Implementing Person-Centered Recovery Planning: New England Mental Health Technology Transfer Center Learning Collaborative Evaluation Report

Abstract

Person-centered recovery planning (PCRP) has been a key aspect in mental health system transformation and delivering quality health care. Despite the mandate to deliver this practice and a growing evidence base, its implementation and understanding of implementation processes in behavioral health settings remain a challenge. New England Mental Health Technology Transfer Center (MHTTC) launched the PCRP in Behavioral Health Learning Collaborative to support agencies’ implementation efforts through training and technical assistance. In an effort to explore and understand the internal implementation process changes facilitated by the learning collaborative, the authors conducted qualitative key informant interviews with the participants and the leadership of the PCRP learning collaborative. The interviews revealed the processes that are part of the PCRP implementation efforts, including staff training, changing agency policies and procedures, modifying treatment planning tools, and the structure of the electronic health records. The higher prior organizational investment and readiness for change, building staff’s competencies in PCRP, leadership investment, and frontline staff buy-in act as factors that facilitate the implementation of PCRP in behavioral health settings. Our findings inform both the implementation of PCRP in behavioral health settings and future efforts of organizing multi-agency learning collaboratives to support PCRP implementation. Supplementary Information The online version contains supplementary material available at 10.1007/s43477-023-00078-3.

Supported decision‐making interventions in mental healthcare: A systematic review of current evidence and implementation barriers

“…For example, limited organisational financial resources and investment in services and staffing affected staff availability, high staff turnover and workloads: ‘we're short of money and … we're short of people’ 28 were issues reported to affect clinicians' ability to undertake shared and supported decision‐making when treatment planning with service users 29–38 . These barriers were further exacerbated by the Covid pandemic 39 . Also, training costs can be substantial 35 and, when insufficiently allocated, could mean that ‘the scene was not set for clinicians’, 21 when they did not receive sufficient information, training or support to understand and adopt such new interventions 36,40 .…”

“… 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 These barriers were further exacerbated by the Covid pandemic. 39 Also, training costs can be substantial 35 and, when insufficiently allocated, could mean that ‘the scene was not set for clinicians’, 21 when they did not receive sufficient information, training or support to understand and adopt such new interventions. 36 , 40 Organisational culture and particularly a lack of readiness to change were also barriers—when organisations and leadership avoided a sustained investment in change, did not involve frontline staff in implementation processes or support the necessary changes to address staff work priorities and availability, IT infrastructure, physical infrastructure (i.e., the need for private spaces), clinical workflows and access to guidelines.…”

“… 36 , 40 Organisational culture and particularly a lack of readiness to change were also barriers—when organisations and leadership avoided a sustained investment in change, did not involve frontline staff in implementation processes or support the necessary changes to address staff work priorities and availability, IT infrastructure, physical infrastructure (i.e., the need for private spaces), clinical workflows and access to guidelines. 29 , 34 , 36 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 In addition, balancing organisational risk management priorities with increased service user involvement in decision‐making could be challenging and a concern for practitioners. 45 , 47 Organisational structure was another barrier to the broad uptake of a new intervention, for example, where a decentralised system meant that consistent cross‐site policies and procedures were not possible across a jurisdiction.…”