Feasibility in Community Mental Health Research: A Scoping Review

Feasibility, the degree to which an innovation is successfully carried out in a given setting, is key to whether an intervention will be implemented as planned and is connected to implementation success and service outcomes. In settings with limited resources, feasibility may be a particularly important determinant of whether an intervention is adopted and/or sustained over time. However, there is limited consensus on how to define, measure, and report feasibility in research conducted in community mental health settings. Following guidance from Arksey and O'Malley (2005), Levac et al. (2010), and Westphaln et al. (2021), the current scoping review aims to synthesize how trials conducted in community mental health settings describe the rationale, definition, measurement approach, and results of feasibility. The search included articles from Medline, PsycInfo, CENTRAL, Global Health, and Global Index Medicus and was conducted in September 2023. Included articles referenced feasibility and had each of the following: (1) delivery of an evidence-based psychotherapy (EBP) in a community mental health setting, (2) participants with elevated mental health symptomatology, and (3) implementation and/or clinical outcomes. Through data extraction, data synthesis, and qualitative content analysis, the authors identified feasibility definitions, measures, results, and explanations as well as intervention characteristics. Sixty-one articles across 20 countries were included. Articles included a wide range of EBPs delivered to individuals across the life span in community mental health settings. While all studies reported some level of feasibility of an intervention or trial, only 60.7% described a rationale for examining feasibility, 11.5% defined feasibility, 73.8% measured feasibility, and 67.2% reported descriptive statistics to accompany the level of feasibility found. Our results highlight the lack of clear and consistent rationales, definitions, measurement approaches, and results of feasibility in research conducted in community mental health settings. To improve the conceptualization and study of feasibility, we propose guidelines for future researchers to consider when examining feasibility. The guidelines include providing a clear definition of feasibility (i.e., the extent to which an EBP is possible in a certain context; Proctor et al., 2011), combining reflective and formative measures of feasibility to assess how feasible an intervention is and why it is deemed feasible (respectively), considering when in the implementation process researchers are engaged, involving multiple voices in the measures of feasibility, and exploring the impact of feasibility on other implementation outcomes as well as clinical outcomes.