Research-based, clinically informed, client- and family-centred ‘best practice’

Abstract

The mental health workforce, plus those who research in the field, have a moral imperative to promote and deliver interventions and programs that have been evaluated for efficacy and continued safe use. Accessibility, equity, effectiveness, acceptability and value for money are other critical considerations in service design and delivery. Identifying which programs and interventions fulfil those requirements necessitates an evaluation andmonitoring of practices, involving both process and outcome evaluation methodologies, and the measurement of client satisfaction. For researchers this means that they need to ensure that their research is grounded in the routine experiences of end users, and the experiences of practitioners and program deliverers, with clear impacts highlighted for how services and programs might need to be replaced, changed or adapted. However, while research may be available, that in of itself does not always transfer to best practice. There is often a disconnect between research and practice, sometimes caused by research that is not replicable in the real world nor reflective of the complexity of issues seen in practice. There may be dissemination issues including a lack of training opportunities. Another obstacle to the transfer of research to practice may be the unwillingness of governments and organisations to change infrastructure and systems, perhaps due to funding constraints. Instead or as well, individual practitioners may be unwilling to make changes to their practice due to time constraints or a general unwillingness to change; ultimately if we ask practitioners to change their behaviour it is implying that what they were doing previously was somehow inadequate and no one wants to hear that. The need to promote the uptake of research to practice is a key tenet of this journal and the processes to do so, often referred to as implementation science, have been showcased in this journal over many years (e.g. Howe et al., 2011; Reupert, 2021). Historically, conceptualisations of the term ‘evidence-based practice’ involved a hierarchy of evidence ratings and where it is argued that the more rigorous the methodology, the stronger the evidence. There is, however, increasing acknowledgement in the medical, public health and mental health fields that how we define ‘best practice’ is broader than relying on the results of large scale randomised controlled trials, and is instead a collaborative decision-making process that considers three key components namely