@article{pmid41449377,

title = {Perspectives on internal vs. external facilitation for implementing guidelines for recovery-oriented practice: a qualitative study},

author = {Myra Piat and Lucy Melville-Richards and Megan Wainwright and Eleni Sofouli and Hélène Albert and Marie-Pier Rivest and Ian D Graham},

doi = {10.1186/s12913-025-13931-y},

issn = {1472-6963},

year  = {2025},

date = {2025-12-01},

journal = {BMC Health Serv Res},

volume = {26},

number = {1},

pages = {154},

abstract = {BACKGROUND: Seven organizations supporting adults with mental health challenges collaborated with researchers to implement Chapter Six of Canada's Guidelines for Recovery-Oriented Practice. An implementation strategy was developed that combined external facilitation, mixed Implementation Teams, a 12-meeting planning process, and ongoing coaching. This paper focuses on the facilitation component, specifically exploring participants' perspectives on internal versus external facilitation within Implementation Teams.nnMETHODS: Forty semi-structured individual online interviews were conducted with 32 members of Implementation Teams, including service users, providers, family members, managers, and knowledge users, along with eight researchers who acted as external facilitators. Participants discussed their experiences of implementing the guidelines supported by an external facilitator and were asked to consider how their experience may differ if it had been led by an internal facilitator.nnRESULTS: Thematic analysis identified seven themes relating to what was perceived as important about internal versus external facilitation: (1) Effect of facilitator position (external versus internal); (2) Flattening power hierarchies; (3) Enacting cultural shifts; (4) Understanding context; (5) Encouraging candour; (6) Building relationships, and (7) Internal facilitator identity and influence. These highlight how participants valued different skills, knowledge, and attributes in each scenario, with responses varying depending on the participant's identity. No clear preference emerged for either approach. Instead, participants debated the benefits and drawbacks of both, where insider knowledge vied with outsider neutrality for primacy.nnCONCLUSIONS: Whether facilitation is internal or external, its effectiveness relies on the facilitator's ability to establish rapport, develop allies, and foster unity between Implementation Team members and the implementation setting itself. A blended approach, which integrates the strengths of both internal and external facilitators, may offer the most effective model for supporting the implementation of recovery-oriented practice.nnAUTHOR(S): Myra Piat, Lucy Melville-Richards Megan Wainwright, Eleni Sofouli, Hélène Albert, Marie-Pier Rivest, Ian D. Graham.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid40233365,

title = {iCogCA to Promote Cognitive Health Through Digital Group Interventions for Individuals Living With a Schizophrenia Spectrum Disorder: Protocol for a Nonrandomized Concurrent Controlled Trial},

author = {Christy Au-Yeung and Helen Thai and Michael Best and Christopher R Bowie and Synthia Guimond and Katie M Lavigne and Mahesh Menon and Steffen Moritz and Myra Piat and Geneviève Sauvé and Ana Elisa Sousa and Elisabeth Thibaudeau and Todd S Woodward and Martin Lepage and Delphine Raucher-Chéné},

