Abstract
ABSTRACT
Adolescent substance use frequently co‐occurs with mental‐health difficulties and social adversity. Existing research highlights heterogeneous risk profiles and a paucity of integrated service models that bridge health‐ and social‐care sectors. A qualitative case study was undertaken at the newly established MiniMaria treatment centre in Sweden. Data were gathered through participant observation of 18 steering‐, project‐ and operative‐group meetings, four workplace meetings, and semi‐structured interviews with five staff members. Reflexive thematic analysis was applied iteratively, guided by a conceptual framework of collaborative advantage (power, trust, organizational culture, leadership, goal management). This study adheres to the Standards for Reporting Qualitative Research (SRQR) checklist. Four overarching themes emerged: (1) divergent organizational cultures and power; (2) fragmented goal management; (3) fluctuating trust and leadership; and (4) operational‐level impact on staff. Middle‐management pragmatism compensated for strategic indecision, sustaining service delivery despite resource constraints (for instance absence of a dedicated physician). The MiniMaria project demonstrates that clear, enforceable governance structures are vital for integrated youth services. When senior‐level alignment falters, empowered front‐line managers can preserve continuity of care, but the sustainability of such models hinges on explicit memoranda, shared information systems and ongoing cultural monitoring.