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What promotes and inhibits cooperation in mental health care across disciplines, services and service sectors? A qualitative study

Published online by Cambridge University Press:  19 August 2011

A. Bramesfeld ,
C. Ungewitter ,
D. Böttger ,
J. El Jurdi ,
C. Losert  and
R. Kilian
A. Bramesfeld*
Affiliation:
Psychiatric Clinic, University of Leipzig, Germany Department of Epidemiology, Social Medicine and Health System Research, Hannover Medical School, Hannover, Germany
C. Ungewitter
Affiliation:
Psychiatric Clinic, University of Leipzig, Germany
D. Böttger
Affiliation:
Psychiatric Clinic, University of Leipzig, Germany
J. El Jurdi
Affiliation:
Psychiatric Department, General Hospital, Eisenhüttenstadt, Germany
C. Losert
Affiliation:
Psychiatric Department II, University of Ulm, BKH Günzburg, Germany
R. Kilian
Affiliation:
Psychiatric Department II, University of Ulm, BKH Günzburg, Germany
*
*Address for correspondence: A. Bramesfeld, Department of Epidemiology, Social Medicine and Health System Research, Hannover Medical School, Hannover, Germany. (Email: bramesfeld.anke@mh-hannover.de)
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Abstract

Aims.

To explore the practice of cooperation in mental health care across services and identify conditions that promote and inhibit cooperation.

Methods.

Focus groups with relevant service providers were conducted in four exemplary regions in Germany (rural/urban and East/West). The discussions were content analysed.

Results.

Seven central categories were deduced: (1) involved service providers, (2) comprehension, (3) reasons, (4) instruments for cooperation, (5) promoting and inhibiting conditions, (6) interdisciplinarity, and (7) regional and personal networks. Cooperation is practiced in networks, rather than defined relations. Who is involved in cooperation depends on patients/clients needs and may vary from case to case. Service providers do not have theoretical concepts of cooperation. Cooperation relies not only on personal contacts and knowledge between services but also on time, financial reimbursement and the social capital of the environment. In particular, cooperation with physicians was considered to be difficult by non-medical professionals. Physician's role models do not seem to include cooperation with other disciplines as a core task.

Conclusions.

To improve cooperation, regional and sustainable mental health networks have to be systematically implemented by providing leadership, time and reimbursement for network meetings. Interdisciplinary cooperation practice should be part of the curricula of medical students and residents in psychiatry.

Keywords

collaborationcontinuity of caremental health servicesnetworkspsychiatryquality of care
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 21 , Issue 1 , March 2012 , pp. 63 - 72
Copyright
Copyright © Cambridge University Press 2011

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