Skip to main content
Log in

Integrated Local Networks as a Model for Organizing Mental Health Services

  • Published:
Administration and Policy in Mental Health and Mental Health Services Research Aims and scope Submit manuscript

Abstract

Organizing services in an integrated network as a model for transforming healthcare systems is often presented as a potential remedy for service fragmentation that should enhance system efficiency. In the mental health sector, integration is also part of a diversified response to the multiple needs of the clients, particularly people with serious mental health disorders. The authors describe how the notion of integrated service networks came to serve as a model for transforming the mental health system in Québec, and they propose a frame of reference for this notion. They also address the challenges and issues raised by this mode of service organization in the mental health sector and more generally in a context of transforming healthcare systems.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

REFERENCES

  • Bill 120. (1991). La Loi 120 sur les Services de Santé et les Services Sociaux. Gouvernement du Québec: Ministére de la Santé et des Services Sociaux (MSSS).

  • Bolland, J.M., & Wilson, J.V. (1994). Three faces of integrative coordination: A model of interorganizational relations in community-based health and human services. Health Services Research, 29(3), 341-366.

    Google Scholar 

  • Brown, M. (1996). Mergers, networking, and vertical integration: Managed care and investors-owned hospitals. Health Care Management Review, 21(1), 29-37.

    Google Scholar 

  • Brown, M., & McCool, B.P. (1990). Health care systems: Predictions for the future. Health Care Management Review, 15(3), 87-94.

    Google Scholar 

  • Burns, L.R. (1999). Polarity management: The key challenge for integrated health systems. Journal of Healthcare Management, 44(1), 14-33.

    Google Scholar 

  • Callon, M. (1989). La protohistoire d'un laboratoire, La science et ses réseaux (pp. 66-116). Paris: La découverte.

    Google Scholar 

  • Charns, M.P. (1997). Organization design of integrated delivery systems. Hospital & Health Services Administration, 42(3), 411-432.

    Google Scholar 

  • Cocozza, J.J., Steadman, H.J., Dennis, D.L., Blasinsky, M., Randolph, F.L., Johnsen, M., & Goldman, H. (2000). Successful systems integration strategies: The ACCESS program for persons who are homeless and mentally ill. Administration and Policy in Mental Health, 27(6), 395-407.

    Google Scholar 

  • Conrad, D.A. (1993). Coordinating patient care services in regional health systems: The challenge of clinical integration. Hospital & Health Administration, 38(4), 491-508.

    Google Scholar 

  • Conrad, D.A., & Shortell, S.M. (1996). Integrated health systems: Promise and performance. Frontiers of Health Services Management, 13(1), 3-40.

    Google Scholar 

  • Dill, A., & Rochefort, D.A. (1989). Coordination, continuity and centralized control: A policy perspective on services strategies to the chronically mentally ill. Journal of Health and Social Behavior, 12, 99-108.

    Google Scholar 

  • Fleury, M.J., & Denis, J.L. (2000). Bilan de la mise em oeuvre et des effets des plans régionaux d'organisation des services (PROS) comme stratégies d'implantation de la réforme des services de santé mentale au Québec. Santé Mentale au Québec, 25(1), 217-240.

    Google Scholar 

  • Fleury, M.J., Mercier, C., & Denis, J.L. (2002). Regional planning implementation and its impact on integration of a mental health care network. The International Journal of Health Planning and Management, 17(4).

  • Gillies, R.R., Shortell, S.M., Anderson, D.A., Mitchell, J.B., & Morgan, K.L. (1993). Conceptualizing and measuring integration: Findings from the health systems integration study. Hospital & Health Services Administration, 38(4), 467-488.

    Google Scholar 

  • Gillies, R.R., Shortell, S.M., & Young, G.J. (1997). Best practices in managing organized delivery systems. Hospital & Health Administration, 42(3), 299-321.

