Table 1 Summary of components that facilitated or hindered the implementation process according to interviews and documentation
Facilitating components | |
 Process | Planning: Meetings and dialogues about model fit involved all organizational levels Engaging: Successful recruitment of opinion leaders Executing: Continuous meetings with opinion leaders, distribution of newsletters, supportive feedback |
 Intervention characteristics | Relative advantage: Appropriate support for the target group; people with affective disorders are in need of RTW support Employment specialist competence of labour market and psychiatry Person-centred, continuous and not time-limited support |
 Inner setting | Networks and communication: Employment specialists built constructive relationships and functioning teams with engaged staff members in the mental healthcare units Opinion leaders enhanced collaboration at the mental healthcare units, and this was important for the ongoing intervention |
 Outer setting | Cosmopolitanism: Fruitful collaboration was developed in some PES and SIA services |
Hindering components | |
 Process | Planning: Large geographic area and involvement of many organizations made implementation complex Major reorganizations delayed implementation Engaging: Difficulty engaging opinion leader in one mental healthcare unit Lack of time and work overload for first line managers |
 Intervention characteristics | Relative disadvantage: Staff members in mental healthcare units had divergent opinions about the IES model fit into their organization Informants from the PES modestly questioned the IES model advantage |
 Inner setting | Implementation climate: Difficulty for employment specialist to integrate into existing mental healthcare teams Compatibility: Responsibility, commission, and financing of RTW support was perceived as unclear, related to vague guidelines for vocational services and organizational boundaries |
 Outer setting | Cosmopolitanism: Collaboration with PES and their subcontractors was complex and time-consuming Patient needs and resources: Differing perspectives on how to design RTW support, location of internships and vocational training were proposed by the PES according to regulations |