Care management in mental health services in England and Northern Ireland: do integrated organizations promote integrated practice?

Objective: To explore whether integrated structures are associated with more integrated and differentiated forms of care management in mental health services. Method: Cross-sectional postal survey of care management arrangements in local authority social services departments in England ( n = 101) and health and social services Trusts in Northern Ireland (NI) ( n = 11). Results: Some, but not all, indicators showed more evidence of integrated practice in NI mental health and social services. This included: greater involvement of health care staff in care management; greater multidisciplinary working and a more integrated approach to assessment and care planning processes; a more differentiated approach to care management, including greater targeting of care management resources; a closer link between care management and specialist provision; and overall more integrated practice. Conclusions: This study concurs with previous research showing that structurally integrated health and social services in NI are more conducive towards, although insufficient to secure, integrated working. As the nature, type of services and ways of working appear to be broadly similar in England and NI, this may imply that greater structural integration per se may not lead to better service outcomes.