Unpacking the Facilitation Component of a Toolkit for Implementing Mental Health Recovery Guidelines into Services

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.