Transforming mental health services: a participatory mixed methods study to promote and evaluate the implementation of recovery-oriented services

Implementation Science

Thomas W Valente²  Orly Estein⁷  Suzanne Rouleau⁵  Carolyn Ells¹  Jon Salsberg³  Janet Stewart⁶  Hiba Zafran⁸  Melissa M Park⁴ 

[1] Department of Medicine and Biomedical Ethics Unit, Faculty of Medicine, McGill University, Montreal H3A 1X1, QC, Canada;Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles 90089-9175, CA, USA;Department of Family Medicine, Participatory Research at McGill, McGill University, Montreal H3S 1Z1, QC, Canada;Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal H3T 1E2, QC, Canada;Ordre des Ergotherapeutes du Quebec, Montreal H3A 2A6, QC, Canada;Centre de santé et services sociaux de la Montagne, Montreal H2V 1 K5, QC, Canada;Centre de santé et services sociaux Cavendish, Montreal H4W 2 T5, QC, Canada;School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montréal H3G 1Y5, QC, Canada

关键词: Integrated knowledge translation;    Participatory research;    Narrative-phenomenology;    Ethnography;    Social network analysis;    Mixed methods;    Applied policy;    Recovery;   

Others  :  1146600
DOI  :  10.1186/s13012-014-0119-7

 received in 2014-07-17, accepted in 2014-08-27,  发布年份 2014

【 摘 要 】

Background

Since 2007, the Mental Health Commission of Canada has worked collaboratively across all provinces to publish a framework and strategy for recovery and well-being. This federal document is now mandated as policy for implementation between 2012 and 2017. The proposed strategies have been written into provincial health plans, hospital accreditation standards, and annual objectives of psychiatric departments and community organizations. The core premise is: to empower persons with mental illness and their families to become participants in designing their own care, while meeting the needs of a diverse Canadian population. However, recovery principles do not come with an implementation guide to fit the variability of different local contexts. How can policy recommendations and accreditation standards be effectively tailored to support a diversity of stakeholder values? To our knowledge, there is little evidence indicating the most effective manner to accelerate the uptake of recovery-oriented services among providers in a given/particular mental health treatment setting.

Methods/Design

This three-year Canadian Institute of Health Research Partnership in Health System Improvement and The Rx&D Health Research Foundation (HRF) Fostering Canadian Innovation in Research study (2013 to 2017) proposed participatory approaches to implementing recovery principles in a Department of Psychiatry serving a highly diverse Canadian and immigrant population. This project will be conducted in overlapping and recursive phases: I) Conduct formative research to (a) measure the current knowledge and attitudes toward recovery and recovery-oriented practices among service providers, while concurrently (b) exploring the experiential knowledge of recovery service-users and family members; II) Collaborate with service-users and the network-identified opinion leaders among providers to tailor Recovery-in-Action Initiatives to fit the needs and resources of a Department of Psychiatry; and III) Conduct a systematic theory-based evaluation of changes in attitudes and practices within the service-user/service-provider partnership group relative to the overall provider network of the department and identify the barriers and supports within the local context.

Discussion

Our anticipated outcome is a participatory toolkit to tailor recovery-oriented services, which will be disseminated to the Mental Health Commission of Canada and Accreditation Canada at the federal level, agencies at the provincial levels, and local knowledge end-users.

