Staying the course?: Challenges in implementing evidence-based programs in community mental health services
2014 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 11, 10752-10769 p.Article in journal (Refereed) Published
This paper focuses on the second phase of the deinstitutionalisation of mentalhealth care in which the development of community-based interventions are supposed to beimplemented in local community mental health care systems. The challenge to sustainableimplementation is illustrated by the Swedish case where the government put forwarda national training program that sought to introduce Assertive Community Treatment(ACT) for people with severe mental illness. This study is based on document analysis andqualitative interviews with actors at the national, regional, and local levels covering a total offive regions and 15 municipalities that participated in the program. The analysis of the nationalexperiences is put in relation to both research on public administration and policy analysis aswell as to current research on implementation of evidence-based programs. The results showeda “drift” of the original model, which had already begun at the policy formulation stage andended up in a large number of different local arrangements where only a few of the originalcomponents of ACT remained. We conclude that issues with implementation can only be fullyunderstood by considering factors at different analytical levels.
Place, publisher, year, edition, pages
Basel, Switzerland: MDPI AG , 2014. Vol. 11, 10752-10769 p.
evidence-based practice, community mental health, implementation, assertive community treatment
IdentifiersURN: urn:nbn:se:umu:diva-94887DOI: 10.3390/ijerph111010752OAI: oai:DiVA.org:umu-94887DiVA: diva2:756778