Integrating home treatment into the Austrian child and adolescent mental health care system: an implementation science perspective.

Abstract

In Austria, similar to other countries, health care planners have considered implementing home treatment (HT) programs for children and adolescents with mental health problems. However, introducing any new service innovation into the complex environment of the child and adolescent mental health care system requires context and implementation issues to be taken into account in advance. We identified implementation themes from international HT models and developed a questionnaire with open-ended implementation-related questions for Austrian professionals. We analysed the qualitative results alongside the domains in the Context and Implementation of Complex Interventions (CICI) framework to detect key implementation challenges for HT in Austria. We found six implementation themes in international HT models, which formed the basis for development of the questionnaire. Within the qualitative data from ten Austrian professionals who responded to the questionnaire, we identified implementation challenges in all eight context and all four implementation domains of the CICI framework. Key implementation challenges detected highlight the need to address the fit of HT within existing sociocultural norms and limited available human resources. Regional context-specific solutions need to be found on how to embed this new element best into the existing provider and financing structures. This calls for monitoring and evaluation alongside implementation to support decision-making.