A Case for Open Network Health Systems: Systems as Networks in Public Mental Health

Document Type : Perspective

Authors

1 Mind Venture International, Maastricht, The Netherlands

2 Department of Psychiatry and Psychology and CAPHRI Research School, Maastricht University, Maastricht, The Netherlands

Abstract

Increases in incidents involving so-called confused persons have brought attention to the potential costs of recent changes to public mental health (PMH) services in the Netherlands. Decentralized under the (Community) Participation Act (2014), local governments must find resources to compensate for reduced central funding to such services or “innovate.” But innovation, even when pressure for change is intense, is difficult. This perspective paper describes experience during and after an investigation into a particularly violent incident and murder. The aim was to provide recommendations to improve the functioning of local PMH services. The investigation concluded that no specific failure by an individual professional or service provider facility led to the murder. Instead, also as a result of the Participation Act that severed communication lines between individuals and organizations, information sharing failures were likely to have reduced system level capacity to identify risks. The methods and analytical frameworks employed to reach this conclusion, also lead to discussion as to the plausibility of an unconventional solution. If improving communication is the primary problem, non-hierarchical information, and organizational networks arise as possible and innovative system solutions. The proposal for debate is that traditional “health system” definitions, literature and narratives, and operating assumptions in public (mental) health are ‘locked in’ constraining technical and organization innovations. If we view a “health system” as an adaptive system of economic and social “networks,” it becomes clear that the current orthodox solution, the so-called integrated health system, typically results in a “centralized hierarchical” or “tree” network. An overlooked alternative that breaks out of the established policy narratives is the view of a ‘health systems’ as a non-hierarchical organizational structure or ‘Open Network.’ In turn, this opens new technological and organizational possibilities in seeking policy solutions, and suggests an alternative governance model of huge potential value in public health both locally and globally.

Keywords

Main Subjects

Full Text

"Watch the Video Summary"

References

  1. Beers R. Verwarde Personen in de maatschapelijk opvang. Amersfoort: Federatie Opvang; 2015.
  2. Delaere M. Burgemeester slaat alarm over gestoorden. Amsterdam: Binnenlands Bestuur; 2015.
  3. VWS. Stedelijk Kompas. The Hague: Ministry of Health; 2009.
  4. VWS. Health Insurance in the Netherlands/AWBZ.  The Hague: Ministry of Health; 2011.
  5. Wolf J. Niemand tussen wal en schip. Referentiekader maatschappelijke zorg voor mensen in multiprobleemsituaties. Nijmegen: Academische werkplaats OGGZ; 2015.
  6. deVries M. Omgaan met ’mensen met een verhaal’: Verkenning van het lokale Openbare geestelijke gezondheidszorglandschap (OGGZ-landschap) naar aanleiding van het tragisch incident op Singel 9 en de noodzaak voor een collectieve benadering. Gemeente Maastricht, Maastricht 2015.
  7. van Everdingen C. Meer verwarde mensen op straat. Almere: Leger des Heils; 2016.
  8. Veiligheidshuis. Jaarverslag 2014. Maastricht: Heuveland; 2015.
  9. Drukker M, Bak M, Campo Jà, Driessen G, Van Os J, Delespaul P. The cumulative needs for care monitor: a unique monitoring system in the south of the Netherlands. Soc Psychiatry Psychiatr Epidemiol. 2010;45(4):475-485. doi:10.1007/s00127-009-0088-3
  10. Rhodes MG. (2013). A network based theory of health systems and cycles of well-being. Int J Health Policy Manag. 2013;1(1):7-15. doi:10.15171/ijhpm.2013.03
  11. Rhodes MG. (2013). Can Social Contagion Help Global Health ‘Jump the Shark’? Int J Health Policy Manag. 2013;1(4):307-310. doi:10.15171/ijhpm.2013.61
  12. Veerbeek M, Knipsel A, Nuijen J. GGZ in tabellen 2013-14. Utrecht: Trimbos Institute; 2015.
  13. Delespaul PAEG, Milo M, Schalken T, Boevink W, van Os J. Goede GGZ, nieuwe concepten, aangepaste taal en beter organisatie., Amsterdam: Prometheus; 2015.
  14. Naylor C. Das P. Ross S. et al. Bringing together physical and mental health: A new frontier for integrated care. London: Kings Fund; 2016.
  15. Economist Intelligence Unit. Mental health and integration. Provision for supporting people with mental illness: a comparison of 30 European countries.  OECD-report. The Netherlands country report. London; 2014.
  16. World Health Organization. Everybody’s business — strengthening health systems to improve health outcomes. WHO’s framework for action. Geneva: WHO; 2007.
  17. Ooms G, Stuckler D, Basu S, McKee M. A global social support system: what the international community could learn from the United States’ national basketball association's scheme for redistribution of new talent. Int J Health Policy Manag. 2015;4(11):715-718. doi:10.15171/ijhpm.2015.126
  18. Rose G. Rose’s Strategy of Preventive Medicine. 2nd ed. Oxford: Oxford University Press; 2008.
  19. Huppert FA. A new approach to reducing disorder and improving wellbeing. Perspect Psychol Sci. 2009;4(1):108-111.
  20. Sollet O. Doorontwikkeling Maatschappelijk Zorg Zuid Limburg: Plan van aanpak op hoofdlijnen. (Continued development of Community care in South Limburg) (Consulting Report). Maastricht: Zwiep Advisory Services; 2015.
  21. Leibowitz S, Margolis S. Path dependence, lock-in, and history. Journal of Law, Economics and Organisation. 1995;11(1):205-226.
  22. Klenke K. Keeping Control in Nonhierarchical Organisations. (In.) Business The Ultimate Resource. http://www.aom-iaom.org/article_kk.pdf. Published 2006.
  23. Algemeen Dagblad. WhatsApp-dienst voor daklozen in Amsterdam. Algemeen Dagblad; 2016.

Files

History

  • Receive Date: 06 October 2016
  • Revise Date: 03 January 2017
  • Accept Date: 03 January 2017
  • First Publish Date: 01 March 2017

Share

How to cite

Statistics