Service Fragmentation Index (SFI)

Purpose

The SFI is designed to:

• contextualize the symptoms that clients share

• monitor any changes over time

• assess the impact of fragmentation on coping and agency

• guide successive interventions

Instructions

For the client:

Think about the past seven days. Answer the following questions at your pace.

Rate:

0 = did not occur

1 = occurred once 

2 = occurred several times 

Index Items

This week...

• I lost access to a service I expected to use. 

• I was turned away from a service at the last minute.

• I received conflicting information from providers.

• A provider I needed became unavailable.

• I was unsure whether a service I need would remain available.

• I had to restart an intake process.

• Transportation barriers prevented me from accessing services.

• Eligibility requirements kept me from receiving support.

Interpreting Scores

• Low fragmentation (0-4)

few service disruptions reported.

• Moderate fragmentation (5-9)

recurring disruptions may be influencing engagement and wellbeing. 

• High fragmentation (10+)

substantial instability is present. Consider continuity-based interventions and service supports. 

Follow-Up Questions 

In the past week...

• Which disruption affected you the most?

• How stressful was this experience? 

• How much control did you feel you had over the situation? 

• What helped you cope with the disruption?