Public Defence: Lars Hestmark

Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.

Trial Lecture – time and place

See Trial Lecture.

Adjudication committee

• First opponent: Professor Claire Henderson, King’s College London, UK
• Second opponent: Senior researcher Ane-Marthe Solheim Skar, NKVTS - Norwegian Centre for Violence and Traumatic Stress Studies; Acting director Norwegian Institute of Public Health,
• Third member and chair of the evaluation committee: Professor Pål Gulbrandsen, University of Oslo

Chair of the Defence

Professor Eivind Engebretsen, University of Oslo

Principal Supervisor

Professor Reidar Pedersen, University of Oslo

Summary

Scientific evidence suggests that family interventions lead to significantly improved outcomes for persons with psychotic disorders, their relatives, and the public health and welfare services, yet the implementation in mental health care is generally poor and irregular.

The aim of the ‘Implementation of Family Involvement for persons with Psychotic disorders’ (IFIP) study was to implement the national guidelines on family involvement for persons with psychotic disorders in Norwegian community mental health centres (CMHCs). At the intersection between the fields of public health and psychiatry, this thesis provides an overview of the cluster randomised IFIP trial, describes and evaluates the implementation process with quantitative methods, and explores clinicians’ perceptions of family involvement through qualitative methods.

Experimental clusters received an ‘implementation support programme’ (ISP) for 18 months to implement family involvement, which included the appointment of a family coordinator and an implementation team, clinical training and supervision, a toolkit, fidelity measurements with onsite feedback and supervision, a focus on leadership commitment, and systematic stakeholder engagement, recommending agency-wide education and multidisciplinary delivery of family involvement.

At baseline, the CMHCs lacked organisational structures and procedures for family involvement, with few patients and relatives being reached. Statistical analyses showed that the ISP had a significant effect on the level of adherence to the national guidelines in the experimental arm, when compared to no implementation support in the control arm. The qualitative study showed that clinicians mainly reported positive experiences with providing family involvement, while describing occasional challenges. The methods and findings of the IFIP study should be highly relevant to policy makers, health service units, administrators, and clinicians who wish to implement family involvement.

Additional information

Contact the research support staff.