【 授权许可】

   
2014 Park et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Knapp M, Mangalore R, Simon J: The global costs of schizophrenia. Schizophr Bull 2004, 30:279-293.
• [2]Citizens for Mental Health: Backgrounder: Mental Illness in Canada. In Canadian Mental Health Association; 2003:2.
• [3]Bhugra D, Minas IH: Mental health and global movement of people. Lancet 2007, 370:1109-1111.
• [4]Mental Health Commission of Canada: Toward recovery and well-being. A framework for a Mental Health Strategy for Canada. In Calgary, AB: Author; 2009:127.
• [5]Mental Health Commission of Canada: Changing directions, changing lives: The mental health strategy for Canada. In Calgary, AB: Author; 2012:152.
• [6]Slade M: 100 Ways to Support Recovery: A guide for Mental Health Professionals. Rethink 2009, 3:30.
• [7]Marshall SL, Crowe TP, Oades LG, Deane FF, Kavanagh DJ: A review of consumer involvement in evaluations of case management: consistency with a recovery paradigm. Psychiatr Serv 2007, 58:396-401.
• [8]Rogers EM: Diffusion of Innovations. Free Press, New York; 1995.
• [9]Israel BA, Schulz AJ, Parker EA, Becker AB: Review of community-based research: assessing partnership approaches to improve public health. Annu Rev Public Health 1998, 19:173-202.
• [10]Valente TW: Evaluating Health Promotion Programs. Oxford University Press, London; 2002.
• [11]Schwartz R, Estein O, Komaroff J, Lamb J, Myers M, Stewart J, Vacaflor L, Park M: Mental health consumers and providers dialogue in an institutional setting: A participatory approach to promoting recovery-oriented care. Psychiatr Rehabil J 2013, 36:113-115.
• [12]Green LW, George MA, Daniel M, Frankish CJ, Herbert CP, Bowie WR, O'Neill M: Study of Participatory Research in Health Promotion. In Book Study of Participatory Research in Health Promotion. Royal Society of Canada, City; 1995:43-50.
• [13]Parry D: A Guide to Researcher and Knowledge-User Collaboration in Health Research. Canadian Institutes of Health Research (CIHR). 2009.
• [14]Accreditation Canada Strategic Plan 2010¿2013 In Book Accreditation Canada Strategic Plan 2010¿2013. Accreditation Canada~Agrément Canada, City; 2010.
• [15]Mertens DM: Transformative Research and Evaluation. The Guilford Press, New York; 2009.
• [16]Mattingly C: The Paradox of Hope: Journeys through a Clinical Borderland. University of California Press, Los Angeles; 2010.
• [17]Lawlor MC, Mattingly C: Resituating Cultural Competence: An ethnographic and longitudinal study. In Book Resituating Cultural Competence: An ethnographic and Longitudinal Study. NIH, City; 2006.
• [18]Lawlor MC, Mattingly C: Boundary crossing: an ethnographic and longitudinal study. University of Southern California 2000.
• [19]Peacock JL, Holland DC: The narrated self: life stories in process. Ethos 1996, 21:19-43.
• [20]Mattingly C, Lawlor MC: The fragility of healing. Ethos 2001, 29:30-57.
• [21]Stoller P: Fusion of the Worlds: an Ethnography of Possession among the Songhay of Niger. The University of Chicago Press, Chicago; 1989.
• [22]Csordas TJ: The rhetoric of transformation in ritual healing. In Body/Meaning/Healing. Edited by Hefner R. Palgrave Macmillan, New York; 2002:11-57. Contemporary Anthropology of Religion
• [23]Csordas TJ: Embodiment and cultural phenomenology. In Perspectives on Embodiment: The Intersections of Nature and Culture. Edited by Weiss G, Haber HF. Routledge, New York; 1999:143-162.
• [24]Jackson M: Existential Anthropology: Events, Exigencies and Effects. Berghahn Books, New York; 2005.
• [25]Garro LC, Mattingly C: Narrative as construct and construction. In Narrative and the cultural construction of illness and healing. Edited by Mattingly C, Garro LC. University of California Press, Los Angeles; 2000:1-48.
• [26]Walter M: Participatory Action Research. In Social Research Methods. Edited by Walter M. Oxford University Press, London; 2009.
• [27]Moore KA, Peters RH, Hills HA, LeVasseur JB, Rich AR, Hunt WM, Young MS, Valente TW: Characteristics of opinion leaders in substance abuse treatment agencies. Am J Drug Alcohol Abuse 2004, 30:187-203.
• [28]Valente TW: Social Networks and Health: Models, Methods, and Applications. Oxford University Press, London; 2010.
• [29]Wasserman SFK: Social Network Analysis: Methods and Applications. Cambridge University Press, Cambridge; 1994.
• [30]Valente TW: Network interventions. Science 2012, 337:49-53.
• [31]Slater MD, Kelly K, Edwards R, Plested B, Thurman PJ, Keefe T, Lawrence F, Henry K: Combining in-school and participatory, community-based media efforts: Reducing marijuana and alcohol uptake among younger adolescents. Health Educ Res 2006, 21:157-167.
• [32]Lomas J: Social capital and health: Implications for public health and epidemiology. Soc Sci Med 1998, 9:1181-1188.
• [33]Flodgren G, Parmelli E, Doumit G, Gattellari M, O¿Brien MA, Grimshaw J, Eccles MP: Local opinion leaders: effects on professional practice and health care outcomes (Review). Cochrane Lib 2011, 8:69.
