A Sustainability Model for Family-Focused Practice in Adult Mental Health Services

Abstract

BackgroundTranslating evidence-based practice to routine care is known to take significant time and effort. While many evidenced-based family-focused practices have been developed and piloted in the last 30 years, there is little evidence of sustained practice in Adult Mental Health Services. Moreover, many barriers have been identified at both the practitioner and organizational level, however sustainability of practice change is little understood. What is clear, is that sustained use of a new practice is dependent on more than individual practitioners' practice.Design and MethodDrawing on research on sustaining Let's Talk about Children in adult mental health services and in the field of implementation science, this article proposes a model for sustaining family focused practice in adult mental health services.Sustainability Model for Family-Focused PracticeAn operational model developed from key elements for sustaining Let's Talk about Children identifies six action points for Adult Mental Health Services and their contexts to support the sustainability of family-focused practices. The model aims to support Services to take action in the complexity of real-world sustainability, providing action points for engaging with service users and practitioners, aligning intra-organizational activities, and the wider context.ConclusionThe model for sustaining family-focused practice draws attention to the importance of sustainability in this field. It provides a practical framework for program developers, implementers, adult mental health services and policy-makers to consider both the components that support the sustainability and their interconnection. The model could be built on to develop implementation guides and measures to support its application.

A Balancing Act: A Systematic Review and Metasynthesis of Family-Focused Practice in Adult Mental Health Services

“…The use of strength-based approaches with clients and dedicated staff resource, within clear guidelines and frameworks, was necessary to maximise FFP delivery. Whilst corroborating and extending the findings of Gregg et al (2021), Shah-Anwar et al (2019 and Allchin et al (2021), this metasynthesis also provides a novel "balancing" conceptualisation of the navigation between practitioners, service-users and their families, and organisational contexts.…”

“…Studies in this review consistently identified "knowledge-practice" gaps in relation to FFP which impeded FFP delivery. Consistent with other research, practitioners described training as a mechanism to build competence (Allchin et al, 2021;Gregg et al, 2021;Maybery & Reupert, 2009;Maybery et al, 2016;Reupert et al, 2021). The importance of training having "real-world" skill-based application is an important finding and one which corroborates Maybery et al's findings (2016).…”

“…Importantly, practitioner factors such as knowledge, attitudes, parental experiences, perceptions of support and training have been demonstrated to be predictors of FFP delivery (Grant et al, 2019;Gregg et al, 2021;Maybery et al, 2016). Allchin et al (2021) have developed a model for sustaining FFP in AMHS, which acknowledges the important role of practitioners as well as their interrelationship with service-users, families, organisations and the wider socio-political context of FFP operation.…”

“…To date, there has been no qualitative review encompassing practitioners' implementation experiences of FFP including facilitators as well as barriers, in AMHS alone, which has its own unique organisational structure (Allchin et al, 2021). Therefore, a more comprehensive and up-todate review would extend and refine the current knowledge base.…”

Promoting Self-Determination in Parents With Mental Illness in Adult Mental Health Settings

“…While effectiveness of evidence-based interventions is commonly established via RCTs, their adaptation in practice to accommodate local contextual issues can undermine their evidence base unless the mechanisms for change are well articulated (Escoffery et al, 2018). Like many family-based interventions for parents with mental illness, there is limited knowledge of these mechanisms of change for LTC (R. Allchin, 2020; Nicholson & Friesen, 2014). By exploring the perspective of parents who register positive changes through participating in the intervention, this study describes the role self-regulation plays in effecting change through worker-facilitated LTC.…”