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Implementing evidence-based psychosocial practices: lessons learned from statewide implementation of two practices.

Lorna L Moser1, Natalie L Deluca, Gary R Bond

  • 1Department of Psychology, Indiana University-Purdue University, Indianapolis, IN 46202-3275, USA. gbond@iupui.edu

CNS Spectrums
|December 25, 2004
PubMed
Summary

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State-level factors significantly impacted the successful implementation of evidence-based practices (EBPs) like assertive community treatment (ACT) over integrated dual disorders treatment (IDDT). Addressing these systemic barriers is crucial for widespread EBP adoption in mental health services.

Area of Science:

  • Mental Health Services Research
  • Implementation Science
  • Healthcare Policy

Background:

  • Effective implementation of evidence-based practices (EBPs) in real-world mental health settings remains a challenge.
  • The National EBP Project investigates factors influencing EBP implementation across multiple states.

Purpose of the Study:

  • To examine barriers and strategies for implementing two specific EBPs: assertive community treatment (ACT) and integrated dual disorders treatment (IDDT) in Indiana.
  • To identify state-level and site-specific factors affecting EBP implementation success.

Main Methods:

  • A 15-month observational study of eight ACT and six IDDT programs.
  • Data collection included monthly site visits, interviews with key leaders, and creation of a comprehensive database.

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  • Barriers and strategies were rated across seven factors: Attitudes, Mastery, Leadership, Staffing, Policies, Workflow, and Program Monitoring.

    • Main Results:

    • Common barriers for ACT included leadership, staffing, and policies; for IDDT, mastery and leadership were most frequent.
    • Overall, IDDT faced more implementation barriers than ACT.
    • Assertive community treatment (ACT) was more successfully implemented than integrated dual disorders treatment (IDDT), largely due to state-level factors like preparation, standards, technical assistance, and funding.

    Conclusions:

    • Both state-level and site-specific factors critically influence the successful implementation of EBPs.
    • Systematic strategies are needed to proactively address and overcome identified barriers to achieve full EBP implementation in mental health care.