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在非专业精神卫生机构中实施基于证据的实践。

Implementing evidence-based practices in nonspecialty mental health settings.

机构信息

Department of Psychiatry.

George Warren Brown School of Social Work.

出版信息

Fam Syst Health. 2022 Jun;40(2):274-282. doi: 10.1037/fsh0000506. Epub 2022 Jan 10.

Abstract

OBJECTIVE

Mental health services are often implemented in settings in which mental health is not the primary mission. Schools, primary care clinics, criminal justice and child welfare institutions, and senior centers have been increasingly adding mental health care to their compendium of services owing to the high rates of mental health needs in these settings. Despite numerous challenges to implementing mental health practices in settings where mental health care has not traditionally been a part of the service model, the demand for mental health services in these settings is growing. Implementation science offers a lens through which to understand unique challenges and potential solutions to implementing mental health services in these settings, with the ultimate goal of ensuring the implementation of evidence-based services.

METHOD AND RESULTS

In this conceptual article, we discuss common overarching barriers to implementing evidence-based mental health interventions in nonspecialty mental health settings, such as workforce challenges, competing priorities, and financial considerations. Then, using examples from schools and primary care, we elucidate unique contextual considerations and implementation challenges in these settings. Finally, we articulate a research agenda for advancing implementation of evidence-based practices in nonspecialty mental health including highlighting promising implementation strategies (e.g., task shifting, adaptation) and the most relevant implementation outcomes to assess in these contexts (e.g., appropriateness, feasibility).

CONCLUSIONS

Given that nonspecialty mental health settings deliver a large proportion of mental health care to traditionally underserved populations, there are important public health implications to advancing research in this area and ensuring implemented services are evidence-based. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

摘要

目的

精神卫生服务通常在精神卫生并非主要任务的环境中实施。由于这些环境中的精神卫生需求率很高,学校、初级保健诊所、刑事司法和儿童福利机构以及老年人中心越来越多地将精神卫生保健纳入其服务范围。尽管在精神卫生服务传统上不属于服务模式一部分的环境中实施精神卫生实践存在诸多挑战,但这些环境对精神卫生服务的需求正在增长。实施科学提供了一个视角,可以了解在这些环境中实施精神卫生服务的独特挑战和潜在解决方案,最终目标是确保实施基于证据的服务。

方法和结果

在这篇概念性文章中,我们讨论了在非专业精神卫生环境中实施基于证据的精神卫生干预措施的常见总体障碍,例如劳动力挑战、优先事项冲突和财务考虑。然后,我们以学校和初级保健为例,阐明了这些环境中的独特背景考虑因素和实施挑战。最后,我们阐述了在非专业精神卫生领域推进基于证据的实践实施的研究议程,包括强调有前途的实施策略(例如任务转移、适应)和在这些背景下最相关的实施结果评估(例如适当性、可行性)。

结论

鉴于非专业精神卫生环境为传统服务不足的人群提供了大部分精神卫生保健,因此在该领域推进研究并确保实施的服务基于证据具有重要的公共卫生意义。(PsycInfo 数据库记录(c)2022 APA,保留所有权利)。

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