Improving collaboration between primary and secondary mental healthcare via boundary spanning: Evaluation of a new joined-up community mental healthcare model in England

Objectives: Community mental healthcare requires the collaboration of multiple services to meet the needs of local populations. Accessing mental health care in England often involves the collaboration of primary and secondary healthcare services. This paper presents the findings from an evaluation of ‘boundary spanning’ processes and practitioner roles aiming to reduce service fragmentation and improve access to mental healthcare.

Methods: Forty-one qualitative interviews with professionals across local healthcare providers were conducted in Peterborough (East England) to assess the impact of boundary spanning processes and practitioner roles and were analysed thematically.

Results: Structured boundary spanning processes and professional roles were found to facilitate communication and knowledge exchange between primary and secondary mental healthcare services, leading to optimisation of GPs' decisions about individuals' treatment pathways, and to improvements in service accessibility. Yet, effectiveness was reported as conditional on GPs' engagement, as well as the decentralised structure of primary care settings.

Conclusion: Community mental healthcare organisations could utilise boundary spanning interventions to flex organisational barriers between primary and mental healthcare and optimise accessibility of service users to mental health services. Boundary spanning processes and professional roles can be used to inform national and local care integration strategies.