Abstract
Norwegian municipalities report that drug misuse is the most important public health challenge. The municipalities play a unique role in drug prevention aimed at youth, since young people rely on several services in their daily lives that are organized by different municipal departments. However, the municipal structure is described as siloed, and the policy areas as differentiated. This situation has led to a need for integration between different policy sectors to prevent drug use and promote health. The following study explores how policymakers describe the structures for integration within local government in practice with regard to drug prevention aimed at youth, contributing to the ongoing debate on collaboration and integration in response to public health challenges. A single case study design was used to investigate the accounts of policymakers from different municipal departments in a Norwegian municipality following Axelsson and Axelsson's conceptual scheme of integration. Collaboration between departments was viewed as important to successfully address drug prevention; however, the policymakers recognized problems with integration. The participants described confusion regarding ownership between the departments and a perceived lack of a mandate for collaboration. The findings and discussion illustrate that integration of drug prevention in a siloed structure relies on departments appreciating their respective roles in drug prevention and advisers experiencing a mandate to manage the siloes that exist in the organization. By gaining a better understanding of the siloed structures, we can provide valuable information needed to navigate them.
Highlights
In recent years, drug prevention directed at youth has increasingly included a health-promoting approach
The municipalities play a unique role in drug prevention aimed at youth, since young people rely on several services in their daily lives that are organized by different municipal departments
Following the development of the social determinants of health, the interplay and collaboration between policy sectors are important to address complex health problems, such as drug prevention aimed at youth
Summary
Drug prevention directed at youth has increasingly included a health-promoting approach. The goal is to prevent and avoid problem behaviours and to strengthen health and well-being and address the root causes of harmful behaviours. This development has paralleled the recognition of the social determinants of health. In a siloed governmental structure, it may be difficult to develop comprehensive and coordinated policies across the different policy areas addressing drug prevention aimed at youth. As outlined in the Norwegian Public Health Act, the municipalities rely on collaboration between different sectors to bridge the siloed bureaucratic government structure. It can be difficult for each department to identify how it can impact the root causes of complex health challenges, such as youth drug use. Hendriks and colleagues[13] point out that there are limited studies on how intersectoral collaboration is perceived by those responsible for policy development, namely, the policymakers from different policy sectors within local government
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