Drivers that influence the development of care and service pathways for mental health clients in health and social service organizations

Abstract

Background: Investigation, diagnosis, treatment, and follow-ups are the stages of care to be integrated into a care trajectory for clients requiring mental health care (MSSS, 2021). As a result of recent structural reforms, health care organizations are focusing on more integrated care and services in order to respond effectively to the complex needs of this clientele, which poses challenges for the institutionalization of clinical and management practices aimed at better integrating care and services. 
 Objective: To identify the drivers that influence the development of care and service pathways for mental health clients in health and social service organizations. 
 Method: Cross-sectional, descriptive, qualitative, single-case study (CISSS in Quebec) with nested levels of analysis covering the settings of a ""Mental Health Care"" trajectory. The settings include the first, second, and third levels of care. Guided by Longpré's (2017) framework (LO-DISS) linking governance, organizational, structural, and clinical processes with key organizational resources, an interview guide was developed. Clinical professionals, managers, and administrators (N = 10) participated in semi-structured interviews that were analyzed using a qualitative data processing tool (NVivo). Result: Drivers of integrated care and services for mental health care pathways have been identified for each component of the LO-DISS model (2017). These highlighted processes include interdisciplinary collaboration, the patient-partner approach, quality assessment mechanisms, the development of integrative roles (case manager), and the mobilization of environmental and technological resources (electronic records, an environment that supports confidentiality and collaboration). The findings support the notion that investments in resources, processes, also clinical and management practices are key to integrating care and services and providing quality of care. 
 Recommandations: Using the LO-DISS care and services integration model to support renewed clinical governance allows for the deployment of strategies aimed at formalizing clinical and management practices that link the various mental health care pathways experienced by the population.