Changing practice to support self-management and recovery in mental illness: application of an implementation model
Melanie Harris A E , Phil Jones B , Marie Heartfield A , Mary Allstrom C , Janette Hancock D , Sharon Lawn A and Malcolm Battersby A
+ Author Affiliations
- Author Affiliations
A Flinders Human Behaviour and Health Research Unit, School of Medicine, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia.
B Community Mental Health, UnitingCare Wesley Port Adelaide, 70 Dale Street, Port Adelaide, SA 5015, Australia.
C UnitingCare Wesley Port Adelaide, 70 Dale Street, Port Adelaide, SA 5015, Australia.
D Organisational Development, UnitingCare Wesley Port Adelaide, 70 Dale Street, Port Adelaide, SA 5015, Australia.
E Corresponding author. Email: melanie.harris@flinders.edu.au
Australian Journal of Primary Health 21(3) 279-285 https://doi.org/10.1071/PY13103
Submitted: 26 July 2013 Accepted: 10 March 2014 Published: 1 April 2014
Abstract
Health services introducing practice changes need effective implementation methods. Within the setting of a community mental health service offering recovery-oriented psychosocial support for people with mental illness, we aimed to: (i) identify a well-founded implementation model; and (ii) assess its practical usefulness in introducing a new programme for recovery-oriented self-management support. We reviewed the literature to identify implementation models applicable to community mental health organisations, and that also had corresponding measurement tools. We used one of these models to inform organisational change strategies. The literature review showed few models with corresponding tools. The Promoting Action on Research Implementation in Health Services (PARIHS) model and the related Organisational Readiness to Change Assessment (ORCA) tool were used. The PARIHS proposes prerequisites for health service change and the ORCA measures the extent to which these prerequisites are present. Application of the ORCA at two time points during implementation of the new programme showed strategy-related gains for some prerequisites but not for others, reflecting observed implementation progress. Additional strategies to address target prerequisites could be drawn from the PARIHS model. The PARIHS model and ORCA tool have potential in designing and monitoring practice change strategies in community mental health organisations. Further practical use and testing of implementation models appears justified in overcoming barriers to change.
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