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

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 and monitoring 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

1. high quality, up to date research evidence and

2. clinical or other forms of practice that comes from sustained experience with many different clients/groups and interventions or programs over time and

3. the values, needs, preferences and perspectives of clients/service users and their families.

Many others have written about these three components, see for example, Miranda and Miah (2019) noting however that family preference and needs are not typically referred to but need to be (Reupert et al., 2022). Along with a responsibility to ensure that our programs and interventions are based on these three components, it is important that we share our results in peer reviewed, appropriate journals, such this one. The many papers in this current issue speak to the different types of evidence outlined here.

From the outset, Bell et al. (2021) advance our knowledge in understanding the role of those with lived experience when developing an online mental health training program for university students. The need to provide a safe space, share power and consider group dynamics in the co-design process were highlighted. Two papers examine mental health and wellbeing during the pandemic (Knowles et al., 2022; Modrzejewska et al., 2022). Both studies present data that helps understand the variables associated with mental health and wellbeing during the pandemic, that can be used to inform interventions and programs and target particular population groups. In Canada, Sarmiento and Reid (2022) surveyed 18 agencies to explore how walk-in clinics for children and families were implemented, and found that such clinics were used to provide accessible services and as a point of intake, using different approaches, across different locations. The study showcases how clinicians were able to address wait lists and meet families’ needs. Von Doussa et al. (2022) evaluated a peer support program for young people whose parents have a mental illness, building on earlier evaluations of the program (Goodyear et al., 2009). Interviews with children, parents/carers and program facilities, found several benefits including a reduction in isolation and family conversations about the parents’ illness. The last paper in this issue comes from McDaid et al. (2022) who identify recent government mental health plans, in various high income, low population countries, finding evidence for the uptake of ‘whole of population’ prevention approaches. This final paper does not so much identify best practice but instead documents what governments are doing about best practice, an important consideration for understanding how governments plan (and do not) plan public health policy.

I thank all the authors for their contributions and the reviewers for their support of the journal.