Background: Key actors in the Swedish social protection systems are the social welfare offices, the social insurance offices, the employment services and primary health care services. These actors provide different cash benefits and care services with the aim to protect individuals from poverty, and social exclusion and to reduce social and health inequality. During the last decades, welfare service institutions in Sweden have undergone a development towards stricter regulations; more specialized work organizations and more focus on cost effectiveness which in turn has influenced the provision of services. Earlier reports have identified that individuals with multifaceted social and health problems in need of support from multiple welfare institutions face an increased risk of falling between different support systems. Various projects have, therefore, been introduced in order to increase and deepen the collaboration between responsible institutions. In order to promote sustainable support system for individuals with multifaceted needs the overall objective of this study was to identify favorable forms of collaboration and methods used within the projects and which are possible to implement into the regular institutional settings. In addition potential hindering factors were studied. 

Methods: The case study followed five municipality based intervention projects, during three years, focusing on individuals, aged 16-64, with multifaceted social and health problems. Interactive research design including interviews, workshops and seminars conducted with team- and steering group members and officials was used.  

Results: The significance of improved information- and knowledge exchange between the institutions, tailored interventions aiming at a holistic view on the individual and a need for personal coordinators were emphasized. 

Implications for Social Work and Social Development practiceServices running from the individuals´ needs, rather than from organizational structures within and between the institutions, have to be promoted. Measures offering a pre-institutional service with institutions in close collaboration could be of interest.