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The field of mental health promotion and early intervention relies heavily on evidence-based practices (Reupert, Citation2023). Evidence types may include various forms of data (qualitative and quantitative) sourced by using a range of different methodologies including but not limited to surveys, interviews and clinical trials. These data can help understand the prevalence and mental health needs of different population groups, risk and protective factors and whether and how interventions work. Nonetheless, there are different types of evidence needed in the field, as per , each with their own distinct foci. Each of these elements is further discussed below.
Figure 1. The four elements of research evidence.
Acceptability in mental health promotion and early intervention refers to the degree by which an intervention, program, or approach is perceived as suitable, satisfactory, and appropriate by stakeholders, including end recipients, their family members and carers, practitioners, communities, and policymakers (Reupert et al., Citation2015). Acceptability is important for the successful implementation and uptake of mental health promotion and early intervention efforts. It ensures that interventions are responsive to the needs and preferences of individuals and communities, thereby promoting engagement, effectiveness, and sustainability.
The next element of evidence used in the mental health field relates to feasibility. Feasibility refers to the practicality and viability of implementing an intervention or program within a specific organisational, community and/or cultural context. It involves assessing whether an intervention or program can be successfully delivered considering factors such as resources, time, expertise, and organisational capacity. Acknowledging feasibility entails having an accurate and timely view of the receptiveness, willingness and capacity of the workforce to implement a chosen intervention or program (Berger et al., Citation2014; Reupert, Citation2020) as well as understanding how feasible and practical it is for end users and their families to access and engage in the intervention or program (Reupert, Bee et al., Citation2022). A program may produce great results but if it is not easy for practitioners to deliver or for end users to access, the chances of it reaching the right population groups are low.
The third evidence element relates to theory, and specially a theory for how a particular intervention or program works. A theory of change typically clarifies the goals and objectives of an intervention, and the pathways through which outcomes are expected to be achieved (Reupert & Maybery, Citation2009). Further extending this point, a theory of change ideally should articulate the causal relationships between inputs, activities, outputs, outcomes, and impacts (Reupert, Maybery, et al., Citation2022). It helps stakeholders understand how different components of an intervention or program can contribute to desired outcomes and how changes at one level may influence outcomes at another level (Hine et al., Citation2022). This understanding enhances the effectiveness and efficiency of interventions by allowing practitioners to focus their efforts on key leverage points. It can also help stakeholders identify the resources needed to implement interventions or programs effectively and allocate resources strategically to maximise impact.
Finally, any given intervention or program needs to show evidence of change for those involved. Such evidence shows what works, what doesn’t work and why and how a particular intervention or program may need to change, or what new program might be introduced (Skivington et al., Citation2021). Evidence of change informs decision-making about the design, implementation, and scaling of mental health promotion interventions which in turn helps organisations, policy makers as well as individuals consider which programs or intervention they want to be a part of, or promote.
Considering evidence holistically, across the four elements of acceptability, feasibility, theory of change and evidence of change, provides a solid basis from which to make culturally informed and evidence-based decision making. To that end, the current issue of Advances in Mental Health showcases the different types of methodologies used to generate different evidence types, which in turn can be used to inform the decision making of end users, their families, and other relevant stakeholders.
Two papers in this issue employed a scoping review approach (Dietzel et al., Citation2024; Valdiviezo-Oña et al., Citation2024) a relatively new approach to evidence synthesis that is increasingly gaining traction in the mental health field to condense and understand a wide body of literature. Two other studies employed semi-structured interviews (Allam & Binnie, Citation2023; Saad et al., Citation2024). Ueno and Osada (Citation2024) conducted a nationwide survey of Japanese healthcare professionals while Guthrie and Leslie (Citation2024) employed a ten-question online survey. The methodologies showcased in this issue provide multiple and diverse pathways for evidence development, and accordingly, can be used to make informed decisions and policies.
