När samverkan faller mellan stolarna - En kvalitativ studie om socionomers upplevelser av hinder och möjligheter vid samverkan mellan socialtjänst och psykiatri

Collaboration between social services and psychiatry in Sweden faces challenges despite the existence of legislation and collaborative tools to facilitate it. This study examined how collaboration in client and patient transfers was shaped by organisational and practical factors. The research questions in this study examined how professionals’ perceptions of hindering and facilitating factors, as well as power relations and hierarchies, affected their discretion among social workers. The method consisted of seven qualitative, semi-structured, vignette-based interviews conducted with social workers employed in social services or psychiatry. The vignette featured a client transferred between organisations whose situation deteriorated from fragmented collaboration. The empirical data were analyzed using thematic analysis using organisational theory and theories on power and professional discretion. The results showed that collaboration was hindered by organisational fragmentation, resource scarcity, and clashing institutional logics. Budget efficiency took priority over patient needs, causing professionals to strictly adhere to organisational boundaries. A power asymmetry was identified, where medical interpretative priority limited the social workers’ professional room for discretion and caused them to adopt a defensive stance in their work. The study concluded that more systematic integration needs to be included in the organisational structures.