From Silos to Integration: Making Joined-Up Care a Reality

For years, mental health services have operated separately from social care, physical health, and the voluntary sector. This has often led to fragmented pathways, making it harder for people to get the right support at the right time.

We know that mental health does not exist in isolation. Someone experiencing a crisis might also be struggling with housing, debt, or a long-term health condition. Yet, instead of wrapping services around people, they are often expected to navigate multiple systems that may not always align. The more we can connect services in a meaningful way, the more we can improve outcomes for individuals and communities.

It Is All Relational: Integration Starts with Collaboration

Achieving true integration is not just about pathways and processes. It is about relationships, shared purpose, and a willingness to collaborate across organisations, sectors, and professional boundaries. It starts with people making the effort to connect; picking up the phone, sending an email, and working together differently.

Health and care systems are under significant pressure. Contractual KPIs, increasing demand and complexity, workforce shortages, and resource constraints all make it challenging to innovate and integrate. Given these pressures, it is remarkable to see the high-quality outcomes that are being achieved every day by dedicated teams across the system. By strengthening collaboration, we can build on these successes and create even better outcomes for the people we support.

What Good Looks Like

There are already great examples of integrated working that make a real difference. Some of these include:

Mental Health and Housing: Mental health teams working closely with housing officers to prevent homelessness rather than responding to it in crisis.

Crisis Alternatives: Services like the Sanctuary model, offering de-escalation and practical support as an alternative to A&E.

Psychosocial Pathways in Physical Health: Integrated mental health support for people with long-term conditions, ensuring psychological support is available alongside medical care.

Community and Social Prescribing: Connecting people with peer support, benefits advice, and employment services, reducing reliance on clinical interventions alone.

Making Integration the Default Not the Exception

Despite the progress being made, there are still practical challenges to embedding integration across services. Barriers such as separate funding streams, differing service criteria, and increasing demand can make joined-up working difficult. However, real change is possible when we focus on:

·       Commissioning with integration in mind by ensuring funding and service models promote collaboration rather than competition.

·       Senior leadership buy-in to champion a partnership approach and enable teams to work across service boundaries.

·       Measuring outcomes that matter by moving beyond service-specific KPIs to focus on overall wellbeing.

·       Supporting the workforce to develop the skills, confidence, and structures needed to collaborate effectively.

It Starts With Us

Integration is not just a system-wide ambition, it is something that happens when individuals and teams commit to working differently. Small changes in how we engage with partners can have a big impact on the way people experience services.

·       Making a call to a partner organisation to explore shared challenges.

·       Sending an email to better understand how another service works.

·       Leaning into collaboration and being curious about how we can connect services more effectively.

Despite the pressures, we know that working together leads to better outcomes. When services connect, people receive more holistic, person-centred care. This is achievable, and it starts with a shared commitment to integration at all levels; commissioning, leadership, and frontline teams.

What is one step you can take today to strengthen connections in your system?