Abstract
BackgroundTo meet the needs of high-vulnerable families with severe and enduring problems across several life domains, professionals must improve their ability to provide integrated care timely and adequately. The aim of this study was to identify facilitators and barriers professionals encounter when providing integrated care.MethodsExperiences and perspectives of 24 professionals from integrated care teams in the Netherlands were gathered by conducting semi-structured interviews. A theory-driven framework method was applied to systematically code the transcripts both deductively and inductively.ResultsThere was a consensus among professionals regarding facilitators and barriers influencing their daily practice, leading to an in depth, thematic report of what facilitates and hinders integrated care. Themes covering the facilitators and barriers were related to early identification and broad assessment, multidisciplinary expertise, continuous pathways, care provision, autonomy of professionals, and evaluation of care processes.ConclusionsProfessionals emphasized the need for flexible support across several life domains to meet the needs of high-vulnerable families. Also, there should be a balance between the use of guidelines and a professional’s autonomy to tailor support to families’ needs. Other recommendations include the need to improve professionals’ ability in timely stepping up to more intensive care and scaling down to less restrictive support, and to further our insight in risk factors and needs of these families.
Highlights
To meet the needs of high-vulnerable families with severe and enduring problems across several life domains, professionals must improve their ability to provide integrated care timely and adequately
Support for high-vulnerable families in Youth Care is performed by multiple professionals from different organizations, for example professionals from community centres, education, specialized mental health care, child protection, parenting support, social work, and residential treatment
To further our understanding of the extent to which these facilitators and barriers influence clinical practice, there is a need for high-quality mixed-methods research. Taken together, this qualitative study highlights the need for flexible support across several life domains to meet the needs of high-vulnerable families
Summary
To meet the needs of high-vulnerable families with severe and enduring problems across several life domains, professionals must improve their ability to provide integrated care timely and adequately. The aim of this study was to identify facilitators and barriers professionals encounter when providing integrated care It is a major challenge for professionals in Youth Care to timely and adequately meet the needs of high-vulnerable families [1]. High-vulnerable families can present resistance to the support from Youth Care professionals It is unclear whether these families actively resist support due to their negative experiences with prior support or difficulties in forming therapeutic alliance [10], or whether they do not receive the support they need. There is a need to substantially improve professionals’ ability to support these families in an integrated way
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