    Google Scholar 

  • Glisson, C., & Hemmelgarn, A. (1998). The effects of organizational climate and interorganizational coordination on the quality and outcomes of children's service systems. Child Abuse & Neglect, 22(5), 401-421.

    Google Scholar 

  • Goldman, H.H., Morrissey, J.P., & Ridgely, M.S. (1990). Form and function of mental health authorities at RWJ foundation program sites: Preliminary observations. Hospital and Community Psychiatry, 41(11), 1222-1229.

    Google Scholar 

  • Gray, B. (1985). Conditions facilitating interorganizational collaboration. Human Relations, 3(10), 911-936.

    Google Scholar 

  • Hoge, M.A., Davidson, L., Griffith, E.E.H., Sledge, W.H., & Howenstine, R.A. (1994). Defining managed care in public-sector psychiatry. Hospital and Community Psychiatry, 45(11), 1085-1089.

    Google Scholar 

  • Hoge, M.A., & Howenstine, R.A. (1997). Administrative update: Organizational development strategies for integrating mental health services. Community Mental Health Journal, 33(3), 175-187.

    Google Scholar 

  • Kizer, W.K., Fonseca, M.L., & Long, L.M. (1997). The Veterans Healthcare System: Preparing for the twenty-first century. Hospital & Health Services Administration, 42(3), 283-298.

    Google Scholar 

  • Knights, D., Murray, F., & Willmott, H. (1993). Networking as knowledge work: A study of strategic interorganizational development in the financial services industry. Journal of Management Studies, 30(6), 975-995.

    Google Scholar 

  • Kovess, V., Lesage, A., Boisguerin, B., Fournier, L., Lopez, A., & Ouellet, A. (2001). Planification et évaluation des besoins en santé mentale (under the direction of the Comité de la Santé Mentale du Québec et de la Direction Générale de la Santé en France, ed.). France: Flammarion.

    Google Scholar 

  • Larson, A. (1992). Network dyads in entrepreneurial settings: A study of the governance of exchange relationships. Administrative Science Quarterly, 37(March), 76-104.

    Google Scholar 

  • Laville, J.L., & Gardin, L. (1999). Les coopératives sociales italiennes. Nouvelles Pratiques Sociales, 11(2), 63-81.

    Google Scholar 

  • Leatt, P., Pink, G.H., & Guerriere, M. (2000). Towards a Canadian model of integrated healthcare. Healthcare Papers, 1(2), 13-37.

    Google Scholar 

  • Leutz, W.N. (1999). Five laws for integrating medical and social services: Lessons from the United States and the United Kingdom. The Milbank Quarterly, 77(1), 77-110.

    Google Scholar 

  • Mercier, C., & White, D. (1994). Mental health policy in Quebec: Challenges for an integrated system. New Directions for Mental Health Services, 61(Spring), 41-52.

    Google Scholar 

  • Ministère de la Santé et des Services Sociaux (MSSS). (1997). Bilan de l'implantation de la Politique de santé mentale. Québec: Gouvernement du Québec (N. Potvin).

    Google Scholar 

  • Ministère de la Santé et des Services Sociaux (MSSS). (1998). Plan d'action pour la transformation des services de santé mentale. Québec: Gouvernement du Québec.

    Google Scholar 

  • Ministére de la Santé et des Services Sociaux (MSSS). (2000). Le système de santé et des services sociaux au Québec... en bref. Québec: Gouvernement du Québec.

    Google Scholar 

  • Ministère de la Santé et des Services Sociaux (MSSS). (2001a). Accentuer la transformation des services de santé mentale, Cibles prioritaires adoptées au Forum sur la santé mentale de septembre 2000. Québec: Gouvernement du Québec.

    Google Scholar 

  • Ministère de la Santé et des Services Sociaux (MSSS). (2001b). Transformation des services de santé mentale, État d'avancement du plan d'action de décembre 1998. Québec: Gouvernement du Québec.