• [34]Valente TW, Pumpuang P: Identifying opinion leaders to promote behavior change. Health Educ Behav 2007, 34:881-896.
• [35]Valente TW, Davis RL: Accelerating the diffusion of innovations using opinion leaders. Ann Am Acad Polit Soc Sci 1999, 566:55-67.
• [36]Peters RH, Moore KA, Hills HA, Young MS, LeVasseur JB, Rich AR, Hunt WM, Valente TW: Use of opinion leaders and intensive training to implement evidence-based co-occurring disorders treatment in the community. J Addict Dis 2005, 24(S1):52-74.
• [37]Curran GM, Thrush CR, Smith JL, Owen RR, Ritchie M, Chadwick D: Implementing research findings into practice using clinical opinion leaders: Barriers and lessons learned. Jt Comm J Qual Patient Saf 2005, 31:700-707.
• [38]Iyengar R, Van den Bulte C, Valente TW: Opinion leadership and contagion in new product diffusion. Market Sci 2010, 30:195-212.
• [39]Jagosh J, Macaulay AC, Pluye P, Salsberg J, Bush PL, Henderson J, Sirett E, Wong G, Cargo M, Herbert CP, Seifer SD, Green LW, Greenhalgh T: Uncovering the benefits of participatory research: implications of a realist review for health research and practice. Milbank Quart 2012, 90(2):311-346.
• [40]Macaulay AC, Commanda LE, Freeman WL, Gibson N, McCabe ML, Robbins CM, Twohig PL: Participatory research maximises community and lay involvement. Br Med J 1999, 319:774-778.
• [41]Cargo M, Mercer S: The value and challenges of participatory research: strengthening its practice. Annu Rev Public Health 2008, 29:1-24.26.
• [42]Graham ID, Tetroe J: How to translate health research into effective healthcare action. Healthc Q 2007, 10:20-22.
• [43]Carr-Chellman A, Savoy M: User-design research. In Handbook of Research on Educational Communications and Technology. Edited by Jonassen DH. Lawrence Erlbaum Associates, Mahwah, NJ; 2004:701-715.
• [44]Geertz C: The Interpretation of Cultures. 1973.
• [45]Holland D, Lachicotte W Jr, Skinner D, Cain C: Identity and Agency in Cultural Worlds. Harvard University Press, Cambridge, MA; 1998.
• [46]The Fate of 'Culture': Geertz and Beyond. University of Southern California, Los Angeles; 1999.
• [47]Toward Recovery and Well-Being. A Framework for a Mental Health Strategy for Canada. 2009.
• [48]Bourdieu P: Outline of a Theory of Practice. Cambridge University Press, New York; 1977.
• [49]Bourdieu P, Wacquant LJD: An Invitation to Reflexive Sociology. University of Chicago Press, Chicago; 1992.
• [50]Geertz C: Common Sense as a Cultural System. Local Knowledge: Further Essays in Interpretive Anthropology 1983, 73-93.
• [51]Park M: Beyond calculus: Apple-apple-apple-ike and other embodied pleasures for a child diagnosed with autism in a sensory integration based clinic.Disabil Stud Quart Special Topic Autism Neurodivers 2010, 30.
• [52]Park M: Pleasure, throwing breaches, and embodied metaphors: tracing transformations-in-participation for a child with autism to a sensory integration-based therapy session. OTJR Occup Participat Health 2012, 32:S34-S47.
• [53]Bedregal L: The recovery knowledge inventory: assessment of mental health staff knowledge and attitudes about recovery. Psychiatr Rehabil J 2006, 30:96-103.
• [54]Salsberg J, Macaulay A: Linkage and Exchange Interventions. In Knowledge Translation in Health Care: Moving from Evidence to Practice. Edited by Straus S, Tetroe J, Graham ID. Wiley-Blackwell/BMJ Books, Oxford; 2013:176-182.
• [55]Pelletier J-F, Lesage A, Delorme A, Macaulay AC, Salsberg J, Vallée C, Davidson L: Feature?~?user-led research: a global and person-centered initiative. Int J Mental Health Promot 2011, 13:4-12.
• [56]Glasgow RE, Emmons KM: How can we increase translation of research into practice? Types of evidence needed. Annu Rev Public Health 2007, 28:413-433.
• [57]Shulha LM, Wilson RJ: Collaborative Mixed Methods Research. In Handbook of Mixed Methods in Social & Behavioral Research. Edited by Tashakkori A, Teddlie C. Sage, London; 2003:639-670.
• [58]Morgan DL: Paradigms lost and pragmatism regained. Methodological implications of combining qualitative and quantitative methods. J Mix Methods Res 2007, 1:48-76.
• [59]Alvesson M, Sköldberg K: Reflexive Methodology. Sage, Thousand Oaks, CA; 2009.
• [60]Leavy P: Method Meets Art: Art-Based Research Practice. The Guilford Press, New York; 2009.
• [61]Emotions in the Field. Stanford University Press, Stanford, CA; 2010.
• [62]Handbook of Qualitative Research. Sage Publications, Beverly Hills, CA; 2000.
• [63]Teddlie C, Tashakkori A: Foundations of Mixed Methods Research: Integrating Quantitative and Qualitative Approaches in the Social and Behavioral Sciences. Sage Publications, London; 2009.
• [64]Curry LA, O¿Cathain A, Clark VLP, Aroni R, Fetters M, Berg D: The role of group dynamics in mixed methods health sciences research teams. J Mix Methods Res 2012, 6:5-20.