Rather, researchers and practitioners can apply implementation science methods and frameworks to account for and address contextual differences and adapt evidence-informed interventions as necessary. There is a critical gap in access to mental health care in low- and middle-income countries (LMICs) and among underserved groups in high-income countries (HICs).1 Although considerable research progress has been made on the efficacy of mental health interventions, the “know-do” gap persists, limiting the availability of evidence-based care. Organizational level financial and market factors at the organizational level clearly affect evidence-based practice implementation in mental health services (Proctor et al. 2007).
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Sustainability is defined as the extent to which a newly implemented treatment is maintained or institutionalized within a service setting’s ongoing, stable operations. Penetration also can be calculated in terms of the number of providers who deliver a given service or treatment, divided by the total number of providers trained in or expected to deliver the service. Schoenwald and colleagues (2005) have developed three 26–45-item measures of adherence at the therapist, supervisor and consultant level of implementation (available from the MST Institute ).
A Successful Implementation Strategy to Support Adoption of Decision Making in Mental Health Services
The field has seldom acknowledged the “humanness” of clinician decision making or leveraged those patterns as targets of implementation strategies. One study found that changing the default in the electronic health record https://www.nationalacademies.org/read/26809/chapter/5 dramatically changed clinicians’ prescribing behavior, spawning a highly applied research program and nudge units in health systems . We argue that the rich literature of behavioral economics offers an alternative and complementary perspective to other leading approaches that implementation science borrows from in viewing clinician decision making as human decision-making, thus allowing us to leverage known decision making patterns to make it easier for clinicians to do the right thing. The emergence of the field stems from the realization that many scientific discoveries never make their way to the individuals who need them, a ubiquitous problem in health and mental health .
Data included responses from consumers and providers of mental health interventions from most study sites. Their quantitative findings demonstrated good evidence for the internal reliability and criterion validity of the instrument using a vignette-based validation approach, where respondents used the mhIST to report on descriptions of high- and low-performing mental health programs. In mental health, as in many areas of health, the gap between evidence and practice is typically greatest in LMIC and implementation science has been recognized as the next step in the evolution of global mental health 7, 8.
- Project SOAR (Supporting Operational AIDSResearch), the implementation science arm of the Population Council, recentlyexamined the feasibility of routinely screening for intimate partner violence andimplementing intimate partner violence referral protocols among women receivingservices in Kenyan sexual health 10clinics.
- The global burden of mental disorders is ever increasing, and the treatment gap still prevails across all income settings.
- One study focused on a new policy framework that would expand the understanding of mental ill health within the country’s welfare system and investigated how the process was dealt with by implementing agencies (Fjellfeldt, 2020).
Adoption is defined as the intention, initial decision, or action to try or employ an innovation or evidence-based practice. Aarons and Palinkas (2007) used semi-structured interviews to assess case managers’ acceptance of evidence-based practices in a child welfare setting. Acceptability should be assessed based on the stakeholder’s knowledge of or direct experience with various dimensions of the treatment to be implemented, such as its content, complexity, or comfort.
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