Abstract
ABSTRACTObjective: Integrated care has been identified as means of managing the demands on the healthcare budget while improving access to and quality of services. It is particularly pertinent to rural health services, which face limited access to specialist and support services. This paper explores the capacity of three rural communities in South Australia to deliver integrated mental health support for older people.Methods: Thirty-one interviews were conducted with local health and social service providers from mental health, community health, general practice, residential aged care, private practice, NGOs and local government as part of a larger action research project on service integration.Results: Participants highlighted differences in service delivery between the communities related to size of the community and access to services. Three structural barriers to delivery of integrated care were identified. These are as follows: fragmentation of governmental responsibility, the current funding climate, and centralisation and standardisation of service delivery.Conclusion: We conclude that despite a focus upon integrated care in mental health policy, many features of current service delivery undermine the flexibility and informal relationships that typically underpin integration in rural communities.
Highlights
The aging of the baby boomer generation is leading to concern in developed countries about management of resources to meet the needs of this population
This paper explores the impact of policy and funding models on capacity to deliver integrated care for older people with mental health problems in rural communities in South Australia
The results highlight the manner in which geographical isolation and rural locale affect the delivery of mental health services for older people
Summary
The aging of the baby boomer generation is leading to concern in developed countries about management of resources to meet the needs of this population. Integrated care is viewed as a means of managing demands on healthcare budgets while improving access to and quality of services. It is viewed as a way to address gaps in service delivery (Petrich et al, 2013). Rural locale is defined as the social relationships and normative values that provide the context for health care (Bourke et al, 2012). Rural service providers have been identified as being more likely to work collaboratively and to adopt generalist and extended roles to maximise available resources (Bourke et al, 2012; Mitton, Dionne, Masucci, Wong, & Law, 2011; Petrich et al, 2013). Collaboration is more likely to occur through informal networks (Crotty, Henderson, & Fuller, 2012) and rural service providers often act as community leaders in other community services (Farmer et al, 2012b)
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