Interprofessional collaboration in mental health crisis response systems: a scoping review

Abstract

Post deinstitutionalization saw the rise of mental health crisis (MHC) response in Canada. First points of contact for individuals in a MHC are often police services or emergency departments. Professionals in these areas may report feeling unprepared, ill equipped, and a lack of confidence to work with clients in crisis. Police indicate that this work is time consuming, demanding, and “not their job”. Entry points can exacerbate the crisis given the chaotic, over-stimulating and frightening environment of emergency departments and the perceived threat of police officers. Despite the outcry of support for working more collaboratively, little is known about the impact Interprofessional collaboration (IPC) has in mental health crisis response systems (MHCRS). Purpose: Given this challenge, the aim of this scoping review is to contribute to understanding the current state of knowledge related to IPC in MHCRS. Methods: A scoping reviews was conducted to address the research topic. Results: Review of the literature identified 18 articles for inclusion, 5 experimental or exploratory papers, 7 models of care, and 6 discussion papers. Analysis identified the following themes: Support for interprofessional collaboration, quest for improved care delivery system, merging distinct visions of care, and challenges to interprofessional collaboration. Implications for practice, policy, and research are discussed, as well as issues in the literature related to: Lack of conceptual clarity, absent client perspectives, unequal representation across sectors, and a young and emergent body of literature. Conclusion: Key concepts need better conceptualization, and further empirical research is needed.Implications for RehabilitationConceptualizing mental health crisis (MHC) response as occurring within a system of services, rather than independent sectors, is critical to meeting the needs of clients.Purposefully built in mechanisms to sustain collaboration across care teams and services are required.Merging the distinct, and at times conflicting, visions of care espoused by the diverse sectors involved in MHC response requires deliberate effort.