency collaboration models catering for a range of mental health-related interactions. All but one of these models involved the police and mental health services or professionals. Several models have sufficient literature to warrant full systematic reviews of their effectiveness, whereas others need robust evaluation, by randomised controlled trial where appropriate. Future evaluations should focus on health-related outcomes and the impact on key stakeholders.
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Affiliation(s)
- Adwoa Parker
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | - Arabella Scantlebury
- Institute of Health and Society, University of Newcastle, Newcastle upon Tyne, UK
| | - Alison Booth
- York Trials Unit, Department of Health Sciences, University of York, York, UK
| | | | | | - Kath Wright
- Centre for Reviews and Dissemination, University of York, York, UK
| | - Catriona McDaid
- York Trials Unit, Department of Health Sciences, University of York, York, UK
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Abstract
Introduction: Meeting the complex health needs of people often
requires interaction among numerous different sectors. No one service can
adequately respond to the diverse care needs of consumers. Providers working
more effectively together is frequently touted as the solution. Cross-sector
service provision is defined as independent, yet interconnected sectors working
together to better meet the needs of consumers and improve the quality and
effectiveness of service provision. Cross-sector service provision is expected,
yet much remains unknown about how it is conceptualised or its impact on health
status. This umbrella review aims to clarify the critical attributes that shape
cross-sector service provision by presenting the current state of the literature
and building on the findings of the 2004 review by Sloper. Methods: Literature related to cross-sector service provision is
immense, which poses a challenge for decision makers wishing to make
evidence-informed decisions. An umbrella review was conducted to articulate the
overall state of cross-sector service provision literature and examine the
evidence to allow for the discovery of consistencies and discrepancies across
the published knowledge base. Findings: Sixteen reviews met the inclusion criteria. Seven themes
emerged: Focusing on the consumer, developing a shared vision of care,
leadership involvement, service provision across the boundaries, adequately
resourcing the arrangement, developing novel arrangements or aligning with
existing relationships, and strengthening connections between sectors. Future
research from a cross-organisational, rather than individual provider,
perspective is needed to better understand what shapes cross-sector service
provision at the boundaries. Conclusion: Findings aligned closely with the work done by Sloper
and raise red flags related to reinventing what is already known. Future
researchers should look to explore novel areas rather than looking into areas
that have been explored at length. Evaluations of out-comes related to
cross-sector service provision are still needed before any claims about
effectiveness can be made.
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