title: Improving the network management of integrated primary mental healthcare for older people in a rural Australian region: protocol for a mixed methods case study.
abstract: BACKGROUND
  An integrated approach to the mental healthcare of older people is advocated across health, aged care and social care sectors. It is not clear, however, how the management of integrated servicing should occur, although interorganisational relations theory suggests a reflective network approach using evaluation feedback. This research will test a network management approach to help regional primary healthcare organisations improve mental health service integration.
  
  
  METHODS
  This mixed methods case study in rural South Australia will test facilitated reflection within a network of health and social care services to determine if this leads to improved integration. Engagement of services will occur through a governance group and a series of three 1-day service stakeholder workshops. Facilitated reflection and evaluation feedback will use information from a review of health sector and local operational policies, a network survey about current service links, gaps and enablers and interviews with older people and their carers about their help seeking journeys. Quantitative and qualitative analysis will describe the policy enablers and explore the current and ideal links between services. The facilitated reflection will be developed to maximise engagement of senior management in the governance group and the service staff at the operational level in the workshops. Benefit will be assessed through indicators of improved service coordination, collective ownership of service problems, strengthened partnerships, agreed local protocols and the use of feedback for accountability.
  Ethics approval will deal with the sensitivities of organisational network research where data anonymity is not preserved. The benefit will be the tested utility of a facilitated reflective process for a network of health and social care services to manage linked primary mental healthcare for older people in a rural region. Dissemination will make use of the sectoral networks of the governance group.
authors.affiliation: School of Nursing & Midwifery, Flinders University, Adelaide, Australia.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Fuller
authors.affiliation: School of Nursing & Midwifery, Flinders University, Adelaide, Australia.
authors.forename: Candice
authors.initials: C
authors.lastname: Oster
authors.affiliation: School of Nursing & Midwifery, Flinders University, Adelaide, Australia.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Dawson
authors.affiliation: School of Nursing & Midwifery, Flinders University, Adelaide, Australia.
authors.forename: Deb
authors.initials: D
authors.lastname: O'Kane
authors.affiliation: School of Medicine, Flinders University, Adelaide, Australia.
authors.forename: Sharon
authors.initials: S
authors.lastname: Lawn
authors.affiliation: School of Nursing & Midwifery, Flinders University, Adelaide, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Henderson
authors.affiliation: School of Nursing & Midwifery, Flinders University, Adelaide, Australia.
authors.forename: Adam
authors.initials: A
authors.lastname: Gerace
authors.affiliation: School of Medicine, Flinders University, Adelaide, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Reed
authors.affiliation: Southern Fleurieu & Kangaroo Island Positive Ageing Taskforce, Victor Harbor, Australia.
authors.forename: Ann
authors.initials: A
authors.lastname: Nosworthy
authors.affiliation: Southern Adelaide-Fleurieu-Kangaroo Island Medicare Local, Bedford Park, Australia.
authors.forename: Philip
authors.initials: P
authors.lastname: Galley
authors.affiliation: Country Health South Australia Local Health Network Mental Health Services, Adelaide, Australia.
authors.forename: Ruth
authors.initials: R
authors.lastname: McPhail
authors.affiliation: School of Nursing & Midwifery, Flinders University, Adelaide, Australia.
authors.forename: Eimear Muir
authors.initials: EM
authors.lastname: Cochrane
mesh_terms: D000368:Aged; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D008605:Mental Health Services / Q000458:organization & administration* / Q000592:standards; D058996:Quality Improvement / Q000458:organization & administration / Q000592:standards; D019035:Rural Health Services / Q000458:organization & administration* / Q000592:standards; D012946:Social Welfare; D013021:South Australia
keywords: HEALTH SERVICES ADMINISTRATION & MANAGEMENT; MENTAL HEALTH; PRIMARY CARE