Table 3 Descriptions of enabling influencers of continued organisational capacity and practitioner use
Category | Enabling influencer | Description |
|---|---|---|
External social, political, financial context | External social, political, financial context | A new political and policy direction (new MH Act, Recovery frameworks, increased MH funding), new national workforce initiative (COPMI (Children of Parents with a Mental Illness) online resource development) and a new research agenda (Government funded RCT on recovery and parenting) were external context enablers for the organisation and the intervention |
Prior organisational capacity: organisation history prior to implementation | Existing organisational structures | Existing organisational structures to support family, children and carer focused work enabled the new intervention to fit. These structures included family, children and carer specific capacity-building roles within the organisation for over 10 years, as well as policy and mandatory training systems to uphold policy |
Existing relationships and partnerships (organisational bridging social capital) | Influential relationships and partnerships enabled prior and continued organisational capacity through bridging the organisation to opportunity and innovation in the field of family, children and carers (training, research, resource development, expanded relationships with universities, government, international experts) | |
Organisational ownership | Organisational ownership of implementation was enabled through the development of own implementation vision and plans and being a steering partner in the research | |
Prior organisational identity | Organisational reputation and brand prior to implementation was already family, children and carer focused with a history of carer support that included children’s voices, of parent-focused work and programs for children. The organisation’s identity also included using research for learning | |
Resources | Resources | Funding, staffing or other resources enabled sustained practice and organisational capacity. Growth funding increased practitioner to client ratio and enabled recovery resources. Research brought funding, attention to issue and resources for data and analysis. National workforce initiative enabled accessibility through high quality, standardised online training and free resources for parents |
Sustainability factors: practitioner: factors about the practitioners that enable sustainability | Parents on caseload | Practitioner’s opportunity to use Let’s Talk was influenced by having parents on their caseload. While demographics of region/team affect % of parents, practitioner’s previous experience, interests and comfort can result in self-selection of parent clients |
Models of practice used by practitioners | A person, parent and family-focused model of practice that attends to relationships enabled practitioners to incorporate parenting and recovery into their work. | |
Support from peers | Other practitioners doing Let’s Talk provided role models, normalised the work, built acceptability and critical mass amongst peers and enabled practitioners to see it is possible to do within pressures of everyday work | |
Practitioner characteristics | Practitioners professional interests, prior experience & training in family, children and carer work and life/personal experience influenced use | |
Practitioner identity | Practitioners are enabled to use Let’s Talk when they are connected and have satisfaction in their role, identify as a good practitioner and have individual accountability for their practice | |
Sustainability factors: organisational: sustainability influencers related to the organisation | Accountability structures | Having organisational structures to drive accountability supported the sustainability of organisational capacity and practitioner use. Such organisational structures included a driving committee embedded into the organisational hierarchy, capacity development personnel and system embedded into the service, a policy communicating priority and core business, systems monitoring policy use, data being used as a driver of practice and compliance with policy |
Leadership accountability | An expectation of leaders to lead was supported through involvement in training, reporting and support systems and reflected in adherence to strategic directions, policy and programs | |
Leadership stability | Stability in leadership allowed for organisational memory and continued commitment, while new leadership within stability brought new energy | |
Organisation fitting the intervention to self | Adaptations were made by the organisation to better the fit of Let’s Talk such as integrating documentation, system prompts, policy development and data reports | |
Organisational identity | Let’s Talk was aligned with the organisation’s reputation and brand which included a recovery family-oriented culture that valued lived experience and had connections, strategic partnerships and relationships that enabled learning and innovation. These were upheld by leadership and reflected in strategic directions, policy and programs | |
Other organisational initiatives | There is a synergy between other initiatives active in the organisations that supported use such as peer leadership, introducing a recovery model and a focus on data documentation | |
Team leadership support | All levels of leadership (including informal) supported sustained practice through buffering changes at internal/external level to manage workload, aiding workforce stability, upholding priority set by the organisation, holding practitioners to account and creating a culture that was open to practice and that can see how it could fit into current practice | |
Training and practice support | The organisation had regular and accessible training that was integrated into data systems and other training. The selection of participants was purposeful and delivery methods incorporate peer facilitators. There were post-training reflective spaces and support that linked to other initiatives and gave attention to measure and build competency | |
Sustainability factors: parent client | The parent client’s stage of recovery and willingness to request help with parenting and children influenced uptake |