A good kind of crossing boundaries

Those of you who are therapists and/or patients of therapists will likely be aware that, in the normal course of things, it’s not a great idea to cross boundaries – as in, slap someone without permission (violating a physical boundary) or engage in emotional blackmail (violating an emotional boundary). But this month, the Mental Health Foundation is launching a new paper, front cover pictured above, entitled Crossing Boundaries: Improving integrated care for people with mental health problems which, it has to be hoped, represents a good kind of crossing boundaries.

The report sets out the findings of an inquiry which ran between April 2012 and June 2013, whose aim was to identify good practice, generate discussion and draw up key messages on integrated healthcare for people with mental health problems.

One of the key findings of the report is that the quality of the leaders involved in delivering mental healthcare services is vital – it is particularly important they understand that an integrated approach is needed. To achieve effective patient outcomes requires the co-operation of many professional disciplines and focus on major social influences such as education, unemployment, housing and poverty. Support based simply on medical diagnosis of mental illness is insufficient in and of itself – medical support is obviously critical, but adverse social factors for example, may mitigate against any positive effect.

This ‘crossing of boundaries’, the report finds, needs to be underpinned by a number of structural and organisational improvements, among the most important being integrated IT systems within and across different care and social organisations, the ability to pool funds from different funding streams into a single budget and shared protocol and partnership agreements.

But most important of all, the report cites, is the involvement of ‘staff who understand the holistic nature of health care and have no professional defensiveness about working closely with colleagues in other disciplines…’. Hmmm. One has to wonder – would a little psychotherapy be in order?

Written by Jacqui Hogan