Abstract
BACKGROUND: People suffering from mental health disorders have lower work participation compared to people without mental challenges. To increase work participation within this group vocational rehabilitation interventions are often offered. Collaboration between the mental health care and social security sectors is needed to enable professionals to perform optimally when carrying out these interventions. Yet, regulatory and financial barriers often hinder sustainable implementation. To overcome these barriers an experimental roadmap for sustainable funding based on a shared savings strategy was piloted in four regions. The aim of the present qualitative study was to gain understanding of the uses of this roadmap and the factors that were important in the experiment's process.
METHOD: The roadmap consisted of five steps based upon insights from shared savings strategies and implementation science knowledge, and was initiated by a national steering board. The roadmap aimed to make sustainable funding agreements (based on shared savings) for the implementation of a vocational rehabilitation intervention. In four regions, stakeholders from the mental health care and social security services sector followed the roadmap. We conducted interviews (n = 16) with involved participants and project leaders of the experiment and collected 54 sets of field notes and documents to evaluate the roadmap process. A thematic analysis was used to analyse the data.
RESULTS: Regions perceived improved stakeholder collaboration around vocational rehabilitation after they were guided by the roadmap. Three regions made, or intended to make, agreements on collaboration and funding, yet not based on shared savings. Moreover, going through the roadmap took more time than anticipated. Stakeholder collaboration depended on factors like personal and organizational interests and collaboration conditions and values. Financial legislation and politics were regarded as barriers and personal motives were mentioned as a facilitator in this process.
CONCLUSIONS: Our study showed that the roadmap supported stakeholders to establish a more sustainable collaboration, even though no sustainable financial agreements were made yet. Although participants acknowledged the function of financial insights and the need for financial resources, the driver for collaboration was found to be more on improving clients' perspectives than on solving unfair financial distribution issues. This suggests modifying the focus of the roadmap from financial benefits to improving clients' perspectives.
| Original language | English |
|---|---|
| Article number | 7 |
| Pages (from-to) | 7 |
| Journal | International Journal of Mental Health Systems |
| Volume | 18 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 10 Feb 2024 |
Bibliographical note
© 2024. The Author(s).Funding
The experiment was funded by the Dutch Ministry of Social Affairs and Employment (SZW) and consisted of a national level project group and four regional project groups. The national project group was comprised of four representatives from the national steering board, complemented with researchers (the authors of this paper). For details on the organizational structure see Fig. . The national project group’s responsibilities were to set up a roadmap, to introduce this roadmap in four regions, to facilitate these regions’ use of the roadmap and to evaluate the development process, the implementation process and client outcomes for the selected vocational rehabilitation intervention. This paper is focused on the evaluation of the development process, results of the latter two evaluations will be described elsewhere, as data collection is still ongoing.
| Funders | Funder number |
|---|---|
| Ministerie van Sociale Zaken en Werkgelegenheid |