doi = {10.2196/63269},

issn = {1929-0748},

year  = {2025},

date = {2025-04-01},

journal = {JMIR Res Protoc},

volume = {14},

pages = {e63269},

abstract = {BACKGROUND: Cognitive impairments are a key aspect of schizophrenia spectrum disorders (SSDs), significantly affecting clinical and functional outcomes. The COVID-19 pandemic has heightened concerns about mental health services and cognitive stimulation opportunities. Despite evidence-based interventions like action-based cognitive remediation (ABCR) and metacognitive training (MCT), a research-to-practice gap exists in their application across mental health settings.nnOBJECTIVE: The iCogCA study aims to address this gap by implementing digital ABCR and MCT through a national Canadian collaborative effort using digital psychological interventions to enhance cognitive health in SSDs.nnMETHODS: The study involves 5 Canadian sites, with mental health care practitioners trained digitally through the E-Cog platform, which was developed by our research group. Over 2.5 years, participants with SSDs will undergo pre- and postintervention assessments for clinical symptoms, cognition, and functioning. Each site will run groups annually for both ABCR and MCT, totaling ~390 participants. A nonrandomized concurrent controlled design will assess effectiveness design, in which one intervention (eg, ABCR) acts as the active control for the other (eg, MCT) and vice versa, comparing cognitive and clinical outcomes between the interventions using generalized linear mixed effect modeling. Implementation strategy evaluation will consider the digital platform's efficacy for mental health care practitioners' training, contextual factors influencing implementation, and sustainability, using descriptive statistics for quantitative data and thematic analysis for qualitative data.nnRESULTS: A pilot pragmatic trial has been conducted previously at the Montreal site, evaluating 3 early implementation outcomes: acceptability, feasibility, and engagement. Patient and therapist acceptability was deemed as high and feasible (21/28, 75% of recruited service users completed therapy, rated feasible by therapists). Technology did not appear to significantly impede program participation. Therapist-rated levels of engagement were also satisfactory. In the ongoing study, recruitment is underway (114 participants recruited as of winter 2024), and intervention groups have been conducted at all sites, with therapists receiving training via the E-Cog learning platform (32 enrolled as of winter 2024).nnCONCLUSIONS: At least 3 significant innovations will stem from this project. First, this national effort represents a catalyst for the use of digital technologies to increase the adoption of evidence-based interventions and will provide important results on the effectiveness of digitally delivered ABCR and MCT. Second, the results of the implementation component of this study will generate the expertise needed to inform the implementation of similar initiatives. Third, the proposed study will introduce and validate our platform to train and supervise mental health care practitioners to deliver these interventions, which will then be made accessible to the broader mental health community.nnTRIAL REGISTRATION: ClinicalTrials.gov NCT05661448; https://clinicaltrials.gov/study/NCT05661448.nnINTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/63269.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid41280435,

title = {Unpacking the Facilitation Component of a Toolkit for Implementing Mental Health Recovery Guidelines into Services},

author = {Myra Piat and Lucy Melville-Richards and Megan Wainwright and Marie-Pier Rivest and Eleni Sofouli and Kanwar Singh and Joël Richardson and Hélène Albert and Ian Graham},

doi = {10.1007/s43477-025-00170-w},

issn = {2662-9275},

year  = {2025},

date = {2025-01-01},

journal = {Glob Implement Res Appl},

volume = {5},

number = {4},

pages = {568--583},

abstract = {Facilitation is an important, but complex strategy for implementing evidence into practice. It involves one or more individuals from within or outside an organisation taking on the role of a facilitator who enables change, provides support and problem-solves. It is often embedded or combined with multiple strategies making it challenging to study. Our objective in this qualitative follow-up study was to unpack the facilitation component of a complex implementation strategy for implementing mental health recovery guidelines for transforming services and systems called Walk the Talk toolkit. All the materials in the online toolkit are designed for facilitators to: (1) Establish an implementation team, (2) Conduct a 12-meeting planning process for implementing a recovery-oriented innovation and (3) Provide ongoing implementation coaching. We recruited 8 facilitators (researchers) and 32 Implementation Team members who had participated in the research project in which the toolkit was created and used for the first time. They participated in a semi-structured interview exploring their perspectives on facilitation. Interviews were analysed thematically. Findings emerged around three overarching themes: (1) Shifts in facilitation approaches, roles and intensity over the course of three toolkit stages, (2) Facilitator skills and attributes, such as relationship-building, simplifying implementation science concepts, and asserting equity, and (3) Facilitation challenges, which included reaching systematically excluded groups, recruiting and retaining service users and family members, confronting issues around facilitator background, and negotiating interpersonal tensions. We unpack the "black box" of facilitation and discuss the significance of deploying recovery as a shared language and vision.nnSUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s43477-025-00170-w.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37603013,

title = {Parent-child relationship outcomes in a randomized controlled trial of housing first for indigenous and non-Indigenous parents experiencing homelessness, mental illness, and separation from their children},

author = {Rachel A Caplan and Geoffrey Nelson and Jino Distasio and Corinne Isaak and Betty Edel and Eric Macnaughton and Myra Piat and Michelle Patterson and Maritt Kirst and Tim Aubry and Vicky Stergiopoulos and Paula Goering},

