Lucy gained her PhD in 2016 exploring the role of boundary objects, shared things and ideas, in implementation through the first iteration of NIHR NHS-university partnerships, CLAHRCs. She has collaborated with NIHR ARC NWC to examine the Health Inequalities Assessment Tool (HIAT) as a boundary object (https://forequity.uk/hiat/). In 2022 she joined Dr Myra Piat’s team at The Douglas Institute of Mental Health Research, McGill University, to investigate the experience of facilitation during the implementation of Canada’s mental health recovery guidelines in a CIHR PHSI funded study. An implementation coaching module will be developed and embedded within The Walk the Talk Toolkit (https://walkthetalktoolkit.ca/) as an outcome.
Lucy is an RMN and splits her time between lecturing in mental health nursing at Bangor University, doing research, and working on an acute CAMHS unit. She lives, practises, and plays in North Wales.
We build on a 5-year project to implement Canada’s mental health recovery guidelines using the co-produced Walk the Talk Toolkit (https://walkthetalktoolkit.ca). Facilitation is explored from multiple stakeholder perspectives to embed lived experience within the Toolkit, enhancing appeal and inclusivity.
This CIHR funded pan-Canadian qualitative study explores facilitation as an active and ongoing process. 40 interviews with those who use and deliver services across 7 mental health organisations, alongside facilitators, examined improving facilitation from each stakeholder’s perspective, during planning, implementation, and coaching. Thematic analysis reveals what is important to stakeholders during facilitation, and how this can be used to enhance the experience and outcomes of future implementation efforts.
Emergent findings revolve around themes of people, process, pitfalls, and payoff. A safe space for those in recovery to engage in implementation is necessary. Conviction, cultural competence, and a nurturing approach are valued facilitator attributes. Establishing parity amongst stakeholders, striking a ‘sweet spot’ between being directive and enabling, alongside resilience and mediation, are helpful during coaching. Momentum and motivation are improved via the prospect of tangible outcomes. Despite efforts to demystify the CFIR, the language of implementation science remains baffling to many.
Co-producing implementation toolkits needs meaningful engagement at all levels involving all stakeholders. Generating ownership during coaching improves success of recovery-oriented interventions, but a shift in leadership can be challenging. Engaging in successful implementation can initiate a legacy of change at an individual and collective level. Work with equity deserving groups including indigenous and LGBTQ+ communities to improve cultural inclusivity is underway. Scaling up across international health and social care is planned.