Barriers and Facilitators to Mental Health Service Integration: A Scoping Review.
Adam Searby, Dianna Burr, Renae Carolin and 1 others
PMID 39381841WHAT IT FOUND
Clinical outcomes were not consistently better in integrated mental health models, although some showed better access, screening, referral or care quality.
Barriers included staff confidence, workload, territorialism and funding.
Key findings
01The included papers described mental health services integrated with primary care, alcohol and other drug services, emergency departments, sexual health clinics, older adult services, First Nations services and youth services.
02Some integrated models showed better access, screening, referral or care quality, but clinical outcomes were not consistently better.
03Facilitators were education, interdisciplinary working and resourcing; barriers were staff factors, consumer factors, territorialism and organisational climate.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review did not assess the quality of included studies, and the studies used very different methods, so the findings cannot be pooled or ranked by strength. It included only English-language peer-reviewed journal articles or grey literature from 1990 onward, so local health service documents describing integration may be missing. Five included papers did not evaluate their integration model; they only described it. Some evaluations did not focus on clinical outcomes, and one Veterans Affairs analysis was at facility level rather than patient level. The paper gives inconsistent counts of included papers, saying 21 papers were included and later referring to 19 papers.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not read this review as proof that mental health service integration improves clinical outcomes. Some models showed better access, screening, referral or quality of care, but the integrated Behavioural Health Home trial found no significant difference in most clinical outcomes, and the review did not assess study quality.