doi = {10.1037/prj0000575},

issn = {1559-3126},

year  = {2023},

date = {2023-08-01},

journal = {Psychiatr Rehabil J},

abstract = {OBJECTIVE: To examine the impacts of Housing First (HF) on parent-child relationships for Indigenous and non-Indigenous parents experiencing homelessness and mental illness.nnMETHOD: Data on parent-child relationships were obtained through baseline and 18-month narrative interviews with parents ( = 43). Participants were randomly assigned to HF ( = 27) or treatment as usual (TAU;  = 16). Parent-child relationship changes were coded as positive or no change. Comparisons between HF and TAU groups were examined for Indigenous parents ( = 21) and non-Indigenous parents ( = 22).nnRESULTS: Parents in HF reported more positive changes, proportionally, in their relationships with their children, when compared with parents in the TAU group. Among Indigenous parents, proportionally more in HF (eight of 13 parents) reported positive changes in their relationships with their children, compared with those in TAU (one of eight parents). For non-Indigenous parents, however, those in HF (five of 14 parents) reported proportionally similar positive changes in relationships with their children to those in TAU (two of eight parents). Narratives of Indigenous parents in HF showed that they made considerable progress over 18 months in reconciling with their children.nnCONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Findings underscore the potential of HF to promote positive parent-child relationships. For Indigenous parents, HF programs that are designed, implemented, and staffed by Indigenous service-providers; guided by Indigenous worldviews; and employ culturally relevant and culturally safe practices are exemplars for understanding how HF programs can be adapted to positively impact parent-child relationships. (PsycInfo Database Record (c) 2023 APA, all rights reserved).},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36210449,

title = {The impacts of implementing recovery innovations: a conceptual framework grounded in qualitative research},

author = {Myra Piat and Megan Wainwright and Marie-Pier Rivest and Eleni Sofouli and Tristan von Kirchenheim and Hélène Albert and Regina Casey and Lise Labonté and Joseph J O'Rourke and Sébastien LeBlanc},

doi = {10.1186/s13033-022-00559-2},

issn = {1752-4458},

year  = {2022},

date = {2022-10-01},

journal = {Int J Ment Health Syst},

volume = {16},

number = {1},

pages = {49},

abstract = {BACKGROUND: Implementing mental health recovery into services is a policy priority in Canada and globally. To that end, a 5 year study was undertaken with seven organisations providing mental health and housing services to people living with a mental health challenge to implement guidelines for the transformation of services and systems towards a recovery-orientation. Multi-stakeholder implementation teams were established and a facilitated process guided teams to choosing and planning for the implementation of one recovery innovation. The recovery innovations chosen were hiring peer support workers, Wellness Recovery Action Planning (WRAP), a family support group, and staff recovery training.nnMETHODS: This study reports on data collected at the post-implementation stage. 90 service users, service providers, family members, managers, other actors and knowledge users participated in 41 group, individual or dyad semi-structured interviews. The interview guides included open-ended questions eliciting participants' impressions regarding the impact of implementing the innovation on service users, service providers and organisations. We applied a collaborative qualitative content analysis approach in NVivo12 to coding and interpreting the data generated from these questions.nnRESULTS: Eighteen impacts of implementing recovery innovations from the perspectives of diverse stakeholder groups were identified. Three impacts of working as an implementation team member and as part of a research project were also identified. Impacts were developed into a conceptual framework organised around four overall categories of impact: Ways of being, Ways of interacting, Ways of thinking, and Ways of operating and doing business.nnCONCLUSIONS: The IMpacts of Recovery Innovations (IMRI) framework version 1 can assist researchers, evaluators and decision-makers identify, explore and understand impact in the context of recovery innovations. The framework helps fill a gap in conceptualising service and organisation-level impacts. Future research is needed to validate the framework and map it to existing methods for studying impact.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35219017,

title = {Translating mental health recovery guidelines into recovery-oriented innovations: A strategy combining implementation teams and a facilitated planning process},

author = {Myra Piat and Eleni Sofouli and Megan Wainwright and Hélene Albert and Marie-Pier Rivest and Regina Casey and Sébastien LeBlanc and Lise Labonté and Joseph J O'Rourke and Sarah Kasdorf},

