Organisational change to integrate self‐management into specialised mental health services: Creating collaborative spaces
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AbstractIntroductionSelf‐management support for schizophrenia has become expected practice leaving organisations to find ways for feasible implementation. Self‐management support involves a foundational cultural shift for traditional disease‐based services, new ways of clients‐providers working together, coupled with delivering a portfolio of tools and techniques. A new model of self‐management support embedded into traditional case management services, called SET for Health (Self‐management Engaging Together for Health), was designed and tailored to make such services meaningfully accessible to clients of a tertiary care centre. This paper describes the proof of concept demonstration efforts, the successes/challenges, and initial organisational changes.MethodAn integrated knowledge translation approach was selected as a means to foster organisational change grounded in users' daily realities. Piloting the model in two community case management programmes, we asked two questions: Can a model of self‐management support be embedded in existing case management and delivered within routine specialised mental health services? What organisational changes support implementation?ResultsFifty‐one clients were enroled. Indicators of feasible delivery included 72.5% completion of self‐management plans in a diverse sample, exceeding the 44% set minimum; and an attrition rate of 21.6%, less than 51% set maximum. Through an iterative evaluation process, the innovation evolved to a targeted hybrid approach revolving around client goals and a core set of co‐created reference tools, supplemental tools and resources. Operationalisation by use of tools was implemented to create spaces for client‐provider collaborations. Monitoring of organisational changes identified realignment of practices. Changes were made to procedures and operations to further spread and sustain the model.ConclusionThis study demonstrated how self‐management support can be implemented, within existing resources, for routine delivery of specialised services for individuals living with schizophrenia. The model holds promise as a hybrid option for supporting clients to manage their own health and wellness.
