Working together and achieving something common : A qualitative study on collaboration between psychiatric inpatient care and social services aimed at homeless patients

The purpose of the paper was to investigate how health and medical care curators in psychiatric inpatient care experience collaboration with social workers in social services when it comes to homeless patients. The purpose was also to investigate what obstacles exist and what can be developed in collaboration. The paper is qualitative and was conducted through nine written interviews in supplemented by three verbal structured interviews. The sample is limited to psychiatric inpatient care in the Stockholm region and the paper covers five psychiatric clinics. The results are reported in three different parts. The first part presents an overview based on the closed questions in the written interviews. In the first part, it appears that the distribution of the answers is evenly distributed between the 5 psychiatric clinics. The most common reasons for the need for collaboration are housing, finances and mental illness. The second part reports the open questions in the written interviews, where the results are presented based on five themes developed, which are collaboration, smoother contact channels, greater understanding of the target group, basic needs and political decisions. The third part reports the questions from the supplementary oral interviews and deals with the discharge process. The analysis shows that the health and medical care curators see a need for better collaboration internally between the social services units, financial assistance and social psychiatry. It needs to be easier and smoother to reach social secretaries and one solution would be to also introduce financial assistance into the Lifecare operating system, which is currently only available to social psychiatry. Psychiatry feels that the social services need to have an improved understanding of the target group and that the requirements for documents are too high. There is also a desire for political decisions that provide the conditions for better housing solutions for homeless patients. The analysis shows that there are good routines for the discharge process, but that the shortcomings occur internally when the doctor does not announce the decision on discharge in good time or when the patient refuses the help offered. The conclusions are that homeless patients are a complex target group. There are requests from the counselors that the contact channels to the social services become faster and smoother. The counselors' proposal is to provide financial assistance with access to the Lifecare operating system. The housing situation for the homeless patients is the biggest obstacle that the counselors in psychiatry experience in collaboration with the social services. The discharge process works well overall.