Leadership perspectives on key elements influencing implementing a family‐focused intervention in mental health services

Abstract

Background Despite a strong evidence base and policy recommendation supporting the implementation of psychoeducation interventions within the mental health system, equitable access for many service users and family members has not been achieved. To enhance translation, developing an evidence-base around the factors that in uence implementation of interventions is critical. Methods The aim of the study was to explore the factors in uencing implementation of a group cofacilitated recovery focused psychoeducation intervention. The study design was explorative qualitative descriptive, involving the collection of data through individual and focus group interviews with key stakeholders (n=75) involved with the implementation within 14 mental health sites in the Republic of Ireland. The Consolidation Framework for Implementation Research (CFIR) was used as a conceptual framework to guide data collection and analysis. Results Key enablers and barriers were identi ed across all CFIR domains of the framework with some factors (depending on context) being both an enabler and a barrier. National policy; structural stability with national systems; leadership at all levels; peer payment system; local champions and support from multidisciplinary team members; evidence strength and quality of the programme design; availability of resources; referral pathways; knowledge, beliefs and self-e cacy of facilitators, as well as local culture in uenced implementation. While some were speci c to the programme, many barriers re ected systemic and structural challenges within health services more generally. Conclusion: Findings from this study provide an enhanced understanding of the different layers of determinants to implementation of an intervention. Overcoming challenges will involve positive and ongoing engagement and collaboration across the full range of stakeholders that are active within each domain, including policy and operational levels. The quality of leadership at each domain level is of crucial importance to successful implementation. Methodology Aim The aim of this current aspect of the study was to explore the factors in uencing implementation of the EOLAS programmes. Methods While a randomised control trial is considered a gold standard for evaluating the effectiveness of an intervention [33], it is limited in its usefulness in understanding factors that in uence the implementation process for psychosocial interventions. Therefore, the study design for the current study was explorative qualitative descriptive, involving the collection of data through individual and focus group interviews. Qualitative descriptive research is directed at providing an in-depth description of an experience or event [34] and enables researchers to develop a deep understanding of the phenomena under study. The Consolidation Framework for Implementation Research (CFIR) [31] was used as a conceptual framework to guide data collection and analysis. The CFIR is a meta-theoretical framework designed to guide the factors that in uence the implementat...

Continued capacity: Factors of importance for organizations to support continued Let's Talk practice – a mixed‐methods study

“…2016; Allchin et al . 2020b). In this study, the four AMHS with senior leadership engagement (Service 2, 4, 5, and 7) were also the four that had engaged in the RCT with the intention of implementing Let’s Talk in their service.…”

“…Implementation intentions enable organizational investment in the intervention and change process (Allchin et al . 2020b), supporting whole‐of‐organization buy‐in which is important for sustaining the implementation of an evidence‐based practice (Swain et al . 2010).…”

“…A study exploring the perspectives of leaders and implementers at the end of the RCT identified that the implementation context across the eight services was an important consideration for understanding sustainability of Let’s Talk (Allchin et al . 2020b). This current study explores the implementation process of each of the eight AMHS and their continued organizational capacity to support practice 12 months after the RCT.…”

Factors impacting the implementation of a psychoeducation intervention within the Mental Health System: a multisite study using the Consolidation Framework for Implementation Research

“…While the inclusion of multiple sites and different cohorts of stakeholders provided a triangulated and deepened understanding of factors in real-world settings [10,[69][70][71] and thus addressed some of the methodological issues identi ed in previous studies [34], there are several limitations that need to be acknowledged. First the self-selection nature of the sample may have resulted in recruitment bias, with those who were more assertive, con dent, and articulate and with strong views opting to participate.…”

An explanatory model of factors enabling sustainability of let’s talk in an adult mental health service: a participatory case study

“…Organisational and practitioner factors have been identified as contributing to this gap. The models of practice common in AMHS are driven by policy and funding that focus on the adult as an individual and work in episodes of care to manage a crisis [ 23 ]. Furthermore, gaps in practitioners’ skills, knowledge and confidence to work with families [ 24 – 26 ], perpetuated by a lack of regular access to parents on their caseload [ 27 ], have limited the use of these interventions in everyday practice.…”