Abstract
Background:Few studies have identified and compared profiles of mental health service networks (MHSN) in terms of structures, processes, and outcomes, based on cluster analyses and perceptions of team managers, MH professionals and service users. This study assessed these associations in Quebec metropolitan, urban and semi-urban MHSN.Methods:A framework adapted from the Donabedian model guided data management, and cluster analyses were used to identify categories. Study participants included team managers (n = 45), MH professionals (n = 311) and service users (n = 327).Results:For all three MHSN, a common outcome category emerged: service users with complex MH problems and negative outcomes. The Metropolitan network reported two categories for structures (specialized MH teams, primary care MH teams) and processes (senior medical professional, psychosocial professionals), and outcomes (middle-age men with positive outcomes, older women with few MH problems). The Urban and Semi-urban networks revealed one category for structures (all teams) and service user (young service users with drug disorders), but two for processes (psychosocial professionals: urban, all professionals: semi-urban).Conclusion:The Metropolitan MHSN showed greater heterogeneity regarding structures and team processes than the other two MHSN. Service user outcomes were largely associated with clinical characteristics, regardless of network configurations for structures and team processes.
Highlights
Integrated care models are increasingly implemented internationally to reduce healthcare service fragmentation and better meet the needs of patients [1,2,3]
The main contribution of the study was to identify service user outcomes that were largely associated with clinical characteristics, regardless of network configurations with different structures and team processes
Another important finding of this study was the greater heterogeneity identified in the Metropolitan mental health service networks (MHSN) in terms of structures and team processes, as compared with the Urban and Semi-urban MHSN, which suggests that implementation of the mental health (MH) reform was relatively more difficult in this type of network
Summary
Integrated care models are increasingly implemented internationally to reduce healthcare service fragmentation and better meet the needs of patients [1,2,3]. Few studies have identified and compared profiles of mental health service networks (MHSN) in terms of structures, processes, and outcomes, based on cluster analyses and perceptions of team managers, MH professionals and service users. This study assessed these associations in Quebec metropolitan, urban and semi-urban MHSN. The Metropolitan network reported two categories for structures (specialized MH teams, primary care MH teams) and processes (senior medical professional, psychosocial professionals), and outcomes (middle-age men with positive outcomes, older women with few MH problems). Service user outcomes were largely associated with clinical characteristics, regardless of network configurations for structures and team processes
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