doi = {10.1016/j.evalprogplan.2022.102054},

issn = {1873-7870},

year  = {2022},

date = {2022-04-01},

journal = {Eval Program Plann},

volume = {91},

pages = {102054},

abstract = {Recovery is the focus of mental health strategies internationally. However, little translation of recovery knowledge has occurred in mental health services. The purpose of this research is to bridge the gap between recovery guidelines and practice by developing a new implementation strategy involving the formation of implementation teams made up of different stakeholders (service users, service providers, managers, knowledge users) and facilitating a 12-meeting implementation planning process. Sevenmental health organizations across Canada successfully completed the process of translating the guidelines into a recovery-oriented innovation that was implemented. Fifty-five implementation team members were interviewed upon completion of the 12-meeting process. Findings indicate that implementation team members perceived the structured planning process as positive. Nevertheless, the language of implementation science remains difficult to understand for a non-academic audience. Key elements of the 12-meeting process included the value of consensus building among implementation team members and the subsequent shifting power relationships. While working with diverse stakeholders came with certain challenges, the process in itself was a form of system transformation. This type of engaged planning process was a significant departure from the more top-down approaches to organizational change that staff were used to.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36035969,

title = {Identifying and Exploring Sustainability Determinants of Mental Health Recovery-Oriented Interventions: A Mixed Methods Study Protocol},

author = {Eleni Sofouli and Shannon Wiltsey-Stirman and Danielle Groleau and Michel Perreault and Myra Piat},

doi = {10.1007/s43477-022-00052-5},

issn = {2662-9275},

year  = {2022},

date = {2022-01-01},

journal = {Glob Implement Res Appl},

volume = {2},

number = {3},

pages = {249--261},

abstract = {Mental health recovery is the new paradigm in the mental health service delivery system worldwide. Recovery-oriented services go beyond traditional clinical care that is centered on symptom remission, aiming to help people: restore social connections with other individuals and the community; develop hope and optimism for the future; reconstruct an identity beyond that of a "mental patient"; discover meaning in life; and feel empowered to gain control over treatment (CHIME framework). Over the last ten years, several efforts at implementation of recovery-oriented interventions have been documented in the scientific literature. However, little attention has been given to their sustainability, even though it is reported that not all health interventions can fully sustain their activities beyond the initial implementation phase. The aim of this mixed methods case study is to better understand the factors that determine the sustainability of two recovery-oriented interventions (peer support and recovery training) after their roll-out in four organizations in Canada that provide community housing for adults with mental health challenges. Qualitative and quantitative data will be collected from managers, service providers, and implementation team members that oversaw the implementation process along with organizational documents. Data collection and analysis will be guided by the Consolidated Framework for Sustainability Constructs in Healthcare, the Framework for Reporting Adaptations and Modifications, and the Program Sustainability Assessment Tool. Findings will expand our current evidence base on the intersection of sustainability and mental health recovery interventions that remains under-explored.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34526136,

title = {Identifying and understanding the contextual factors that shaped mid-implementation outcomes during the COVID-19 pandemic in organizations implementing mental health recovery innovations into services},

author = {Myra Piat and Megan Wainwright and Danielle Cherkas and Sébastien Leblanc and Eleni Sofouli and Marie-Pier Rivest and Hélène Albert and Regina Casey and Joseph J O'Rourke and Lise Labonté},

doi = {10.1186/s43058-021-00206-w},

issn = {2662-2211},

year  = {2021},

date = {2021-09-01},

journal = {Implement Sci Commun},

volume = {2},

number = {1},

pages = {101},

abstract = {BACKGROUND: Seven housing and health services organizations were guided through a process of translating Chapter Six of the Canadian Guidelines for Recovery-Oriented Practice into a recovery-oriented innovation and plan for its implementation. At the time of the COVID-19 outbreak and lockdown measures, six of the seven organizations had begun implementing their chosen innovation (peer workers, wellness recovery action planning facilitator training, staff training and a family support group). This mid-implementation study used the Consolidated Framework for Implementation Research (CFIR) to identify contextual factors that influenced organizations to continue or postpone implementation of recovery-oriented innovations in the early months of the COVID-19 pandemic.nnMETHODS: Twenty-seven semi-structured 45-min interviews were conducted between May and June 2020 (21 implementation team members and six providers of the innovation (trainers, facilitators, peer workers). Interview guides and analysis were based on the CFIR. Content analysis combined deductive and inductive approaches. Summaries of coded data were given ratings based on strength and valence of the construct's impact on implementation. Ratings were visualized by mid-implementation outcome and recovery innovation to identify constructs which appear to distinguish between sites with a more or less favorable mid-implementation outcomes.nnRESULTS: Four mid-implementation outcomes were observed at this snapshot in time (from most to least positive): continued implementation with adaptation (one site), postponement with adaptation and estimated relaunch date (four sites), indefinite postponement with no decision on relaunch date (one site), and no implementation of innovation yet (one site). Two constructs had either a negative influence (external policies and incentives-renamed COVID-19-related external policy for this study) or a positive influence (leadership engagement), regardless of implementation outcome. Four factors appeared to distinguish between more or less positive mid-implementation outcome: adaptability, implementation climate and relative priority, available resources, and formally appointed internal implementation leaders (renamed "engaging implementation teams during the COVID-19 pandemic" for this study).nnCONCLUSIONS: The COVID-19 pandemic is an unprecedented outer setting factor. Studies that use the CFIR at the mid-implementation stage are rare, as are studies focusing on the outer setting. Through robust qualitative analysis, we identify the key factors that shaped the course of implementation of recovery innovations over this turbulent time.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33952336,

