Electronic Thesis and Dissertation Repository


Doctor of Philosophy


Health and Rehabilitation Sciences


Dr. Lilian Magalhaes


In Canada, many national, provincial, and regional policies indicate that working together within and across sectors in health and social care is necessary and expected but evidence to support this call is lacking. This dissertation study explored the concept of cross sector service provision (CSSP), defined as: independent, yet interconnected sectors working together to better meet the needs of service users and improve the quality and effectiveness of service provision. The intent was to advance our understanding of processes involved in shaping service provision offered by two or more sectors. The thesis contains three studies. A Scoping Review that explored collaboration in mental health crisis response services uncovered findings pointing to the need to consider crisis services as occurring within a system of providers, including those from sectors outside of mental health. An Umbrella Review explored CSSP more generally, focusing broadly on health and social care sectors where the findings point to a lack of evaluation outcomes and theoretical underpinnings of CSSP. Finally, a secondary analysis utilizing existing data collected during an evaluation of the Towards Flourishing Mental Health Promotion Strategy (TF-the original study) was undertaken to generate a theory of processes that shape CSSP at the boundary between the two sectors - mental health and public health. Secondary analysis methodology was paired with constructivist grounded theory methods. Five processes emerged that together shape cross sector service provision in the TF strategy. These include: Establishing and growing the project around needs, priorities, and evidence; encouraging meaningful and enduring engagement from both sectors; aligning with what already exists; preparing and supporting stakeholders; and adapting to challenging contextual landscapes (social, historical, political) of both sectors. The findings from the three studies contribute to the fields of Education, Practice, Policy and Research.