Implementing assertive community care for patients with schizophrenia. A case study of co-operation and collaboration between mental health care and social services.

Abstract

The aim of this study was to describe the personal experiences of collaboration and co-operation between staff from the community mental health and social services programmes in their daily work with schizophrenic patients. An additional aim was to generate the first step in a theory of how staff in the field of health care and social services manages to integrate their efforts on an individual and organizational level. The study group consisted of five members of a multidisciplinary team who had been working for 2 years with assertive outreach intensive clinical case management. Verbatim-transcribed thematic interviews were analysed according to the comparative method for grounded theory. The analysis was focused on quality of interpersonal interaction between practitioners, representing different professions in community-based mental health care, as well as the professional relationship to the patients/clients and their relatives. In the light of an individual and organizational perspective, different typologies of interpersonal interactions appeared. Three main variables were identified: collaborative relationship, co-operative partnership and professional-amateurism. Our findings on these qualitative differences in interpersonal relations should be taken into account in the continuing reorganization of the community health care services. This knowledge can also help in overcoming barriers between patients, professionals and organizations in the mental health services.