title = {Factors influencing the implementation of mental health recovery into services: a systematic mixed studies review},

author = {Myra Piat and Megan Wainwright and Eleni Sofouli and Brigitte Vachon and Tania Deslauriers and Cassandra Préfontaine and Francesca Frati},

doi = {10.1186/s13643-021-01646-0},

issn = {2046-4053},

year  = {2021},

date = {2021-05-01},

journal = {Syst Rev},

volume = {10},

number = {1},

pages = {134},

abstract = {BACKGROUND: Countries around the world have committed in policy to transforming their mental health services towards a recovery orientation. How has mental health recovery been implemented into services for adults, and what factors influence the implementation of recovery-oriented services?nnMETHODS: This systematic mixed studies review followed a convergent qualitative synthesis design and used the best-fit framework synthesis method. Librarians ran searches in Ovid- MEDLINE, Ovid-EMBASE, Ovid-PsycInfo, EBSCO-CINAHL Plus with Full Text, ProQuest Dissertations and Theses, Cochrane Library, and Scopus. Two reviewers independently screened studies for inclusion or exclusion using DistillerSR. Qualitative, quantitative, and mixed methods peer-reviewed studies published since 1998 were included if they reported a new effort to transform adult mental health services towards a recovery orientation, and reported findings related to implementation experience, process, or factors. Data was extracted in NVivo12 to the 38 constructs of the Consolidated Framework for Implementation Research (CFIR). The synthesis included a within-case and a cross-case thematic analysis of data coded to each CFIR construct. Cases were types of recovery-oriented innovations.nnRESULTS: Seventy studies met our inclusion criteria. These were grouped into seven types of recovery-oriented innovations (cases) for within-case and cross-case synthesis. Themes illustrating common implementation factors across innovations are presented by CFIR domain: Intervention Characteristics (flexibility, relationship building, lived experience); Inner Setting (traditional biomedical vs. recovery-oriented approach, the importance of organizational and policy commitment to recovery-transformation, staff turnover, lack of resources to support personal recovery goals, information gaps about new roles and procedures, interpersonal relationships), Characteristics of Individuals (variability in knowledge about recovery, characteristics of recovery-oriented service providers); Process (the importance of planning, early and continuous engagement with stakeholders). Very little data from included studies was extracted to the outer setting domain, and therefore, we present only some initial observations and note that further research on outer setting implementation factors is needed.nnCONCLUSION: The CFIR required some adaptation for use as an implementation framework in this review. The common implementation factors presented are an important starting point for stakeholders to consider when implementing recovery-oriented services.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33413699,

title = {The CFIR Card Game: a new approach for working with implementation teams to identify challenges and strategies},

author = {Myra Piat and Megan Wainwright and Eleni Sofouli and Hélène Albert and Regina Casey and Marie-Pier Rivest and Catherine Briand and Sarah Kasdorf and Lise Labonté and Sébastien LeBlanc and Joseph J O'Rourke},

