Evidence-Based Practice As Mental Health Policy: Three Controversies And A Caveat

2005 ◽  
Vol 24 (1) ◽  
pp. 163-173 ◽  
Author(s):  
Sandra J. Tanenbaum
2003 ◽  
Vol 183 (2) ◽  
pp. 105-113 ◽  
Author(s):  
Brian Cooper

BackgroundArguments for and against evidence-based psychiatry have mostly centred on its value for clinical practice and teaching. Now, however, use of the same paradigm in evaluating health care has generated new problems.AimsTo outline the development of evidence-based health care; to summarise the main critiques of this approach; to review the evidence now beingemployed to evaluate mental health care; and to consider how the evidence base might be improved.MethodThe following sources were monitored: pub ications on evidence-based psychiatry and health care since 1990; reports of randomised trials and meta-analytic reviews to the end of 2002; and official British publications on mental health policy.ResultsAlthough evidence-based health care is now being promulgated as a rational basis for mental health planning in Britain, its contributions to service evaluation have been distinctly modest. Only 10% of clinical trials and meta-analyses have been focused on effectiveness of services, and many reviews proved inconclusive.ConclusionsThe current evidence-based approach is overly reliant on meta-analytic reviews, and is more applicable to specific treatments than to the care agencies that control theirdelivery. A much broader evidence base is called for, extending to studies in primary health care and the evaluation of preventive techniques.


PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0244940
Author(s):  
Debra Leigh Marais ◽  
Inge Petersen ◽  
Michael Quayle

Background Marrying principles of evidence-based policymaking, with its focus on what works, with principles of consultative policymaking, with its focus on what works for whom, means finding ways to integrate multiple knowledge inputs into policy decisions. Viewed through the lens of the embodied-enacted-inscribed knowledge framework, policy consultation is a site of knowledge enactment, where the embodied knowledge enacted by individuals engages with the inscribed knowledge contained in policy documents, creating new forms of embodied and inscribed knowledge that move beyond these spaces. Aim Using this knowledge framework, this study aimed to trace the movement of knowledge inputs through South Africa’s mental health policy consultation summit. Methods Breakaway group session transcripts from the national consultation summit were thematically analysed to identify the types of knowledge that participants explicitly drew on (experiential or evidence-based) during discussions and how these knowledge inputs were used, responded to, and captured. Findings Findings suggest that there was little explicit reference to either evidence-based or experiential knowledge in most of the talk. While slightly more evidence-based than experiential knowledge claims were made, this did not render these claims any more likely to be responded to or engaged with in group discussions, or to be inscribed in group recommendations. Discussion The importance of designing participatory processes that enable optimal use of knowledge inputs in these enacted spaces is discussed. Conclusion Attending to the specific ways in which knowledge is transformed and moved through a policy consultation process has the potential to enhance the value that consultation offers policymakers.


Author(s):  
Valentina Iemmi ◽  
Nicole Votruba ◽  
Graham Thornicroft

This chapter describes evidence-based mental health policy with the help of illustrative examples. After briefly setting the use of research evidence to inform mental health policy within the broader historical context, the second section of the chapter provides a brief description of evidence-based mental health policy and its rationale. The third section illustrates how mental health research may help inform mental health policy, with a description of the research cycle, the policy cycle, their relationship, and the use of epidemiological studies for policymaking. The fourth section provides examples of the use of research evidence in mental health policy at different organizational levels, from the clinical level (micro-level), through the service provision/healthcare facility level (meso-level) and the whole health system level (macro-level), to the global level (mega-level). Finally, the chapter concludes by reflecting on some of the opportunities and challenges that influence evidence-based mental health policy.


2000 ◽  
Vol 55 (7) ◽  
pp. 740-749 ◽  
Author(s):  
Ralph Swindle ◽  
Kenneth Heller ◽  
Bernice Pescosolido ◽  
Saeko Kikuzawa

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