2259 – Translating evidence into practice: renewed perspectives in mental health services organisation

Abstract

The science of implementation consider the steps that influence the translation of evidence-based treatments into routine use. The implementation of a new Portuguese National Mental Health Plan started in 2007. In order to improved the way that services are delivered, an implementation process of a case-management (CM) was initiated by the National Programme for Mental Health. To assess the results of a implementation programme considering the following dimensions: mental health services main characteristics, leadership profile, main obstacles to implementation, implementation fidelity. 40 public and private mental health services were included for evaluation. Implementation activities included a CM training programme. Implementation degree and main obstacles to implementation were rated by: Barriers and Facilitators Assessment Instrument (Peters, 2001) and Illness Management Fidelity Scale (Mueser, 2009). Assessment of services showed: liaison (50%), guidelines use (57%), single clinical records (50%), in service formal education plan (85%), research practice (21%). Regarding professionals profile, 70% used case management in practice, only 20% with formal training. Full implementation occurred in 36,3% of services, fair implementation in 45,4%, but still not enough implemented in 18,3%. Main barriers were lack of time (61%), lack of dedicated facilities (61%), low motivation (38%) and absence of financial incentives (38%). In spite the efforts to implement evidence based practices in Portuguese mental health services, there are still several obstacles that difficult full implementation. Structured implementation programmes may constitute coadjutants to ameliorate the delivery of effective practices.