[Factors Influencing the Implementation of the Barometre Practice Model in the Field of Psychosocial Rehabilitation in Mental Health: Results from a Multiple Case Study].

Le résumé fourni par la source

Over the past few years, several psychosocial rehabilitation strategies in mental health (PSR) have been developed to assist individuals living with severe mental health disorders (SMHDs) to fully exercise their social participation. However, the effectiveness of PSR strategies is often undermined as they remain fragmented, compartmentalized, and not cohesively integrated with one another. Furthermore, while there is scientific consensus and evidence on the usefulness and need for integrative PSR practice models, their effective implementation is not well understood and continues to be a marginal practice. Objective The main objective of this research is to identify and describe the contextual factors (enablers, barriers) influencing the implementation of the Baromètre Practice Model in different organisational contexts. The research also aims to co-produce recommendations with various stakeholders to improve the BPM and the strategies for its implementation. Methodology Drawing from the organizational participatory approach, a qualitative multiple case study was conducted with two French organization's housing individuals living with SMHD. Data collection involved multiple sources including participant observations, focus groups with accompanied persons, semi-structured dyad interviews with health professionals, and round-table discussions with a scientific committee. A theoretical synthesis combining the Capability and Personalised Care and Services approaches, and the Consolidated Framework for Implementation Research (CFIR), guided the iterative thematic analysis process. Results More than 40 contextual factors were identified and grouped into four main interrelated categories: organizational context and process; interprofessional practices; support practices; personal recovery process and maximum participation of people living with SMHDs. The interactions between these different factors led to the emergence of specific systemic dynamics: the contagion of experiences (positive or problematic); inertia, leading to a return to previous habits and modes of operation; and dynamization, which brings about a reinforcement of the motivation among actors to adopt and implement new practices. Conclusion This research provides a better understanding of the internal organizational contextual factors that influence the implementation of the Baromètre Practice Model. It also shows that it is possible to operationalise this model in various organisations offering care and services to individuals living with SMHDs. Research must continue to facilitate the implementation within health care and health service networks wishing to realize collaborative practices that promote the rights of individuals, their self-determination, and their personal recovery.

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