Factors influencing the implementation of mental health recovery into services: a systematic mixed studies review

Piat, Myra; Wainwright, Megan; Sofouli, Eleni; Vachon, Brigitte; Deslauriers, Tania; Préfontaine, Cassandra; Frati, Francesca

doi:10.1186/s13643-021-01646-0

Cited by 23 publications

(31 citation statements)

References 146 publications

(316 reference statements)

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“…Our research highlights the negative impact that COVID-19, an outer setting factor, had on the implementation of recoveryinnovations into services. Due to most recovery innovations being predicated upon face-to-face interactions and relationship-building [ 71 ], lockdown policies made it impossible to continue implementation as planned. Only one of seven sites was able to continue implementing without interruption by adapting their innovation to a virtual format.…”

Section: Discussionmentioning

confidence: 99%

Identifying and understanding the contextual factors that shaped mid-implementation outcomes during the COVID-19 pandemic in organizations implementing mental health recovery innovations into services

Piat

Wainwright

Cherkas

et al. 2021

Implement Sci Commun

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Background Seven housing and health services organizations were guided through a process of translating Chapter Six of the Canadian Guidelines for Recovery-Oriented Practice into a recovery-oriented innovation and plan for its implementation. At the time of the COVID-19 outbreak and lockdown measures, six of the seven organizations had begun implementing their chosen innovation (peer workers, wellness recovery action planning facilitator training, staff training and a family support group). This mid-implementation study used the Consolidated Framework for Implementation Research (CFIR) to identify contextual factors that influenced organizations to continue or postpone implementation of recovery-oriented innovations in the early months of the COVID-19 pandemic. Methods Twenty-seven semi-structured 45-min interviews were conducted between May and June 2020 (21 implementation team members and six providers of the innovation (trainers, facilitators, peer workers). Interview guides and analysis were based on the CFIR. Content analysis combined deductive and inductive approaches. Summaries of coded data were given ratings based on strength and valence of the construct’s impact on implementation. Ratings were visualized by mid-implementation outcome and recovery innovation to identify constructs which appear to distinguish between sites with a more or less favorable mid-implementation outcomes. Results Four mid-implementation outcomes were observed at this snapshot in time (from most to least positive): continued implementation with adaptation (one site), postponement with adaptation and estimated relaunch date (four sites), indefinite postponement with no decision on relaunch date (one site), and no implementation of innovation yet (one site). Two constructs had either a negative influence (external policies and incentives—renamed COVID-19-related external policy for this study) or a positive influence (leadership engagement), regardless of implementation outcome. Four factors appeared to distinguish between more or less positive mid-implementation outcome: adaptability, implementation climate and relative priority, available resources, and formally appointed internal implementation leaders (renamed “engaging implementation teams during the COVID-19 pandemic” for this study). Conclusions The COVID-19 pandemic is an unprecedented outer setting factor. Studies that use the CFIR at the mid-implementation stage are rare, as are studies focusing on the outer setting. Through robust qualitative analysis, we identify the key factors that shaped the course of implementation of recovery innovations over this turbulent time.

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Section: Discussionmentioning

confidence: 99%

Identifying and understanding the contextual factors that shaped mid-implementation outcomes during the COVID-19 pandemic in organizations implementing mental health recovery innovations into services

Piat

Wainwright

Cherkas

et al. 2021

Implement Sci Commun

Self Cite

View full text Add to dashboard Cite

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“…Since the integration and incorporation of the philosophy and tenets of recovery and recovery-oriented practices in MHSA services, the past two decades have seen a huge rise in the number of scholarly and research publications in the field. This has also encouraged the publication of systematic reviews examining the status of the literature in this growing field [ 3 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 ]. This literature suggests that while recovery orientation has become firmly established in the culture of MHSA care and there is a consensus on the critical elements of recovery conceptualizations and the principles of recovery-oriented practice, there are still some controversies regarding three significant issues that have been voiced in the more recent literature [ 36 , 40 ].…”

Section: Introductionmentioning

confidence: 99%

Part III: Recovery-Oriented Practices in Community Mental Health and Substance Abuse Services: A Meta-Synthesis

Klevan

Sommer

Borg

et al. 2021

IJERPH

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In recent decades, recovery-oriented practice has become the major approach in mental health and substance abuse care, especially in community mental health and substance abuse services. Various models of recovery-oriented practice have come to form the basis of the integration of this approach in service settings. The study aims to elucidate the characteristics of recovery-oriented practice as experienced by participants in the practice. The method used was a qualitative meta-synthesis that integrated the findings from thirty-four empirical papers published by one research group. Four meta-themes were developed: (a) helping and supporting, (b) collaborating and relating, (c) identity integration in practice, and (d) generating hope through nurturing and helping. These themes emphasize the value of relationships and connectedness, contextuality, and resources that can be mobilized in practice. The results emphasize the need to incorporate the elements in the four major themes as “working capital” for practitioners to realize recovery-oriented practice. The concepts of personal, social, and economic capital as working capital are elaborated, drawing from the meta-themes as the basis for recovery-oriented practice in mental health and substance abuse services.

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“…Some previously identified challenges when implementing recovery-oriented practices include organizational logistics, competing demands and care culture (Cusack et al 2017;Hornik-Lurie et al 2018;Lorien et al 2020;McAllister & McCrae 2017;Waldemar et al 2019). In a recent review, the authors concluded that there were several factors impeding implementation of mental health recovery into services and for transformation to happen there was a need for more general changes across the whole organization (Piat et al 2021).…”

Section: Discussionmentioning

confidence: 99%

Staff experiences related to implementation of a recovery‐oriented nursing programme in psychiatric inpatient care

Salberg

Ekselius

Hursti

et al. 2022

Int J Mental Health Nurs

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Nursing in psychiatric inpatient care is peripheral to a dominating biomedical model of care. Efforts are being made to implement nursing models based on core values and theories for nursing, such as recovery-oriented practices. The aim of the study was to explore experiences of a recovery-oriented nursing programme (Steps Towards Recovery, STR) among nursing staff in psychiatric inpatient care and their ratings of stress (Maslach Burnout Inventory scores), quality of care (Quality of Psychiatric Care -Inpatient staff scores) and satisfaction with nursing care (Satisfaction with Nursing Care and Work scale scores), before and after the implementation-and compare with ratings from reference wards. A quasi-experimental and prospective, pretest-post-test design was used. Specific questions about the nursing programme were answered by staff at the intervention wards. Staff reported predominantly positive experiences of the nursing programme. At follow-up, higher ratings were reported in two dimensions of quality of care in the STR group, and lower ratings in one dimension of stress were evident in the reference group. No differences in ratings between the STR and reference wards were found. Staff members' positive experiences of STR and higher ratings regarding participation and secure environment after implementation suggest that STR is a well-accepted and promising nursing programme. It is important to implement and evaluate recovery-oriented interventions in psychiatric inpatient care, where a focus on symptom relief still prevails. The results indicate that there is potential for further exploration of STR in this context.

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Factors influencing the implementation of mental health recovery into services: a systematic mixed studies review

Cited by 23 publications

References 146 publications

Identifying and understanding the contextual factors that shaped mid-implementation outcomes during the COVID-19 pandemic in organizations implementing mental health recovery innovations into services

Identifying and understanding the contextual factors that shaped mid-implementation outcomes during the COVID-19 pandemic in organizations implementing mental health recovery innovations into services

Part III: Recovery-Oriented Practices in Community Mental Health and Substance Abuse Services: A Meta-Synthesis

Staff experiences related to implementation of a recovery‐oriented nursing programme in psychiatric inpatient care

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