Implementation of Illness Management and Recovery in Mental Health Services

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

Detailed Description
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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.

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

Conditions
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Bipolar Disorder, Schizophrenia, Affective Disorders, Psychotic, Mood Disorders, Mental Disorders

Intervention / Treatment
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* Behavioral: Illness Management and Recovery


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: IMR therapists, IMR patients<br>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. | Behavioral: Illness Management and Recovery<br>* Evidence-based practice given individually or in groups, weekly for 10-12 months.<br>* Other names: IMR;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Illness Management Fidelity Scale (SAMHSA, 2009) | Assesses the degree of fidelity with 13 items on a 5-point likert scale where 5 indicates full implementation and 0 indicates no implementation | 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Illness Management & Recovery Treatment Integrity Scale (IT-IS) (McGuire et al., 2012 | A 16-item scale measuring clinicians' faithful replication of the model | 12 months | 
| The Adult State Hope Scale (Snyder et al., 1996) | A 6-item self-report scale of patients' hope and optimism | 12 months | 
| The Illness Management and Recovery Scale (SAMHSA, 2009) | Assessing patients' recovery outcomes in the IMR program with 15 items. | About 11 months after start of intervention | 
| General Organizational Index (SAMHSA, 2009) | A 12-item scale measuring organisational outcome of implementation by common agency practices that support evidence-based practices | 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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recovery, Implementation process, implementation strategy, Implementation research, evidence based practice, Illness management and recovery