Periodic Reporting for period 1 - NEST-Care (NEST–care: meNtal hEalthcare Service neTworking solutions)
Reporting period: 2023-11-01 to 2025-10-31
Health and social care systems across Europe are facing increasing pressure due to rising mental health needs, growing social inequalities, and the complexity of coordinating care across multiple services and professional roles. In many contexts, individuals with mental health needs interact with a wide range of actors, including primary care providers, specialised services, social workers, and community organisations. While this diversity of support has the potential to improve care, fragmentation and weak coordination often limit its effectiveness, leading to unequal access, inefficiencies, and unmet needs.
This project was developed in response to the growing recognition that improving mental health care requires not only new services or resources, but also a better understanding of how professionals, organisations, and sectors interact in practice. Current policy frameworks at European and national levels increasingly emphasise integrated, community-based, and person-centred care. However, there remains a gap between these strategic objectives and the day-to-day realities of service delivery, particularly regarding how collaboration is organised, sustained, and experienced on the ground.
The overall objective of the project is to generate actionable knowledge on how patterns of collaboration among health and social care professionals shape the integration, accessibility, and equity of mental health services. Rather than focusing solely on individual services or outcomes, the project examines care as a relational system, where interactions, information flows, and informal coordination play a central role. By analysing these relational dynamics, the project aims to identify structural strengths, gaps, and opportunities for improvement within existing service networks.
The project follows a pathway to impact that combines empirical research, stakeholder engagement, and knowledge co-production. Data are collected directly from professionals involved in mental health care using participatory and co-design approaches, ensuring that the research captures real-world practices and constraints. This emphasis on co-design responds to the practical challenge that health professionals often work under time pressure and organisational constraints, which can limit the feasibility of traditional top-down research or policy interventions. By actively involving practitioners, the project seeks to produce findings that are both scientifically robust and practically relevant.
A central ambition of the project is to support evidence-informed decision-making for service planning and governance. The results are expected to help identify where coordination is strong, where it breaks down, and how collaboration could be strengthened to improve continuity of care. In the medium to long term, this knowledge can contribute to more integrated service models, reduced duplication of efforts, and improved experiences for both service users and professionals.
The project is grounded in the integration of social sciences and humanities, particularly sociology, social network research, and qualitative inquiry. These disciplines play a key role in understanding how institutional structures, professional cultures, power relations, and everyday practices influence collaboration and service delivery. By combining relational analysis with interpretative insights from the social sciences, the project moves beyond purely technical or organisational solutions and highlights the social processes that underpin effective care systems.
At a broader scale, the project contributes to ongoing European efforts to strengthen mental health systems, reduce health inequalities, and promote socially sustainable models of care. Its findings are relevant not only for local service improvement, but also for policymakers, researchers, and practitioners interested in scalable approaches to integrated care. Through dissemination activities and dialogue with stakeholders, the project aims to ensure that its results are accessible, transferable, and capable of informing future initiatives in mental health and beyond.
This project was developed in response to the growing recognition that improving mental health care requires not only new services or resources, but also a better understanding of how professionals, organisations, and sectors interact in practice. Current policy frameworks at European and national levels increasingly emphasise integrated, community-based, and person-centred care. However, there remains a gap between these strategic objectives and the day-to-day realities of service delivery, particularly regarding how collaboration is organised, sustained, and experienced on the ground.
The overall objective of the project is to generate actionable knowledge on how patterns of collaboration among health and social care professionals shape the integration, accessibility, and equity of mental health services. Rather than focusing solely on individual services or outcomes, the project examines care as a relational system, where interactions, information flows, and informal coordination play a central role. By analysing these relational dynamics, the project aims to identify structural strengths, gaps, and opportunities for improvement within existing service networks.
The project follows a pathway to impact that combines empirical research, stakeholder engagement, and knowledge co-production. Data are collected directly from professionals involved in mental health care using participatory and co-design approaches, ensuring that the research captures real-world practices and constraints. This emphasis on co-design responds to the practical challenge that health professionals often work under time pressure and organisational constraints, which can limit the feasibility of traditional top-down research or policy interventions. By actively involving practitioners, the project seeks to produce findings that are both scientifically robust and practically relevant.
A central ambition of the project is to support evidence-informed decision-making for service planning and governance. The results are expected to help identify where coordination is strong, where it breaks down, and how collaboration could be strengthened to improve continuity of care. In the medium to long term, this knowledge can contribute to more integrated service models, reduced duplication of efforts, and improved experiences for both service users and professionals.
The project is grounded in the integration of social sciences and humanities, particularly sociology, social network research, and qualitative inquiry. These disciplines play a key role in understanding how institutional structures, professional cultures, power relations, and everyday practices influence collaboration and service delivery. By combining relational analysis with interpretative insights from the social sciences, the project moves beyond purely technical or organisational solutions and highlights the social processes that underpin effective care systems.