doi = {10.1186/s43058-020-00099-1},

issn = {2662-2211},

year  = {2021},

date = {2021-01-01},

journal = {Implement Sci Commun},

volume = {2},

number = {1},

pages = {1},

abstract = {BACKGROUND: The Consolidated Framework for Implementation Research (CFIR) and the ERIC compilation of implementation strategies are key resources for identifying implementation barriers and strategies. However, their respective density and complexity make their application to implementation planning outside of academia challenging. We developed the CFIR Card Game as a way of working with multi-stakeholder implementation teams that were implementing mental health recovery into their services, to identify barriers and strategies to overcome them. The aim of this descriptive evaluation is to describe how the game was prepared, played, used and received by teams and researchers and their perception of the clarity of the CFIR constructs.nnMETHODS: We used the new CFIR-ERIC Matching Tool v.1 to design the game. We produced a deck of cards with each of the CFIR-ERIC Matching Tool barrier narratives representing all 39 CFIR constructs. Teams played the game at the pre-implementation stage at a time when they were actively engaged in a planning process for implementing their selected recovery-oriented innovation. The teams placed each card in either the YES or NO column of the board in response to whether they anticipated experiencing this barrier in their setting. Teams were also asked about the clarity of the barrier narratives and were provided with plain language versions if unclear. Researchers completed a reflection form following the game, and participants completed an open-added questionnaire that included questions specific to the CFIR Card Game. We applied a descriptive coding approach to analysis.nnRESULTS: Four descriptive themes emerged from this analysis: (1) the CFIR Card Game as a useful and engaging process, (2) difficulties understanding CFIR construct barrier narratives, (3) strengths of the game's design and structure and room for improvement and (4) mediating factors: facilitator preparation and multi-stakeholder dynamics. Quantitative findings regarding the clarity of the barrier narratives were integrated with qualitative data under theme 2. Only seven of the 39 original barrier narratives were judged to be clear by all teams.nnCONCLUSIONS: The CFIR Card Game can be used to enhance implementation planning. Plain language versions of CFIR construct barrier narratives are needed. Our plain language versions require further testing and refining.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33032366,

title = {Indigenous and non-Indigenous parents separated from their children and experiencing homelessness and mental illness in Canada},

author = {Rachel Caplan and Geoffrey Nelson and Jino Distasio and Corinne Isaak and Betty Edel and Myra Piat and Eric Macnaughton and Maritt Kirst and Michelle Patterson and Tim Aubry and Susan Mulligan and Paula Goering},

doi = {10.1002/jcop.22455},

issn = {1520-6629},

year  = {2020},

date = {2020-11-01},

journal = {J Community Psychol},

volume = {48},

number = {8},

pages = {2753--2772},

abstract = {The purpose of this study is to examine the parent-child experiences of Indigenous and non-Indigenous mothers and fathers experiencing homelessness, mental illness, and separation from their children. A qualitative thematic analysis of baseline and 18-month follow-up narrative interviews was used to compare 12 mothers (n = 8 Indigenous and n = 4 nonindigenous) with 24 fathers (n = 13 Indigenous and n = 11 non-Indigenous). First, it was found that children are more central in the lives of mothers than fathers. Second, Indigenous parents' narratives were characterized by interpersonal and systemic violence, racism and trauma, and cultural disconnection, but also more cultural healing resources. Third, an intersectional analysis showed that children were peripheral in the lives of non-Indigenous fathers, and most central to the identities of Indigenous mothers. Gender identity, Indigenous, and intersectional theories are used to interpret the findings. Implications for future theory, research, and culturally relevant intervention are discussed.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid30945581,

title = {Choice and personal recovery for people with serious mental illness living in supported housing},

author = {Myra Piat and Kimberly Seida and Deborah Padgett},

doi = {10.1080/09638237.2019.1581338},

issn = {1360-0567},

year  = {2020},

date = {2020-06-01},

journal = {J Ment Health},

volume = {29},

number = {3},

pages = {306--313},

abstract = { The relationship between personal choice and mental health recovery in the context of supported housing has not been explored. To gain an understanding of how choice facilitates recovery processes in supported housing environments for those with serious mental illness (SMI). Qualitative in-depth interviews were conducted with 24 tenants with SMI living in supported housing. Choice while living in supported housing was a large contributor to wellbeing and mental health recovery. Tenants valued three domains of choice: (1) choosing to be responsible for one's life, (2) choosing how to organize one's social life and (3) choices that make them feel "at home". This is one of the first studies on choice and recovery for persons who have transitioned to supported housing. Findings reveal the need for research to move beyond focusing on choice of housing (e.g. housing type) and explore the scope and relevance of choice in housing.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid31794027,

title = {Building capacity in mental health care in low- and middle-income countries by training primary care physicians using the mhGAP: a randomized controlled trial},

author = {Jessica Spagnolo and François Champagne and Nicole Leduc and Michèle Rivard and Wahid Melki and Myra Piat and Marc Laporta and Imen Guesmi and Nesrine Bram and Fatma Charfi},

