System-level intersectoral linkages between the mental health and non-clinical support sectors: a qualitative systematic review

Whiteford, Harvey, McKeon, Gemma, Harris, Meredith, Diminic, Sandra, Siskind, Dan and Scheurer, Roman (2014) System-level intersectoral linkages between the mental health and non-clinical support sectors: a qualitative systematic review. Australian and New Zealand Journal of Psychiatry, 48 10: 895-906. doi:10.1177/0004867414541683

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Author Whiteford, Harvey
McKeon, Gemma
Harris, Meredith
Diminic, Sandra
Siskind, Dan
Scheurer, Roman
Title System-level intersectoral linkages between the mental health and non-clinical support sectors: a qualitative systematic review
Journal name Australian and New Zealand Journal of Psychiatry   Check publisher's open access policy
ISSN 0004-8674
Publication date 2014-07-07
Year available 2014
Sub-type Article (original research)
DOI 10.1177/0004867414541683
Open Access Status File (Author Post-print)
Volume 48
Issue 10
Start page 895
End page 906
Total pages 12
Place of publication London, United Kingdom
Publisher Sage Publications Ltd.
Language eng
Formatted abstract
Objectives: Concerns about fragmented mental health service delivery persist, particularly for people with severe and persistent mental illness. The objective was to review evidence regarding outcomes attributed to system-level intersectoral linkages involving mental health services and non-clinical support services, and to identify barriers and facilitators to the intersectoral linkage process.

Methods: A systematic, qualitative review of studies describing attempts to coordinate the activities of multiple service agencies at the policy, program or organisational level was conducted. Electronic databases Medline, PsycINFO and EMBASE were searched via OVID from inception to July 2012.

Results: Of 1593 studies identified, 40 were included in the review – 26 in adult and 14 in vulnerable youth populations. Identified mechanisms to promote positive system-level outcomes included: interagency coordinating committees or intersectoral/interface workers engaged in joint service planning; formalised interagency collaborative agreements; a single care plan in which the responsibilities of all agencies are described; cross-training of staff to ensure staff culture, attitudes, knowledge and skills are complementary; service co-location; and blended funding initiatives to ensure funding aligns with program integration. Identified barriers included: adequacy of funding and technology; ensuring realistic workloads; overcoming ‘turf issues’ between service providers and disagreements regarding areas of responsibility; ensuring integration strategies are implemented as planned; and maintaining stakeholder enthusiasm.

Conclusions: System-level intersectoral linkages can be achieved in various ways and are associated with positive clinical and non-clinical outcomes for services and clients. Some linkage mechanisms present greater implementation challenges than others (e.g. major technology upgrades or co-location in geographically remote areas). In some instances (e.g. co-location) alternative options may achieve equivalent benefits. Publication bias could not be discounted, and studies using high-quality research designs are scarce. The limited information base applicable to system-level integration argues strongly for the evaluation of the models that evolve in the rollout of the national Partners in Recovery initiative.
Keyword Mental disorders
Health services
Non clinical support
Health Policy
Intersectoral links
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Public Health Publications
School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 7 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 7 times in Scopus Article | Citations
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Created: Thu, 30 Oct 2014, 18:40:08 EST by Ms Sandra Diminic on behalf of School of Public Health