Coordination of Health and Social Care Services between Primary and Secondary health and social care institutions in the Eastern Regional Health Enterprise (RHE) : The coordination challenges and problems in the mental health and social care sector for long term mental patients

Abstract

The objective of my research study is to find the problems and challenges of coordinating health and social care services for chronic or long term mental care patients. And what can be done to alleviate the problems and challenges of coordinating health and social care services in the mental health care sector, and their effects on the patients. My research study, applies to the mental care patients with individual patient plan, and who receive health and social care services from both primary and secondary health care organizations.

The research study concentrated in the counties and municipalities of Akerhus and Oslo, which is a part of the Eastern Regional Health Enterprise. My research study employed the Qualitative Research Methods, using In-dept Interviews to find out the problems and challenges of coordinating health and social care services for the mental care patients. During the interviews process, I had conducted interviews with the representatives of the following institutions: • The Directorate of Health and Social Affairs (DHSA) • Primary Health and Social Care Services (PHSCO) • The Secondary Health and Social Care Services (SHSCO) My interviewees are the top, medium and low level managers from the above mentioned health and social care institutions.

My research study revealed that the problems and the challenges of coordinating health and social care services in the mental health care sector, is caused by and among others, the problem of coordinating and implementing the national health and social policies. These include individual patient plan act, earmarked state grants and cooperation agreement between primary and secondary health care organizations. There are also the problems of organizations, structures routines, information and communication in both primary and secondary health care institutions, resulting to fragemented sector and divisions, which cause intra/inter-organizational challenges of coordinating health and social care services. The under funding of mental health care sector is causing capacity and competence problems in the mental health care organizations, which is affecting the continuity and holistic delivery of health and social care services, and thereby, affecting patients chances for recovery and rehabilitation in their communities.