Models, frameworks and theories in the implementation of programs targeted to reduce formal coercion in mental health settings: a systematic review

Lantta, Tella, Duxbury, Joy ORCID: https://orcid.org/0000-0002-1772-6874 , Haines-Delmont, Alina, Björkdahl, Anna, Husum, Tonje Lossius, Lickiewicz, Jakub, Douzenis, Athanassios, Craig, Elaine, Goodall, Katie, Bora, Christina, Whyte, Rachel and Whittington, Richard (2023) Models, frameworks and theories in the implementation of programs targeted to reduce formal coercion in mental health settings: a systematic review. Frontiers in Psychiatry, 14 .

Preview

PDF - Published Version Available under License CC BY Download (498kB) | Preview

Abstract

Introduction: Implementation models, frameworks and theories (hereafter tools) provide researchers and clinicians with an approach to understand the processes and mechanisms for the successful implementation of healthcare innovations. Previous research in mental health settings has revealed, that the implementation of coercion reduction programs presents a number of challenges. However, there is a lack of systematized knowledge of whether the advantages of implementation science have been utilized in this field of research. This systematic review aims to gain a better understanding of which tools have been used by studies when implementing programs aiming to reduce formal coercion in mental health settings, and what implementation outcomes they have reported.

Methods: A systematic search was conducted using PubMed, CINAHL, PsycINFO, Cochrane, Scopus, and Web of Science. A manual search was used to supplement database searches. Quality appraisal of included studies was undertaken using MMAT—Mixed Methods Appraisal Tool. A descriptive and narrative synthesis was formed based on extracted data. Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines were followed in this review.

Results: We identified 5,295 references after duplicates were removed. Four additional references were found with a manual search. In total eight studies reported in nine papers were included in the review. Coercion reduction programs that were implemented included those that were holistic, and/or used professional judgement, staff training and sensory modulation interventions. Eight different implementation tools were identified from the included studies. None of them reported all eight implementation outcomes sought from the papers. The most frequently reported outcomes were acceptability (4/8 studies) and adaptation (3/8). With regards to implementation costs, no data were provided by any of the studies. The quality of the studies was assessed to be overall quite low.

Discussion: Systematic implementation tools are seldom used when efforts are being made to embed interventions to reduce coercive measures in routine mental health care. More high-quality studies are needed in the research area that also involves perspectives of service users and carers. In addition, based on our review, it is unclear what the costs and resources are needed to implement complex interventions with the guidance of an implementation tool.

Systematic review registration: [Prospero], identifier [CRD42021284959].

Item Type:	Article
Journal / Publication Title:	Frontiers in Psychiatry
Publisher:	Frontiers Media
ISSN:	1664-0640
Departments:	Institute of Health > Nursing
Additional Information:	Joy Duxbury, Professor of Mental Health and Director of Research for the Institute of Health at the University of Cumbria, UK. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice.
Depositing User:	Joy Duxbury
Date Deposited:	07 Oct 2024 09:08
Last Modified:	07 Oct 2024 09:27
URI:	https://insight.cumbria.ac.uk/id/eprint/8435

Downloads