Detecting “Cracks” in Mental Health Service Systems: Application of Network Analytic Techniques

Abstract

In one form or another, the fragmentation of health and human services in the community has been identified as a major impediment to effective service delivery (Agranoff & Pattakos, Cumming, 1967; Leopold & Schein, 1975; Tessler & Goldman, 1982; Turner & TenHoor, 1978). Historically, attempts to coordinate services among agencies have relied upon voluntary mechanisms that have sought to maintain agency autonomy while facilitating coordinated activity in areas where there is agreement (Litwak & Rothman, 1970). These voluntary coordination mechanisms have generally not proven effective (Warren, 1973). The failure to create better coordinated services has been attributed to excessive autonomy of service agencies (attempts to preserve prerogatives about problem definition, intervention, priority, and client disposition) and to patterns of funding (Agranoff & Pattakos, 1979; Greenley & Kirk, 1973; Levine, 1974).