"Vem bär ansvaret?" - En kvalitativ studie om socialsekreterares erfarenheter av samverkan mellan socialtjänst och psykiatri

Sammanfattning

This study aimed to explore how social workers in the field of substance use and addiction experience and perceive organizational boundaries, division of responsibilities, and collaboration routines in the relationship between social services and psychiatric care, and how these factors affect the possibility of offering cohesive support to people with comorbidity. A qualitative research design was employed, using semi-structured interviews to collect data for the study. The study included six social workers in the field of substance use and addiction, all employed in different municipalities in southern Sweden. The empirical material was analyzed using thematic analysis and interpreted through Lipsky's theory of street-level bureaucracy and discretion, Danermark's theory on model power, and Payne's interpretation of systems theory. The results showed that collaboration between social services and psychiatric care was often limited due to unclear responsibilities, differences in defining the problem, and limited knowledge of comorbid conditions and the SIP process. Psychiatric care often appeared as unavailable and a structurally strong actor with more influence over collaboration forms compared to social services. The lack of collaboration contributed to inadequate support for people with comorbidities. The study concluded that improvement in collaboration is necessary to assess the needs of the individual and that integrated care is a possible tool. The study also showed that there needs to be clearer structures in how responsibility is divided between the actors, an increased knowledge of comorbidities and SIP, and a stronger focus on individual needs and participation.