doi = {10.1093/heapol/czz138},

issn = {1460-2237},

year  = {2020},

date = {2020-03-01},

journal = {Health Policy Plan},

volume = {35},

number = {2},

pages = {186--198},

abstract = {To address the rise in mental health conditions in Tunisia, a training based on the Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) was offered to primary care physicians (PCPs) working in the Greater Tunis area. Non-specialists (such as PCPs)' training is an internationally supported way to target untreated mental health symptoms. We aimed to evaluate the programme's impact on PCPs' mental health knowledge, attitudes, self-efficacy and self-reported practice, immediately following and 18 months after training. We conducted an exploratory trial with a combination of designs: a pretest-posttest control group design and a one-group pretest-posttest design were used to assess the training's short-term impact; and a repeated measures design was used to assess the training's long-term impact. The former relied on a delayed-intervention strategy: participants assigned to the control group (Group 2) received the training after the intervention group (Group 1). The intervention consisted of a weekly mhGAP-based training session (totalling 6 weeks), comprising lectures, discussions, role plays and a support session offered by trainers. Data were collected at baseline, following Group 1's training, following Group 2's training and 18 months after training. Descriptive, bivariate and ANOVA analyses were conducted. Overall, 112 PCPs were randomized to either Group 1 (n = 52) or Group 2 (n = 60). The training had a statistically significant short-term impact on mental health knowledge, attitudes and self-efficacy scores but not on self-reported practice. When comparing pre-training results and results 18 months after training, these changes were maintained. PCPs reported a decrease in referral rates to specialized services 18 months after training in comparison to pre-training. The mhGAP-based training might be useful to increase mental health knowledge and self-efficacy, and decrease reported referral rates and negative mental health attitudes among PCPs in Tunisia and other low- and middle-income countries. Future studies should examine relationships among these outcome variables.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid30978474,

title = {Knowledge translation and implementation of housing first in Canada: A qualitative assessment of capacity building needs for an evidence-based program},

author = {Julian Hasford and Geoffrey Nelson and S Kathleen Worton and Eric Macnaughton and Tim MacLeod and Myra Piat and Sam Tsemberis and Vicky Stergiopoulos and Jino Distasio and Tim Aubry and Paula Goering},

doi = {10.1016/j.evalprogplan.2019.03.001},

issn = {1873-7870},

year  = {2019},

date = {2019-08-01},

journal = {Eval Program Plann},

volume = {75},

pages = {1--9},

abstract = {We examined communities' expressed needs for capacity building in the implementation of Housing First (HF) for persons experiencing homelessness. The findings are based on thematic analyses of qualitative data obtained from participants (n = 77) in 11 focus groups conducted in seven Canadian cities. We identified capacity building needs in the areas of training (e.g., HF principles, clinical services, landlord engagement) and technical assistance (e.g., intake coordination, client prioritization, fidelity assessment). These findings were used to tailor training and technical assessment (TTA) to the stages of HF implementation in these cities. Limitations and implications for future theory, research, and practice are discussed.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid30572941,

title = {"We find what we look for, and we look for what we know": factors interacting with a mental health training program to influence its expected outcomes in Tunisia},

author = {Jessica Spagnolo and François Champagne and Nicole Leduc and Wahid Melki and Myra Piat and Marc Laporta and Nesrine Bram and Imen Guesmi and Fatma Charfi},

