Effective mental health service ecosystems: The role of collaborative professional networks.

这个项目是为了回应关于英格兰精神健康服务提供有效性的决定性发现而开发的。自2008年以来，通过改善获得心理治疗(IAPT)服务为精神健康提供了法定资金/支持，该服务是为“解决”国家精神疾病的“流行病”而开发的。然而，NHS最近的数据(见NHS，2016)表明，到目前为止，这一点在多个方面都未能奏效，总共只有2.5%的人成功地进入了患病人口。此外，据报道，在那些接受了最初“成功”干预的人中，复发率约为50%(Ali等人，2017年)。漫长的等待时间也是一个问题，第一次预约的平均等待时间为26天，第二次预约的平均等待时间为31天。因此，人们发现，第一次会议的任何好处通常都会在第二次会议的漫长等待中完全丧失(NHS，2016)。这样的发现似乎表明，需要对酝酿国家卫生政策的生态系统进行全面改革。卫生服务体系作为一个整体已经经历了旨在降低成本和改善患者体验的重大变化(Zolkiewski，2004；2011)。联合会的出现证明了对初级保健中协作工作作用的日益重视，联合会的出现基本上是企业对企业的合作，它们形成、沟通并集体确定行动和达成决定的优先顺序。与Hunter-Jones和Zolkiewski监督的早期成功案例学生有关的发现发现，当有效工作时，这种合作可以导致更多的资金和持续的服务交付(Sinton等人，2017)。鉴于这些发现，2016年，该学生项目背后的研究团队开始研究默西塞德心理健康服务中合作工作的存在。这项研究包括2017年5月的活动(120个组织参加)和2017年11月的60个组织参加的活动。讨论的主题是分享、相互学习和借鉴成功案例的胃口。这导致了实践社区的发展，这是一个对协作和交流感兴趣的专业网络。本研究旨在探索协作专业网络在有效的心理健康服务生态系统中的作用。研究将密切关注新兴网络及其所在的服务生态系统。将对现有的保健协作模式进行调查，以确定如何发展该网络，以便最好地满足社区的需要。这将包括与行为者的直接接触和使用定性方法，如案例研究和访谈。研究目标：识别和评估与过去和现在的精神卫生保健相关的法定和非法定服务生态系统。调查精神卫生服务生态系统内是否存在专业协作网络。经验性地质疑协作专业网络可能对有效的心理健康服务生态系统做出的贡献。促进与专业网络有关的经验证据基础，特别是与服务生态系统有关的证据。

This project has been developed in response to damning findings regarding the efficacy of mental health service delivery in England. Since 2008, statutory funding/support for mental health has been delivered via the Improving Access to Psychological Therapies (IAPT) service, which was developed in order to 'solve' the nation's 'epidemic' of mental illness. However, recent NHS data (see NHS, 2016) indicates that this has so far failed to deliver on multiple grounds, with a total successful penetration into the 'sick' population of only about 2.5%. This is in addition to a reported relapse rate of approximately 50% in those who undergo initially 'successful' interventions (Ali et al., 2017). Lengthy waiting times have also been highlighted as problematic, with an average wait to first appointment of 26 days and an average wait to second appointment of 31 days. It has thus been found that any benefit from the first session will typically be entirely lost in the long wait to the second session (NHS, 2016).Such findings appear indicative of the need for an overhaul of the ecosystem in which national health policy is conceived. The health service system as a whole has already been undergoing significant change, designed to reduce costs and enhance patient experience (Zolkiewski, 2004; 2011). An increased focus on the role of collaborative working in primary care is evidenced by the emergence of Federations, essentially business-to-business collaborations which form, communicate and collectively prioritise actions and reach decisions. Findings linked to an earlier successful CASE studentship supervised by Hunter-Jones and Zolkiewski found that, when working effectively, such collaborations can result in increased funding and sustained, if not enhanced, service delivery (Sinton et al., 2017).In light of such findings, in 2016, the research team behind this studentship began researching the existence of collaborative working in Merseyside-based mental health services. This research included events in May 2017, in which 120 organisations participated, and in November 2017, in which sixty participated. Discussions were dominated by an appetite to share, learn from each other, and build upon success stories. This led to the development of a community of practice, a professional network with an interest in collaboration and communication.This study is designed to explore the role of collaborative professional networks within an effective mental health service ecosystem. Research will look closely at the emergent network and the service ecosystem in which it is based. Existing examples of collaboration models in health care will be investigated in order to establish how the network might be developed to best serve the needs of the community. This will involve direct engagement with actors and the employment of qualitative methodologies, such as case studies and interviews.Research Objectives:To identify and evaluate the statutory and non-statutory service ecosystem linked to mental health care, past and present. To investigate the existence of collaborative professional networks within the mental health service ecosystem. To empirically question the contribution a collaborative professional network might make to an effective mental health service ecosystem. To contribute to the empirical evidence-base associated with professional networks, particularly in relation to service ecosystems.