LEADERSHIP AND ITS FUNCTIONALITY IN THE CROSS-SECTORAL COLLABORATION OF PSYCHOSOCIAL SERVICES FOR CHILDREN AND ADOLESCENTS – OULU COLLECTIVE IMPACT STUDY

Background: The use of institutional social and healthcare services for children and adolescents has increased worldwide, partly due to a fragmented service system with separate practices and strategic goals, e.g. education and social and healthcare. Setting strategic goals to promote cross-sectoral collaboration (CSC) in services for children and families has been seen as a way to reduce institutional psychiatric and child welfare care. Aims: This study analyses leadership and its functionality in implementing Collective Impact (CI)-based CSC work to enhance psychosocial service integration for children and adolescents. Methods: An online survey was conducted among employees and leaders in social and healthcare, daycare, special education and youth work service sectors of the five regional Welfare Service Areas (WSAs) in the City of Oulu, Finland. The research instrument used was the Oulu cross-sectoral Collaboration and Leadership (OCL) scale, which has been validated as having good psychometric properties. The OCL scale is based on the CI approach but also includes leadership as an additional element. Results: Leaders in WSAs, where CI-based CSC work was ongoing, viewed strategic goals as more successful than in WSAs where the CI-based work had not yet started. Employees did not perceive strategic goals in psychosocial integration. Both leaders and employees identified various practical CI-based CSC activities such as a shared follow-up system and the backbone support organization coordinating consultation meetings. The CI-based domains, such as practices that support and follow up, and backbone support structure, were recognized by both employees and leaders. An example of this kind of practice is onecontact service, a common feedback system and consultation meetings coordinated by the backbone support organization. The response rate for the survey was 37.2%. Conclusions: The findings of this study highlight the role of leadership in internalizing the strategic goals of the CI-based CSC implementation process. However, these goals appeared not to be effectively transferred to employees. Therefore, leadership should focus on communication of the strategy and its internalization at all levels to enhance the integration of the psychosocial service system through CI-based CSC.