4858 Mental Health Report - National University of Ireland, Galway

Collaborative Practice and Policy
problems of all kinds in the coming decades, it is necessary to break down the
barriers to effective international collaboration in developing, disseminating, and
implementing science and evidence based prevention and health promotion
programmes, strategies, and policies (Hosman 2000).
A system of open co-ordination, in which there are formally established means to
learn from the experience of others while taking account of national
circumstances, provides an opportunity to promote best practice, increasing
exchange of information on what works and what does not, and in what
circumstances (Mossialos et al. 2001). In many cases it will be possible to develop
shared approaches to common problems, but this process must respect historical,
political and cultural diversity and not force the harmonisation of processes that,
while pursuing the same goal, are organised in ways that are incompatible with
each other.
In both Northern Ireland and the Republic of Ireland multi-sectoral collaboration
is recognised in the respective health strategies. Strengthening partnerships has
been identified as a strategic objective by the Institute of Public Health in Ireland
(1999).
Effectiveness of Collaboration
Alliances or partnership initiatives to promote health across sectors, across
professional and lay boundaries and between public, private and nongovernmental
agencies, do work, according to Gillies (1998). They work in tackling
the broader determinants of health and well-being in populations in a sustainable
manner, as well as in promoting individual health-related behavioural change.
Collaboration can be seen as a ‘good thing’, but there are calls emphasising the
need for evidence of its effectiveness (El Ansari et al. 2001). However effectiveness
is a value-laden concept and may be seen as much about perceived cost benefits
as objective indicators (Costongs and Springett 1997). In addition, this type of
evaluation depends on who is defining the criteria of effectiveness (Costongs and
Springett 1997) and the differing interpretations that have been placed on
evaluation (El Ansari et al. 2001). The challenge to provide evidence of the
effectiveness of health promotion activities in pre-determined outcomes should
not be underestimated. It is a challenge to assemble evidence in ways that are
relevant to the complexities of contemporary health promotion, and to avoid the
possibility that this may lead action down a narrow, reductionist route (Nutbeam
1999). Hosman (2000) highlights the need to turn our scientific expertise to
studying the factors that facilitate or impede effective collaboration. If
collaboration is to be successful in making a difference in the lives of people,
then increasing the precision and context of appraising its effectiveness
will reduce the nature of inconclusive evidence and is likely to
improve the practice of partnerships, coalitions and joint
working in health and social care (El Ansari et al. 2001).
77