Care coordination: an alternative to service system integration

Introduction: Interagency collaboration is imperative when designing recovery oriented services for persons with severe and persistent mental illness [SPMI]. Service system integration is a commonly attempted method to facilitate the collaboration of services. However, it is fraught with difficulties. Objectives: The purpose of this paper is to present a viable alternative to service system integration when designing services for persons with SPMI Methods: Utilizing available literature and lessons learnt from the care coordination model of Partners in Recovery initiative of Australia, a case is made for care coordination as a viable alternative to service system integration. Results: The care coordination model of Australia’s PIR initiative enabled better interservice collaboration, a team approach to patient care and no duplication of services. The model was able to reduce unmet needs among clients from between 60 and over 90%. Most frequently reported unmet needs of psychological distress, daytime activity, and company reduced from 89%, 72% & 67% respectively at baseline to 27%, 22% & 22%, respectively at follow up. The total cost of providing the service for a consumer per year (set-up and ongoing) was estimated to be AUD$15,755 and the ongoing cost per year was estimated to be AUD$13,434. The cost of doing nothing is likely to cost more in the longer term. Conclusions: A model of care coordination trialled in Australia is a viable alternative to service system integration.It might be worth it for local and federal governments to fund randomised controlled trials of care-coordinated models for recovery-oriented services.