doi = {10.1186/s12889-018-6261-4},

issn = {1471-2458},

year  = {2018},

date = {2018-12-01},

journal = {BMC Public Health},

volume = {18},

number = {1},

pages = {1398},

abstract = {BACKGROUND: Primary care physicians (PCPs) working in mental health care in Tunisia often lack knowledge and skills needed to adequately address mental health-related issues. To address these lacunas, a training based on the Mental Health Gap Action Programme (mhGAP) Intervention Guide (IG) was offered to PCPs working in the Greater Tunis area between February and April 2016. While the mhGAP-IG has been used extensively in low- and middle-income countries (LMICs) to help build non-specialists' mental health capacity, little research has focused on how contextual factors interact with the implemented training program to influence its expected outcomes. This paper's objective is to fill that lack.nnMETHODS: We conducted a case study with a purposeful sample of 18 trained PCPs. Data was collected by semi-structured interviews between March and April 2016. Qualitative data was analyzed using thematic analysis.nnRESULTS: Participants identified more barriers than facilitators when describing contextual factors influencing the mhGAP-based training's expected outcomes. Barriers were regrouped into five categories: structural factors (e.g., policies, social context, local workforce development, and physical aspects of the environment), organizational factors (e.g., logistical issues for the provision of care and collaboration within and across healthcare organizations), provider factors (e.g., previous mental health experience and personal characteristics), patient factors (e.g., beliefs about the health system and healthcare professionals, and motivation to seek care), and innovation factors (e.g., training characteristics). These contextual factors interacted with the implemented training to influence knowledge about pharmacological treatments and symptoms of mental illness, confidence in providing treatment, negative beliefs about certain mental health conditions, and the understanding of the role of PCPs in mental health care delivery. In addition, post-training, participants still felt uncomfortable with certain aspects of treatment and the management of some mental health conditions.nnCONCLUSIONS: Findings highlight the complexity of implementing a mhGAP-based training given its interaction with contextual factors to influence the attainment of expected outcomes. Results may be used to tailor structural, organizational, provider, patient, and innovation factors prior to future implementations of the mhGAP-based training in Tunisia. Findings may also be used by decision-makers interested in implementing the mhGAP-IG training in other LMICs.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid30411663,

title = {Supported housing for persons with serious mental illness and personal recovery: What do families think?},

author = {Myra Piat and Kimberly Seida},

doi = {10.1177/0020764018806928},

issn = {1741-2854},

year  = {2018},

date = {2018-12-01},

journal = {Int J Soc Psychiatry},

volume = {64},

number = {8},

pages = {707--714},

abstract = {BACKGROUND AND AIMS: Previous research on supported housing for people with serious mental illness focuses primarily on tenant/client experiences. The aim of this article is to present families' perspectives on the role of supported housing in recovery, utilizing the CHIME framework of personal recovery.nnMETHOD: Qualitative interviews were conducted with 14 families of individuals with serious mental illness living in supported housing. Participants were across five supported housing sites in four Canadian provinces.nnRESULTS: Families credited supported housing with helping tenants redefine a positive sense of identity, re-establish social relationships and regain control over their lives. Families were less confident about supported housing facilitating future employment or 'full' recovery, focusing on stability rather than continual improvement.nnCONCLUSION: This is one of the first studies to report family perspectives on the role of supported housing in their loved one's recovery processes - both strengths and weaknesses.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid29980964,

title = {Correction to: A Tertiary-Care/Primary-Care Partnership Aimed at Improving Care for People with Eating Disorders},

author = {Lea Thaler and Shiri Freiwald and Chloe Paquin Hodge and Émilie Fletcher and Danaelle Cottier and Esther Kahan and Erika Rossi and Myra Piat and Shalini Lal and Mimi Israel and Howard Steiger},

doi = {10.1007/s10597-018-0300-6},

issn = {1573-2789},

year  = {2018},

date = {2018-11-01},

journal = {Community Ment Health J},

volume = {54},

number = {8},

pages = {1162},

abstract = {The original version of this article unfortunately contained a mistake in EAT-26 values under "Patients Receiving Treatment for an ED in their Sector" section.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid29948625,

title = {A Tertiary-Care/Primary-Care Partnership Aimed at Improving Care for People with Eating Disorders},

author = {Lea Thaler and Shiri Freiwald and Chloe Paquin Hodge and Émilie Fletcher and Danaelle Cottier and Esther Kahan and Erika Rossi and Myra Piat and Shalini Lal and Mimi Israel and Howard Steiger},

doi = {10.1007/s10597-018-0290-4},

issn = {1573-2789},

year  = {2018},

date = {2018-11-01},

journal = {Community Ment Health J},

volume = {54},

number = {8},

pages = {1154--1161},

abstract = {We describe the implementation and impact of a province-wide program of knowledge exchange (KE), aimed at developing capacity for the treatment of people with eating disorders (EDs). The program is designed to equip clinicians working in nonspecialized health-care installations with skills to evaluate and treat people with EDs. Trainings were conducted at 21 institutions. The majority of clinicians reported satisfaction with the KE program and indicated that the trainings enhanced their confidence and ability to treat patients with EDs. A subset of clinicians received case supervision with a specialist ED therapist and followed patients with EDs (n = 119). Treated patients showed significant improvements on eating and depressive symptoms, and reported satisfaction with the treatments they received.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}