Coordinating Mental Health Services for People with Serious Mental Illness: A Scoping Review of Transitions from Psychiatric Hospital to Community

  • Marianne StormEmail author
  • Anne Marie Lunde Husebø
  • Elizabeth C. Thomas
  • Glyn Elwyn
  • Yaara Zisman-Ilani
Original Article


Effective coordination as people with serious mental illness (SMI) move between care settings is essential. We aimed to review challenges to care coordination for people with SMI and identify approaches for improving it. Sixteen articles were identified. Two main challenges emerged: people with SMI facing adjustment challenges during transitions and services struggling to provide continuity of care. Effective approaches addressed coordination challenges and resulted in better improvements in service utilization, social functioning and quality of life. Future interventions may benefit from shared decision-making, support for caregivers, and addressing the challenges associated with complicated medication regimes and accessing medications.


Care coordination Continuity of care Care transitions Serious mental illness Scoping review 



The authors express gratitude to Thomas L. Mead, retired Reference Librarian, Dartmouth Institute for Health Policy and Clinical Practice for performing the systematic literature searches.


First author 2017–2018 Harkness fellow Marianne Storm received support for this research by the Norwegian Research Council Grant Agreement No. 276638 and The Commonwealth Fund. The views presented here are those of the authors and should not be attributed to The Commonwealth Fund or its directors, officers, or staff.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research Involving Human and Animal Participants

This scoping review article does not contain any studies with human participants performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Marianne Storm
    • 1
    • 2
    Email author
  • Anne Marie Lunde Husebø
    • 1
    • 5
  • Elizabeth C. Thomas
    • 3
  • Glyn Elwyn
    • 4
  • Yaara Zisman-Ilani
    • 3
  1. 1.Department of Public Health, Faculty of Health SciencesUniversity of StavangerStavangerNorway
  2. 2.Faculty of Health Sciences, Center for Resilience in HealthcareUniversity of StavangerStavangerNorway
  3. 3.Department of Rehabilitation Sciences, College of Public HealthTemple UniversityPhiladelphiaUSA
  4. 4.Dartmouth CollegeInstitute of Health Policy and Clinical PracticeLebanonUSA
  5. 5.Department of Gastroenterological SurgeryStavanger University HospitalStavangerNorway

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