Integrated care for individuals with mental illness and substance abuse – the example of the coordinated individual plan in Sweden

Abstract

ABSTRACT Specialisation in care and welfare services often leads to inflexible boundaries between organisations and professions, resulting in fragmented and ineffective care, not least in the areas of severe mental illness and substance abuse. Collaborative models such as case management, multidisciplinary teams and coordinated care plans are used in many countries to address this problem. In a parallel development, demands have been made that individual users/patients should have more influence over their own care. In Sweden, legislation requires the social service and health care to draw up Coordinated Individual Plans (CIP) to clarify responsibility, improve the care process and increase users’ involvement in their own care. This article explores the impact of coordinated care plans, using the Swedish CIP as an example. What can we learn about conditions for integrated care according to the degree of collaboration, involvement for the individual user and supporting structures? The authors have studied 25 case files in a local authority. Findings indicate a low to moderate degree of collaboration and few indications of meaningful user involvement. Further studies are needed concerning factors hindering CIP from achieving a higher degree of collaboration and fully including the intentions and wishes of the individual.