Implementation of Illness Management and Recovery in Mental Health Services

Implementation of Illness Management and Recovery in Mental Health Services: Facilitators and Barriers in the Implementation Process.

The purpose of this study is to examine the barriers and facilitators of implementing Illness Management and Recovery (IMR) in Norwegian mental health services.

IMR is an evidence-based practice developed for people with severe mental illnesses. It is based on the principles of recovery to help people set individual meaningful goals for their lives and gain illness self-management skills and thereby contribute to their individual recovery-process. IMR can be given individually or in groups, once a week for 10-12 months. In this project the investigators will implement Illness Management and Recovery (IMR) in mental health services. The implementation strategy are carried out according to the IMR toolkits which include informational and training materials, implementation recommendations, and fidelity scales to facilitate use of the model in routine practices. The implementation process and outcome will be of main focus. The study has an observational prospective cohort design. 30 therapists from 9 different mental health services will be trained and supervised in IMR. The investigators aim to enrol 40 patients. The primary outcome is therapists' fidelity to the model and organisational implementation outcome. Secondary outcomes are patients' level of functioning and hope.

Implementation process, implementation strategy, Implementation research, evidence based practice, recovery, Illness management and recovery

30 voluntary therapists from 9 mental health services will be trained and coached in IMR. 40 patients from the 9 mental health services will receive Illness Management and Recovery from the therapists in training.

Assesses the degree of fidelity with 13 items on a 5-point likert scale where 5 indicates full implementation and 0 indicates no implementation

A 12-item scale measuring organisational outcome of implementation by common agency practices that support evidence-based practices

Inclusion Criteria Therapists: Voluntary recruited therapists in the participating mental health services trained and consulted in IMR Inclusion Criteria Patients: Adults (18+) Associated with one of the participating mental health services symptoms on or diagnosis of severe mental illness with or without drug abuse giving informed consent verbally and in writing Exclusion Criteria Patients: Patients with acute risk of suicidal behaviour not able to communicate in Norwegian

Egeland KM, Hauge MI, Ruud T, Ogden T, Heiervang KS. Significance of Leaders for Sustained Use of Evidence-Based Practices: A Qualitative Focus-Group Study with Mental Health Practitioners. Community Ment Health J. 2019 Nov;55(8):1344-1353. doi: 10.1007/s10597-019-00430-8. Epub 2019 Jun 12.

Egeland KM, Ruud T, Ogden T, Fardig R, Lindstrom JC, Heiervang KS. How to implement Illness Management and Recovery (IMR) in mental health service settings: evaluation of the implementation strategy. Int J Ment Health Syst. 2017 Jan 23;11:13. doi: 10.1186/s13033-017-0120-z. eCollection 2017.