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P-613 - Implementation Science: A new Paradigm in Organizing Mental Health Services

Published online by Cambridge University Press:  15 April 2020

P. Mateus
Affiliation:
Ministry of Health of Portugal, Portugal
J. Caldas Almeida
Affiliation:
Faculdade de Ciências Médicas, UNL, Portugal
Á. Carvalho
Affiliation:
Ministry of Health of Portugal, Portugal
M. Xavier
Affiliation:
Ministry of Health of Portugal, Portugal Dept. Mental Health, Faculty of Medical Sciences, UNL, Lisbon, Portugal

Abstract

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Introduction:

Implementation science evaluates the processes that move evidence-based treatments into routine use.

In Portugal, a new National Mental Health Plan with a community model has been launched in 2007. in order to change the operational model for mental health teams, a case-management (CM) training program has been prepared by the Ministry of Health.

Objectives:

To evaluate the effectiveness of the “implementation process” according to: a) profile of mental health services, b) organisational culture, c) barriers, d) degree of implementation.

Methods:

30 mental health services were assessed. the “implementation process” included a CM course (SAMHSA procedures). Implementation effectiveness and barriers were assessed by: Barriers and Facilitators Assessment Instrument (MAJ Peters, 2001) and Illness Management Fidelity Scale - IMR (Mueser, 2009).

Results:

Assessment of services showed: liaison with primary health care (50%), routine use of guidelines (57%), single clinical records (50%), training and continuous education plan (85%), research practice (21%). Regarding the professionals, 70% reported previous case management practice, but only 20% had a formal training in CM. the CM approach was fully implemented in 36,3% of the services, fairly implemented in 45,4%, but still not enough implemented in 18,3%. Main barriers identified were related with availability of time (61%), lack of dedicated facilities (61%), low motivation (38%) and absence of financial incentives (38%).

Conclusions:

In Portugal several barriers still undermine the full implementation of CM. Implementation science may contribute to improve the delivery of evidence-based care.

Type
Abstract
Copyright
Copyright © European Psychiatric Association 2012
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