At a broader scale, the project contributes to ongoing European efforts to strengthen mental health systems, reduce health inequalities, and promote socially sustainable models of care. Its findings are relevant not only for local service improvement, but also for policymakers, researchers, and practitioners interested in scalable approaches to integrated care. Through dissemination activities and dialogue with stakeholders, the project aims to ensure that its results are accessible, transferable, and capable of informing future initiatives in mental health and beyond.
The project implemented a quantitative and participatory research design aimed at analysing patterns of collaboration within mental health and social care systems. The core scientific activities focused on co-designed data collection with professionals, the construction of relational datasets, and the application of advanced social network analysis to examine coordination and integration processes across services.
A central scientific activity of the project was the development and implementation of a participatory data collection strategy. Relational data were collected directly from health and social care professionals involved in mental health service provision across multiple care settings. The research design placed strong emphasis on co-design, engaging professionals in the definition of relevant actors, relational dimensions, and forms of collaboration to be captured. This approach ensured that the resulting datasets reflected actual patterns of interaction, including cross-sector and inter-professional collaboration that are not typically observable through administrative data. The co-design process required iterative engagement and extended the data collection phase, due to the limited availability of full-time professionals, but substantially enhanced data quality and construct validity.
The quantitative component of the project involved the construction of multiple network datasets representing collaboration and information-sharing relationships among professionals and services. These data were analysed using advanced social network analysis techniques to examine structural properties such as connectivity, centralisation, density, clustering, and role differentiation. Particular attention was given to identifying coordination hubs, boundary-spanning roles, and structural gaps affecting the continuity and integration of care.
The analyses produced detailed empirical evidence on how collaboration is organised in practice and how relational structures shape coordination capacity within mental health care systems. The results highlight the importance of specific network configurations for sustaining cross-organisational collaboration, especially in contexts characterised by high workload, limited resources, and complex service pathways. The findings also reveal how reliance on a small number of highly connected actors may create both efficiencies and vulnerabilities within care networks.
A key scientific achievement of the project is the development of an empirically grounded, network-based approach to studying integrated mental health care. By conceptualising service delivery as a relational system rather than a set of isolated organisations, the project advances existing research on integrated care and provides a replicable analytical framework for examining collaboration in other health and social care contexts.
At the time of reporting, data collection and core analytical activities have been completed. The scientific outcomes are being consolidated and interpreted in collaboration with domain experts to ensure analytical robustness and clarity of conclusions. These final steps will support the production of peer-reviewed outputs and provide a strong empirical basis for future research on network-based interventions and service integration.
Overall, the project has achieved its main scientific objectives by generating original relational data, applying advanced analytical methods, and producing new evidence on the structural conditions that enable or constrain collaboration within mental health care systems.
A central scientific activity of the project was the development and implementation of a participatory data collection strategy. Relational data were collected directly from health and social care professionals involved in mental health service provision across multiple care settings. The research design placed strong emphasis on co-design, engaging professionals in the definition of relevant actors, relational dimensions, and forms of collaboration to be captured. This approach ensured that the resulting datasets reflected actual patterns of interaction, including cross-sector and inter-professional collaboration that are not typically observable through administrative data. The co-design process required iterative engagement and extended the data collection phase, due to the limited availability of full-time professionals, but substantially enhanced data quality and construct validity.
The quantitative component of the project involved the construction of multiple network datasets representing collaboration and information-sharing relationships among professionals and services. These data were analysed using advanced social network analysis techniques to examine structural properties such as connectivity, centralisation, density, clustering, and role differentiation. Particular attention was given to identifying coordination hubs, boundary-spanning roles, and structural gaps affecting the continuity and integration of care.
The analyses produced detailed empirical evidence on how collaboration is organised in practice and how relational structures shape coordination capacity within mental health care systems. The results highlight the importance of specific network configurations for sustaining cross-organisational collaboration, especially in contexts characterised by high workload, limited resources, and complex service pathways. The findings also reveal how reliance on a small number of highly connected actors may create both efficiencies and vulnerabilities within care networks.
A key scientific achievement of the project is the development of an empirically grounded, network-based approach to studying integrated mental health care. By conceptualising service delivery as a relational system rather than a set of isolated organisations, the project advances existing research on integrated care and provides a replicable analytical framework for examining collaboration in other health and social care contexts.
At the time of reporting, data collection and core analytical activities have been completed. The scientific outcomes are being consolidated and interpreted in collaboration with domain experts to ensure analytical robustness and clarity of conclusions. These final steps will support the production of peer-reviewed outputs and provide a strong empirical basis for future research on network-based interventions and service integration.
Overall, the project has achieved its main scientific objectives by generating original relational data, applying advanced analytical methods, and producing new evidence on the structural conditions that enable or constrain collaboration within mental health care systems.
