Mental health network governance and coordination: comparative analysis across Canadian regions

• Main Authors: Mary E. Wiktorowicz, Marie-Josée Fleury, Carol E. Adair, Alain Lesage, Elliot Goldner, Suzanne Peters
• Format: Article
• Language: English
• Published: Ubiquity Press 2010-10-01
• Series: International Journal of Integrated Care
• Subjects: coordination; integration; mental health; networks; governance; continuity of care
• Online Access: http://www.ijic.org/index.php/ijic/article/view/525

<p align="left"><strong>Objective</strong>: Modes of governance were compared in ten local mental health networks in diverse contexts (rural/urban and regionalized/non-regionalized) to clarify the governance processes that foster inter-organizational collaboration and the conditions that support them.</p><p align="justify"><strong>Methods</strong>: Case studies of ten local mental health networks were developed using qualitative methods of document review, semi-structured interviews and focus groups that incorporated provincial policy, network and organizational levels of analysis.</p><p align="justify"><strong>Results</strong>: Mental health networks adopted either a <em>corporate structure</em>, <em>mutual adjustment </em>or an <em>alliance </em>governance model. A <em>corporate structure </em>supported by regionalization offered the most direct means for local governance to attain inter-organizational collaboration. The likelihood that networks with an <em>alliance </em>model developed coordination processes depended on the presence of the following conditions: a moderate number of organizations, goal consensus and trust among the organizations, and network-level competencies. In the small and mid-sized urban networks where these conditions were met their <em>alliance </em>realized the inter-organizational collaboration sought. In the large urban and rural networks where these conditions were not met, externally brokered forms of network governance were required to support <em>alliance </em>based models.</p><p><strong>Discussion</strong>: In metropolitan and rural networks with such shared forms of network governance as an <em>alliance </em>or <em>voluntary mutual adjustment</em>, external mediation by a regional or provincial authority was an important lever to foster inter-organizational collaboration.</p>