    Google Scholar 

  • Ministère des Affaires Sociales (MAS). (1987). Pour un partenariat élargi (Rapport Harnois). Québec: Gouvernement du Québec.

    Google Scholar 

  • Ministère des Affaires Sociales (MAS). (1989). La politique de santé mentale. Québec: Gouvernement du Québec.

    Google Scholar 

  • Monroe-DeVita, M.B., & Mohatt, D.E. (1999). The state hospital and the community: An essential continuum for persons with severe and persistent mental illness. New Directions for Mental Health Services, 84(Winter), 85-97.

    Google Scholar 

  • Morrissey, J., Calloway, M., Johnsen, M., & Ullman, M. (1997). Service system performance and integration: A baseline profile of the ACCESS demonstration sites. Psychiatric Services, 48(3), 374-380.

    Google Scholar 

  • Morrissey, J.P., Tausig, M., & Lindsey, M.L. (1985). Community mental health delivery systems. A network perspective. American Behavioral Scientist, 28(5), 704-720.

    Google Scholar 

  • Mur-Veeman, I.A., van Raak, A., & Paulus, A. (1999). Integrated care: The impact of governmental behaviour on collaborative networks. Health Policy, 49, 149-159.

    Google Scholar 

  • Oliver, A. L., & Ebers, M. (1998). Networking network studies: An analysis of conceptual configurations in the study of inter-organizational relationships. Organization Studies, 19(4), 549-583.

    Google Scholar 

  • Park, S.H. (1996). Managing an interorganizational network: A framework of the institutional mechanism for network control. Organization Studies, 17(5), 795-824.

    Google Scholar 

  • Pettigrew, A., Ferlie, E., & McKee, L. (1992). Shaping strategic change. London: Sage.

    Google Scholar 

  • Provan, K.G., & Milward, H.B. (1995). A preliminary theory of interorganizational network effectiveness: A comparative study of four community mental health systems. Administrative Science Quarterly, 40, 1-33.

    Google Scholar 

  • Randolph, F., Blasinsky, M., Leginski, W., Buckley Parker, L., & Goldman, H.H. (1997). Creating integrated service systems for homeless persons with mental illness: The ACCESS program. Psychiatric Services, 48(3), 369-373.

    Google Scholar 

  • Rosenheck, R., Morrissey, J., Lam, J., Calloway, M., Johnsen, M., Goldman, H., Randolph, F., Blasinsky, M., Fontana, A., Calsyn, R., & Teague, G. (1998). Service system integration, access to services, and housing outcomes in a program for homeless persons with severe mental illness. American Journal of Public Health, 88(11), 1610-1615.

    Google Scholar 

  • Shortell, S.M., Kellogg, J.L., Gillies, R.R., Anderson, D.A., Morgan, K.L., & Marwick, P. (1993). Creating organized delivery systems: The barriers and facilitators. Hospital and Health Services Administration, 38(4), 447-466.

    Google Scholar 

  • Van Etten, P. (1999). Camelot or common sense? The logic behind the UCSF/Stanford merger. Health Affairs, 18(2), 143-148.

    Google Scholar 

  • Van Raak, A., Mur-Veeman, I.A., & Paulus, A. (1999). Understanding the feasibility of integrated care: A rival viewpoint on the influence of actions and the institutional context. International Journal of Health Planning and Management, 14, 235-248.

    Google Scholar 

  • Walston, S.L., Kimberly, J.R., & Burns, L.R. (1996). Owned vertical integration and health care: Promise and performance. Health Care Management Review, 21(1), 83-92.

    Google Scholar 

  • White, D., & Mercier, C. (1991). Coordinating community and public-institutional mental health services. Some unintended consequences. Social Science and Medicine, 33(6), 729-739.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Fleury, MJ., Mercier, C. Integrated Local Networks as a Model for Organizing Mental Health Services. Adm Policy Ment Health 30, 55–73 (2002). https://doi.org/10.1023/A:1021227600823

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1021227600823

Navigation