In a case study in continuity of mental health care, medical records showed that over the years 81 social workers or nurses, spread over 25 health and social services, had been involved in the rehabilitation process of an addicted couple. Problems in continuity of care are linked to lack of information, missing procedures and guidelines, fragile relationships with the patient, and a reluctant public health approach. Take home message was that case presen­tation in psychiatric journals should give syste­matic at­ten­tion to sources of error in continuity of mental health­care.

One of the reviewers was not impressed:

"The paper is poorly written even allowing for the fact that it may be written by someone who has Dutch as their mother tongue (I have considerable experience of working with Dutch authors). The reliance on a single case study which is not well presented and on unsupported generalisations about care is weak. The analysis is not particularly clear and the recommendations are insufficiently concrete. They are more “motherhood and apple pie”. There is weak consideration of what might be done to ameliorate such discontinuities via commissioning, joint training, information technology and other mechanisms well documented in the literature. I have thought about whether extensive revision is feasible but I fear that this would not be a good use of the authors’ time therefore I suggest that the paper is not publishable."

IJIC editors accepted this version for publication:

Breakdown of continuity in public mental healthcare in the Netherlands: a longitudinal case study. André Wierdsma, Meta van der Schee, Cornelis L. Mulder - International Journal of Integrated Care, 11(2011), URN:NBN:NL:UI:10-1-101573