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

这一项目是针对有关英格兰精神卫生服务提供效力的确凿调查结果而制定的。自2008年以来，通过“改善获得心理治疗的机会”服务，为心理健康提供了法定资金/支持，该服务是为了“解决”全国精神疾病的“流行病”而制定的。然而，最近的NHS数据（见NHS， 2016）表明，到目前为止，由于多种原因，这一目标未能实现，仅成功渗透到“患病”人口中约2.5%。此外，据报道，在接受最初“成功”干预的患者中，复发率约为50% （Ali等人，2017）。漫长的等待时间也是一个突出的问题，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，在第二次会议的漫长等待中，第一次会议的任何好处通常都会完全丧失（NHS, 2016）。这些发现似乎表明，有必要对国家卫生政策所依据的生态系统进行彻底改革。卫生服务系统作为一个整体已经经历了重大的变化，旨在降低成本和提高病人的经验（Zolkiewski, 2004; 2011）。联盟的出现证明了对协作工作在初级保健中的作用的日益重视，这些联盟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的优先次序并达成决策。与Hunter-Jones和Zolkiewski指导的早期成功的CASE学生相关的研究结果发现，如果有效地工作，这种合作可以导致资金增加和持续（如果不是增强的话）服务提供（Sinton等人，2017）。鉴于这些发现，2016年，该学生背后的研究团队开始研究默西塞德郡心理健康服务中协作工作的存在。这项研究包括2017年5月的活动，其中有120个组织参加，2017年11月有60个组织参加。讨论的主要内容是分享、相互学习和以成功故事为基础。这导致了一个实践社区的发展，一个对合作和交流感兴趣的专业网络。本研究旨在探讨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基于的服务生态系统。将调查卫生保健合作模式的现有实例，以便确定如何发展网络以最好地满足社区的需要。这将涉及与行为者的直接接触和采用定性方法，例如案例研究和访谈。研究目的：识别和评估过去和现在与精神卫生保健相关的法定和非法定服务生态系统。探讨精神卫生服务生态系统中协作性专业网络的存在。实证研究协作专业网络对有效心理健康服务生态系统的贡献。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经验证据基础。

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.