Table 2

Research questions and associated data collection and analysis methods

Question 1
What organisational links currently exist in a rural region for the provision of mental healthcare for older people?
Organisational network analysis (interview survey)
Up to 30 key informants from relevant health and human service organisations (identified through the governance group) will be interviewed using organisational network analysis to explore the regional service network structure. Organisational network analysis, also known as social network analysis, gathers information about which organisations are linked, in this case on the activities of information sharing, referrals and the management, planning and operation of services for the mental healthcare of older people.34 35 This provides quantitative information specific to the local network and to the unique and complex interactions between these organisations. See online supplementary appendix 1 for the survey and interview guide.

Measures of organisational network analysis will be used to provide information about which organisations are linked, the number of links in the network, the types of interactions between organisations (eg, exchanging information, referrals and planning), and the level and strength of each relationship.34 35 Maps displaying the patterns of connections between organisations will be generated utilising the UCINET software.36 The visual and detailed nature of organisational network maps serves as a powerful heuristic device for discussion about the structure of the network, about which services are linked and on which activities. See online supplementary appendix 2 for a hypothetical map.
Question 2
What are the gaps, barriers and enablers in linking services, as perceived by key service stakeholders, older people and their carers?
Qualitative interviews: key informant service providers and care seeking journeys
Qualitative interviews will explore the above 30 service key-informants’ perspectives on the linkage gaps, barriers and enablers between services.

In addition 10 older people and their carers will be interviewed using the Pathways Interview Schedule.37 This is a semistructured instrument designed for the systematic gathering of information on their routes to and sources of care. Two groups will be purposively selected with the assistance of the service key informants: those who have successfully negotiated a care journey and those who have not.

Framework analysis will be used to explore the present linkage strategies and management gaps, barriers and enablers between mental health, aged care, primary care and social care services, and how these affect people's help seeking experience and journey. Framework analysis is a qualitative method that is suited to applied research with specific questions, a limited timeframe, a predesigned sample, and a priori issues that are to be explored.38 The NVivo software package will be used to manage and assist analysis of the qualitative data.39
Question 3
What is the role of policy in supporting the development of linked care for older people in a rural region?
Policy analysis
Policy documents at the national, state and the local operational levels will be examined for their relevance to the development of integrated mental healthcare for older people in the region. The national and state level policies will be identified through online searches and advice from the governance group, while operational policies (eg, service plans, local guidelines and protocols etc.) will be identified though the service key informant interviews. The local operational policies from the various sectors (primary care, mental health, aged care, social care services) will be examined for congruence, direction and resource opportunities.
Question 4
What links could be established between services for the mental healthcare of older people?
Facilitated network reflection
Data from the methods above will be fed back in the governance group and in the three service stakeholder workshops held over 12 months. The purpose of each workshop is to progressively work towards the final goal of securing commitment among a group of stakeholder services for a network problem solving approach to the delivery of mental healthcare to older people in the region.
  • Workshop 1: Comment on and adapt the network planning framework, identify potential champions and begin to explore organisational readiness and capacity for change. Data pertaining to participants’ perceptions of current as well as ideal links will also be collected.

  • Workshop 2: Findings related to the organisational network analysis, service key informant interviews and policy analysis will be fed back. This information will provide the participants with the opportunity to consider network strengths and weaknesses and explore early opportunities for change. After the organisational network analysis and key informant data are fed back, small group discussion will be guided by the following prompts: (1) Does the network look as you would expect on the maps/ what stands out/ what seems missing? (2) What else do you want to know—the maps show the links, not what goes down them? (3) Do the maps suggest what might be working and what else might be needed?

  • Workshop 3: Final analysis will be added to that presented at workshop 2 and will include the data on older people's care seeking journeys. The current state of the network will be examined against the theory on linkage strategies and enablers to identify strengths, weaknesses and opportunities for change. From this examination the priorities for action will be proposed to the governance group for improved integration in regional mental health servicing for older people.

Workshop discussions will be recorded and used along with other data in the case study analysis to answer question 5.
Question 5
How does the ‘framework for network planning’ enable an informal network to plan and manage linked primary mental healthcare for older people in a rural region?
Case study
Data will be collected throughout the study to evaluate the utility of the ‘framework for network planning’ for an informal network to develop more integrated mental healthcare for older people in this rural region. These data will include records of the governance group and service stakeholder workshops. In addition, further service key informant interviews will be conducted at the end of the project to explicitly explore whether they have found the framework useful or not using the following prompts:
  1. Can you describe how you found the facilitated reflective process (workshops, survey, interviews) as a way to manage the range of services as a network, in terms of the following:

    • Acceptability of the process

    • Ability to identify and act on issues

  2. Did the project achieve what you expected?

  3. Would you use this process again—would you change anything?

Engagement at senior management (governance group) and operational (key stakeholder) levels will be essential to develop the trust and insight to accurately assess the applicability of the network planning framework.