Administrative Considerations for Successful Implementation of Primary Care Mental Health Programs

Objective The Access to Allied Psychological Services (ATAPS) programs implemented through Divisions of General Practice (now Medicare Locals) enables general practitioners (GPs) to refer consumers with high-prevalence mental disorders for up to 12 individual and/or group sessions of evidence-based mental health care. The great strength of ATAPS is its ability to target vulnerable and hard-to-reach populations. Several initiatives have been introduced that focus on particular at-risk populations. This study aimed to determine the factors that had influenced Divisions’ decisions to implement the various Tier 2 initiatives. Methods An online survey was sent to all Divisions. The survey contained mostly multiple choice questions and sought to determine which factors had influenced their decision-making. Results The most common factors influencing the decision to implement an initiative were the perception of local need and whether there was an existing service model that made it easier to add in new programs. The most commonly cited factors for not implementing were related to resources and administrative capacity. Conclusions This research provides valuable insights into the issues that primary care organisations face when implementing new programs; the lessons learnt here could be useful when considering the implementation of other new primary care programs. What is known about the topic? Previous evaluations of ATAPS have shed light on some of the factors that act as barriers to the implementation of new mental health initiatives by Divisions operating in primary care, but there is nothing known about why Divisions choose to implement some programs over others. Previous research suggests that ‘barriers’ to change, as reported by organisations, may be constructions that are used to make sense of a situation and that the real impediment to change are intra-organisational factors such as the self-identity of organisations. What does this paper add? This paper reports on a survey that was undertaken with Divisions regarding the reasons they chose to implement particular mental health initiatives. The paper provides insight into the barriers that Divisions perceived when implementing new mental health programs. They were primarily cited as funding and resource barriers. The findings also provide further indirect evidence of the role of the self-identity of organisations in change. What are the implications for practitioners? The study has some implications for government policy development both locally and internationally. For instance, it is likely that primary care organisations such as Divisions, especially smaller ones, require support in terms of increased funding and resources if new mental health initiatives are to be successful. Mandating the delivering of initiatives also contributes to their successful uptake. It is likely that as primary care organisations become more experienced with implementing new mental health programs, the perceived barriers will reduce and implementation will occur with more ease.

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The Goodness of Fit between Evidence-Based Early Childhood Mental Health Programs and the Primary Care Setting

Integrated Early Childhood Behavioral Health in Primary Care ◽

10.1007/978-3-319-31815-8_4 ◽

2016 ◽

pp. 35-70

Author(s):

Dana E. Crawford ◽

Rahil D. Briggs

Keyword(s):

Mental Health ◽

Primary Care ◽

Early Childhood ◽

Goodness Of Fit ◽

Primary Care Setting ◽

Health Programs ◽

Evidence Based ◽

Early Childhood Mental Health ◽

Childhood Mental Health ◽

Mental Health Programs

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VA to Bring Mental Health Programs to Primary Care Settings

Psychiatric Services ◽

10.1176/ps.2007.58.8.1134 ◽

2007 ◽

Vol 58 (8) ◽

pp. 1134-1135

Keyword(s):

Mental Health ◽

Primary Care ◽

Health Programs ◽

Primary Care Settings ◽

Mental Health Programs

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Program description and implementation findings of MyCare: enhancing community mental health care in Tasmania, Australia

Australian Journal of Primary Health ◽

10.1071/py20046 ◽

2020 ◽

Vol 26 (5) ◽

pp. 374

Author(s):

Renee O'Donnell ◽

Darshini Ayton ◽

Bengianni Pizzirani ◽

Melissa Savaglio ◽

Debra Fast ◽

...

Keyword(s):

Mental Health ◽

Implementation Strategy ◽

Controlled Trial ◽

Implementation Strategies ◽

Health Programs ◽

Successful Implementation ◽

Health Issues ◽

Community Based ◽

Mental Health Issues ◽

Mental Health Programs

Since 2014, Tasmania has experienced unprecedented rates of hospitalisations related to mental health issues. To address reliance on such acute-based care, government funding was invested to enhance community-based care, which, in turn, led to the development of MyCare. This paper represents the initial phase of a larger body of work (i.e. an effectiveness-controlled trial of MyCare) that describes the MyCare program and the successful implementation strategy underpinning the program. The implementation of MyCare was evaluated with 41 key stakeholders (staff, clients and senior executives) using semistructured interviews and focus groups, informed by the Consolidated Framework for Implementation Research (CFIR). According to stakeholders, three CFIR constructs that were directly addressed by the program, namely Tension for Change, Evidence Strength and Quality, and Available Resources for Implementation, facilitated the successful implementation of MyCare. In contrast, a feature of the program that impeded implementation was Patient Needs and Resources, which restricted program access to those with the most severe mental health issues. The reporting of implementation strategies underpinning mental health programs is rare. This study describes the implementation strategy underpinning a community-based mental health program that was successful in facilitating program uptake. We encourage other researchers to not only report on implementation findings, which may help avoid replication failure, but also to apply these innovative implementation processes (i.e. address the tension for change and ensure the program is evidence informed and that sufficient resources are available for implementation) within mental health programs to aid successful uptake.

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