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- Title
P-613 - Implementation science: a new paradigm in organizing mental health services
- Authors
Mateus, P.; Caldas Almeida, J.; Carvalho, Á.; Xavier, M.
- Abstract
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.
- Subjects
PORTUGAL; MENTAL health services; MENTAL health planning; PRIMARY health care; MEDICAL records; MOTIVATION (Psychology)
- Publication
European Psychiatry, 2012, Vol 27, p1
- ISSN
0924-9338
- Publication type
Abstract
- DOI
10.1016/S0924-9338(12)74780-6