Developing Interpersonal Trust Between Service Users and Professionals in Integrated Services: Compensating for Latent Distrust, Vulnerabilities and Uncertainty Shaped by Organisational Context

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  • Rie Mandrup Poulsen
  • Kathrine Hoffmann Pii
  • Lene Falgaard Eplov
  • Mathias Meijer
  • Ute Bultmann
  • Christensen, Ulla

Introduction: Studies show a need for trust between stakeholders in integrated services. However, few studies have investigated how trust develops between stakeholders on a micro-level. In a Danish intersectoral intervention for persons on sick leave due to common mental disorders, we explored why trust is needed and how trust is developed between micro-level stakeholders.

Methodology: The qualitative study was based on 12 observations of inter-organisational meetings, 16 interviews with service users, 24 interviews with health care professionals and employment consultants, and 8 interviews with supervisors. The analysis was guided by the theoretical concepts (dis-) trust, vulnerability and uncertainty.

Results: Latent distrust between involved organisations, and vulnerabilities and uncertainties related to employment consultants' statutory power over service users caused a perceived need for interpersonal trust. Time to establish knowledge-based relationships, healthcare professionals' caring approach, and creating a feeling of sharing interests were compensating trust-building strategies that were often regarded as positive.

Discussion and conclusion: Trust in personal relationships between stakeholders appeared to compensate for contextually shaped distrust, vulnerability and uncertainty. Identifying latent distrust, vulnerabilities, uncertainties, and power structures might be key to improving trust-building strategies in a specific context. The time-consuming process of trust-building between micro-level stakeholders should be supported structurally.

Original languageEnglish
Article number1
JournalInternational Journal of Integrated Care
Issue number3
Number of pages13
Publication statusPublished - 2021

    Research areas

  • trust, integrated services, common mental disorders, organisational context, person-centred services, process evaluation, COMMON MENTAL-DISORDERS, QUALITATIVE RESEARCH, SECONDARY ANALYSIS, WORK, RETURN, EXPERIENCES, HEALTH, PERCEPTIONS, GOVERNANCE, EMPLOYEES

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