Specifically, participants indicated that someone who is not fully engaged in the type and intensity of behavioral health treatment necessary to manage their condition should be prioritized for a mental health caseload. Rather, individuals who are receiving treatment and/or medications may have stable mental health that is not impacting their compliance with supervision and could, therefore, be supervised on a standard caseload. As part of the pilot, the partnering agency wanted to identify priority factors to help determine which individuals should be considered for assignment to a mental health caseload and subsequent step-down to a lower level of supervision. However, a recent study of the agency’s SMHS program revealed that persons with mental health needs were faring significantly worse on supervision than those without mental illnesses.
Decision: Methods and tools to assess implementation of mental health policies and plans: A systematic review — R1/PR10
Lastly, the Feasibility scale was the only scale to have three factors identified in EFA and it also had the most variability in structure when comparing EFA results within and across sites. A single item (AC15), which asked consumers whether they understood the way things were explained during the intervention, did not load onto either factor. Items on the Acceptability scale also loaded onto two distinct factors. This non-loading item asked consumers whether they had a problem with the wait time before beginning the intervention (RA02) and has been reworded in subsequent use to not be reverse coded. Each scale of the Consumer mhIST was designed to measure a single implementation determinant or outcome. Average age across studies ranged from 35 to 55 among consumers and 28 to 44 among providers.
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Furthermore, narrative reviews do not involve the stringent selection and appraisal criteria characteristic of systematic reviews. Grants that partner with industry, such as NIH Small Business Innovation Research grants, are critical in acknowledging that MH researchers will likely not also be experts in app design; such mechanisms can allow the strengths of both academia and industry to shine through (Hidalgo-Mazzei et al. 2020). Grants take years from initial conception to publication of findings, and traditional RCTs require the innovation to remain static for the duration of the study period. Additional research is needed to determine whether the number of log-ins, clicks, or modules completed may be more appropriate metrics of sustained use (Bakker et al. 2016; Donkin et al. 2011; Hermes et al. 2019; Mohr et al. 2019). Further research is needed to determine how best to facilitate use via these more personalized and adaptive strategies.
Their work illustrates the need for flexibility in both the training and the provision of the intervention in implementing trauma-focused CBT for youth in three low-resourced settings (rural South Carolina, Puerto Rico, and El Salvador). Schueller and Torous (2020) employ a widely-used implementation framework to describe the myriad potential barriers and facilitators to the use of DMHIs. Becker et al. (2020) examine approaches to disseminate information and increase awareness about EBPs for adolescent substance use among parents of adolescents.
- Sustainability is defined as the extent to which a newly implemented treatment is maintained or institutionalized within a service setting’s ongoing, stable operations.
- Using the Apprenticeship Training Model,intervention adaptation was completed in tandem with training of lay counselors,including university students, local and international NGO staff, and lay healthworkers from local hospitals.
- Without this knowledge, there is little basis for generating opinions on the quality and type of implementation.
- To date, most implementation studies by global mental health researchers have relied exclusively on qualitative assessment, with relatively few using quantitative implementation measures (Wagenaar et al., 2020).
Quantitative measures must be reliable, valid and practical to be useful for implementation research or practice, though comprehensive reviews of published implementation measures have noted that the field faces several major issues. Our expert panel concluded that pragmatic concerns are key to choosing between measures and validation approaches. Implementation measure usage and adaptation/validation approaches Measures were used in a diverse range of contexts across Latin America, Sub-Saharan Africa, Eastern Europe and South/Southeast Asia. Table 4 describes the usage of implementation measures reported by at least two investigators in LMIC settings.
In this equation, implementation effectiveness is a function of implementation quality, intervention effectiveness, and contextual factors. The study found that the implementation of a comprehensive implementation plan, including training and technical assistance, resulted in significant improvements in treatment outcomes. Their engagement and participation are essential for ensuring that implementation strategies are tailored to the local context and meet the needs of the target population. Mental health care is a critical component of overall healthcare, and its importance has been underscored by the growing prevalence of mental health issues worldwide. A taxonomy of implementation outcomes can help organize the key variables and frame research questions required to advance implementation science. To increase the success of implementation, implementation strategies need to be employed strategically.
We provide evidence that the Consumer and Provider versions of the mhIST are internally valid and reliable across diverse contexts and stakeholder groups for mental health research in LMIC. There has been a well-documented gap between research (e.g., https://www.nationalacademies.org/read/26809/chapter/5 evidence-based programs, interventions, practices, policies, guidelines) and practice (e.g., what is routinely delivered in real-world community and clinical settings). Our findings should contribute to policy dialogues on the development, implementation and assessment of implementation of national mental health strategies.