References
- Allam, L., & Binnie, J. (2023). Lived experience of mental distress and sense-making in black ethnic groups according to cultural heritage. Advances in Mental Health, 22(2), 166–178. doi:10.1080/18387357.2023.2249556
- Berger, E., Hasking, P., & Reupert, A. (2014). “We're working in the dark here”: Education needs of teachers and school staff regarding student self-injury. School Mental Health, 6(3), 201–212. doi:10.1007/s12310-013-9114-4
- Dietzel, C., Bello, B., O’Shea, B., Cullum, J., & Numer, M. (2024). Mental health of LGBTQ+ people during the COVID-19 pandemic: A scoping review. Advances in Mental Health, 22(2), 122–152. doi:10.1080/18387357.2023.2248299
- Guthrie, S., & Leslie, P. (2024). ‘We didn’t realise how much we needed you’. Speech and language therapy provision in adult mental health settings. Advances in Mental Health, 22(2), 212–228. doi:10.1080/18387357.2023.2250885
- Hine, R., Patrick, P., Berger, E., Diamond, Z., Hammer, M., Morris, Z., Fathers, C., & Reupert, A. (2022). From struggling to flourishing and thriving: Optimizing educator wellbeing within the Australian education context. Teaching and Teacher Education, 115. https://doi.org/10.1016/j.tate.2022.103727
- Reupert, A. (2020). Mental health and academic learning in schools: Approaches for facilitating the wellbeing of children and young people. Routledge.
- Reupert, A. (2023). Research-based, clinically informed, client- and family-centred ‘best practice’. Advances in Mental Health, 21(1), 1–3. https://doi.org/10.1080/18387357.2023.2180847
- Reupert, A., Bee, P., Hosman, C., van Doesum, K., Drost, L. M., Falkov, A., Foster, K., Gatsou, L., Gladstone, B., Goodyear, M., Grant, A., Grove, C., Isobel, S., Kowalenko, N., Lauritzen, C., Maybery, D., Mordoch, E., Nicholson, J., Reedtz, C., … Ruud, T. (2022a). Prato Research collaborative for change in parent and child mental health: Principles and recommendations for working with children and parents living with parental mental illness. Journal of Child Psychology and Psychiatry, 63(3), 350–353. doi:10.1111/jcpp.13521
- Reupert, A., & Maybery, D. (2009). A “snapshot” of Australian programs to support children and adolescents whose parents have a mental illness. Psychiatric Rehabilitation Journal, 33(2), 125–132. doi:10.2975/33.2.2009.125.132
- Reupert, A., Maybery, D., Bartholomew, C., Cuff, R., Matar, J., Pettenuzzo, L., & Foster, K. (2022b). An online intervention for vulnerable young adults: Identifying mechanisms of change using a grounded theory approach. Social Psychiatry and Psychiatric Epidemiology, 57(2), 293–303. doi:10.1007/s00127-021-02082-0
- Reupert, A., Maybery, D., Nicholson, J., Gopfert, M., & Seeman, M. (2015). Parental psychiatric disorder: Distressed parents and their families. Cambridge University Press.
- Saad, G., Honey, A., Schaecken, P., & Scanlan, J. N. (2024). Strategies and supports used by mental health peer workers to facilitate role performance and satisfaction. Advances in Mental Health, 22(2), 179–195. doi:10.1080/18387357.2023.2237135
- Skivington, K., Matthews, L., Simpson, S. A., Craig, P., Baird, J., Blazeby, J. M., Boyd, K. A., Craig, N., French, D. P., McIntosh, E., Petticrew, M., Rycroft-Malone, J., White, M., & Moore, L. (2021). A new framework for developing and evaluating complex interventions: Update of Medical Research Council guidance. BMJ, 374, n2061. doi:10.1136/bmj.n2061
- Ueno, R., & Osada, H. (2024). Routine identification of children of adults with mental illness: A nationwide survey of healthcare practitioners’ perspectives and practices in Japan. Advances in Mental Health, 22(2), 196–211. doi:10.1080/18387357.2023.2248300
- Valdiviezo-Oña, J., Toscano-Molina, L., Chávez, J. F., Herrera, J. E., & Paz, C. (2024). Outcomes of usage of psychedelics by people reporting an eating disorder in clinical and non-clinical settings: A scoping review. Advances in Mental Health, 22(2), 153–165. doi:10.1080/18387357.2023.2235030