Strengthening Integration in Mental Health Support: a Mixed Methods Approach to Exploring Service Users’ Perspectives.

Introduction
In 2019 the UK’s National Health Service planned to integrate mental healthcare services including primary, secondary, and social care, public health, and charities. However, studies report a current lack of integration with people falling through the gap between different services.

Goals and Methods
Our study aims to identify ways to strengthen integration among different mental healthcare services.
To collate the views of a variety of service users we employed Group Concept Mapping (GCM), a structured mixed methods approach that aggregates individuals’ qualitative data into a group map that depicts participants’ ideas. We conducted five GCM workshops with twenty-three participants. In each workshop, participants individually wrote statements in response to the question “In your experience, what would make mental health services work better together?" Participants shared their statements with the group and discussed if each statement related to one another. Individually, participants then clustered similar statements together. To aggregate the individual clustering, we performed multidimensional scaling and hierarchical cluster analysis to produce a group map. One group map was created for each workshop.

Results
In one workshop, the group concept map comprised four clusters: 1) increase funding and parity of esteem (i.e., valuing mental health equally to physical health), 2) information sharing among service providers and with service users, 3) reduce onus on service user to access and navigate care pathways, and 4) holistic and person-centred care. Analysis for the other workshops is ongoing and we expect similar and new concepts to arise.

Conclusions
GCM has many benefits: the structured process organises ideas and ensures all voices are heard. The group concept maps are grounded in participants’ experiences and foster consensus among participants. Our results highlight areas where our participants believe change is most needed to improve integration. GCM is a useful tool to aid research, service planning, and evaluation.