The project has the potential to produced original scientific results that advance the state of the art in the study of integrated mental health and social care systems. While existing research on service integration often relies on organisational descriptions, policy frameworks, or aggregated performance indicators, this project introduces a fine-grained, relational perspective that empirically captures how collaboration is structured and enacted among professionals in practice.
A key result of the project is the generation of original, co-designed relational datasets that map inter-professional collaboration across health and social care settings. These datasets go beyond conventional administrative or survey-based indicators by explicitly modelling interactions among individual professionals and services. This enables the identification of coordination patterns, boundary-spanning roles, and structural gaps that are not visible through existing approaches, thereby providing a more accurate representation of how integrated care functions in real-world contexts.
From a methodological perspective, the project advances the application of social network analysis to mental health systems by adapting and applying advanced network measures to study coordination and integration. The analyses demonstrate how specific structural configurations—such as the concentration of ties around key actors or the presence of weakly connected subgroups—affect information flow, continuity of care, and system resilience. This contributes novel empirical evidence to a field where relational data remain scarce and underutilised.
Conceptually, the project moves beyond the dominant organisational lens by framing integrated care as a relational system shaped by everyday interactions, rather than solely by formal arrangements. This shift provides a new analytical framework for understanding integration processes and complements existing policy-oriented models. The results show that effective integration depends not only on institutional design, but also on the structure and distribution of collaborative ties among professionals.
The findings have clear potential impacts for research, policy, and practice. For research, the project establishes a replicable methodological approach that can be extended to other health and social care domains, supporting comparative studies and longitudinal analyses of system change. Further research would be particularly valuable to examine how network structures evolve over time and how targeted interventions may reshape collaboration patterns.
For policy and service planning, the results offer an evidence base for identifying leverage points to strengthen coordination without increasing administrative burden. By revealing where collaboration is overly dependent on a small number of actors or where structural disconnections persist, the findings can inform more targeted and sustainable integration strategies. These insights are especially relevant for health systems facing workforce shortages and increasing demand.
To ensure further uptake and long-term impact, several enabling conditions can be identified. These include the continued development of relational data infrastructures within health systems, institutional support for participatory data collection approaches, and the integration of network-based indicators into service evaluation frameworks. In addition, scaling the approach would benefit from demonstration studies and from alignment with supportive regulatory and governance frameworks that recognise collaboration as a measurable and actionable component of care quality.
Overall, the project delivers results that extend beyond the current state of the art by combining methodological innovation, empirical originality, and conceptual advancement. It provides new tools and evidence to support the design, evaluation, and improvement of integrated mental health care systems, with relevance that extends to other complex service environments.
A key result of the project is the generation of original, co-designed relational datasets that map inter-professional collaboration across health and social care settings. These datasets go beyond conventional administrative or survey-based indicators by explicitly modelling interactions among individual professionals and services. This enables the identification of coordination patterns, boundary-spanning roles, and structural gaps that are not visible through existing approaches, thereby providing a more accurate representation of how integrated care functions in real-world contexts.
From a methodological perspective, the project advances the application of social network analysis to mental health systems by adapting and applying advanced network measures to study coordination and integration. The analyses demonstrate how specific structural configurations—such as the concentration of ties around key actors or the presence of weakly connected subgroups—affect information flow, continuity of care, and system resilience. This contributes novel empirical evidence to a field where relational data remain scarce and underutilised.
Conceptually, the project moves beyond the dominant organisational lens by framing integrated care as a relational system shaped by everyday interactions, rather than solely by formal arrangements. This shift provides a new analytical framework for understanding integration processes and complements existing policy-oriented models. The results show that effective integration depends not only on institutional design, but also on the structure and distribution of collaborative ties among professionals.
The findings have clear potential impacts for research, policy, and practice. For research, the project establishes a replicable methodological approach that can be extended to other health and social care domains, supporting comparative studies and longitudinal analyses of system change. Further research would be particularly valuable to examine how network structures evolve over time and how targeted interventions may reshape collaboration patterns.
For policy and service planning, the results offer an evidence base for identifying leverage points to strengthen coordination without increasing administrative burden. By revealing where collaboration is overly dependent on a small number of actors or where structural disconnections persist, the findings can inform more targeted and sustainable integration strategies. These insights are especially relevant for health systems facing workforce shortages and increasing demand.
To ensure further uptake and long-term impact, several enabling conditions can be identified. These include the continued development of relational data infrastructures within health systems, institutional support for participatory data collection approaches, and the integration of network-based indicators into service evaluation frameworks. In addition, scaling the approach would benefit from demonstration studies and from alignment with supportive regulatory and governance frameworks that recognise collaboration as a measurable and actionable component of care quality.
Overall, the project delivers results that extend beyond the current state of the art by combining methodological innovation, empirical originality, and conceptual advancement. It provides new tools and evidence to support the design, evaluation, and improvement of integrated mental health care systems, with relevance that extends to other complex service environments.