Beyond Organizing Structures: Necessary Conditions to Provide Integrated Care for Youth at-Risk in Practice
Abstract
Abstract Background Youth at-risk face multiple and severe problems across various life domains and poses significant risks to themselves and others. The high-risk and high-pressure circumstances and unique needs of youth at-risk make providing integrated care for these youth challenging yet even more crucial. Integrated care refers to coherent, coordinated, and continuous support across services and sectors. Objective This qualitative study explores the conditions necessary for providing integrated care for youth at-risk according to professionals, organizational representatives, and policymakers. Method Using a grounded-theory approach, we conducted 31 semi-structured interviews with professionals, organizational representatives, and policymakers across four Dutch youth-care regions. Seven observations of multidisciplinary case discussions were used to support triangulation. The study was co-created with stakeholders, including a youth representative who reflected on the findings. Results The iterative grounded theory analysis suggests that shared responsibility, shared care coordination, and professional autonomy are key conditions according to stakeholders. Stakeholders perceived that when one of these conditions was lacking, collaboration challenges and stagnation and insufficiency in care were more likely to occur. Stakeholders perceivedthat these conditions mutually influenced one another, such that deficits in one condition can undermine the others. Conclusions According to stakeholders, providing integrated care in high-risk contexts involves continuous alignment, collective decision-making, and flexibility among professionals and organizations. Attention to these conditions may help support integrated care practices for youth at-risk.
Authors 6
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Leiden University · Leiden University Medical Center
Affiliation as printed
Academic Collaborative Youth At-Risk, Post Box 53, Nijmegen, 6500 AB, The Netherlands
LUMC Curium - Department of Child and Adolescent Psychiatry, Leiden University Medical Centre, Post Box 15, 2300 AA, Leiden, The Netherlands
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Leiden University · Leiden University Medical Center
Affiliation as printed
Academic Collaborative Youth At-Risk, Post Box 53, Nijmegen, 6500 AB, The Netherlands
LUMC Curium - Department of Child and Adolescent Psychiatry, Leiden University Medical Centre, Post Box 15, 2300 AA, Leiden, The Netherlands
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Leiden University · Leiden University Medical Center
Affiliation as printed
Academic Collaborative Youth At-Risk, Post Box 53, Nijmegen, 6500 AB, The Netherlands
LUMC Curium - Department of Child and Adolescent Psychiatry, Leiden University Medical Centre, Post Box 15, 2300 AA, Leiden, The Netherlands
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Affiliation as printed
Lokalis, Joseph Haydnlaan 2A, 3433 AE, Utrecht, The Netherlands
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Amsterdam University Medical Centers · Amsterdam UMC Location University of Amsterdam · iHub
Affiliation as printed
Academic Collaborative Youth At-Risk, Post Box 53, Nijmegen, 6500 AB, The Netherlands
Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam University Medical Centre, Meibergdreef 5, Amsterdam, 1105 AZ, The Netherlands
iHUB, Mozartlaan 148, 3055 KL, Rotterdam, The Netherlands
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University of Amsterdam · Amsterdam University Medical Centers · Amsterdam UMC Location University of Amsterdam
Affiliation as printed
Academic Collaborative Youth At-Risk, Post Box 53, Nijmegen, 6500 AB, The Netherlands
Child Development and Education, University of Amsterdam, Post Box 15780, Amsterdam, 1001 NG, The Netherlands
Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam University Medical Centre, Meibergdreef 5, Amsterdam, 1105 AZ, The Netherlands
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