Does resource scarcity create interorganizational coordination and formal service linkages? A case study of a rural mental health system

Abstract

The major objective of this research is to examine and characterize service delivery systems for persons with mental illness in a resource scarce environment, i.e. a rural area characterized by persistent poverty and disadvantaged poulations. Although a number of studies have investigated the integration of mental health, general health, and social services, few have focused on systems of care in rural areas. To characterize service delivery systems, this exploratory study uses a case study approach that includes network analysis, quantitative analysis, and a system assessment. The findings suggest that scarcity of resources in these rural environments is an overriding factor in the development of an integrated service delivery system for persons with a mental illness. With no psychiatrists, long waits for commitment, and few emergency accomodations, these rural environments afford service providers little opportunity for proactive or strategic planning. In fact, we view the development of integrated (e.g. client referral and technical information exchange) service networks in rural communities, especially areas of extreme resource scarcity, as problematic. The resource exchange networks that exist are best characterized as informal, moderately centralized, and of limited density. This translates into a system of care that is provider-driven and crisis-oriented.

Citation

Topping, S. and Calloway, M. (2000), "Does resource scarcity create interorganizational coordination and formal service linkages? A case study of a rural mental health system", Advances in Health Care Management (Advances in Health Care Management, Vol. 1), Emerald Group Publishing Limited, Leeds, pp. 393-419. https://doi.org/10.1016/S1474-8231(00)01015-6