Making things happen: the need for implementation research

Abstract

Much has been written about the adverse impacts from COVID-19, on our economies, hospitals, workplaces, schools and to our mental and physical health. In the face of these unprecedented problems, there has been a rush to develop a vaccine, as a salve to quell the pandemic and its resulting fallout. What has become very obvious however, is an absence of a systematic plan for rolling out the vaccine to the public. Implementation science is an important consideration in this regard, defined as promoting the ‘systematic uptake of research findings and other evidence-based practices into routine practice’ that serves to ‘improve the quality and effectiveness of health services’ (Eccles & Mittman, 2006, p. 1). Given that implementation science is about prompting the uptake of evidence-based interventions into routine care, implementation plans need to incorporate and address the preference and needs of individual clients, the interests and capacities of clinicians, systemic issues related to leadership, organisations and policy, and the nature of the communities in which the initiative is being delivered (Grant & Reupert, 2016; Grant et al., 2019). Thus, strategies for introducing the vaccine will need to grapple with the varied nature of healthcare and community settings, and encourage uptake to the public, some of whom maybe suspicious or fearful. Embedding new initiatives into routine care is not easy however and implementation issues, sometimes portrayed as the research-practice chasm, have existed for some time. In 2010, Fixsen and colleagues wrote, ‘the use of effective interventions on a scale sufficient to benefit society requires careful attention to implementation strategies...One without the other is like serum without a syringe: the cure is available but the delivery is not’ (2010, p. 448). Never have truer words been spoken in these present times. The brief of this journal is early intervention, the prevention of mental illness and the promotion of mental health and wellbeing. All three foci demand long-term planning that takes into consideration how, when and where different mental health initiatives can be delivered to different population groups. Effective implementation is more than developing an evidencebased intervention or making an intervention available. A community, broad ecological view is required, that incorporates policy and management, often necessitating major changes to infrastructure, staffing and resourcing (Tchernegovski et al., 2018). Such efforts can be challenging given the many and often competing funding demands for essential tertiary services. However, I would argue that constrained funding in the area of prevention, promotion and early intervention is a false economy given the direct costs of treating someone with a mental illness and indirect costs of unemployment, sick leave, income support payments and the incarceration or homelessness sometimes resulting from mental health issues (Reupert, 2020). It is within this context that implementation science needs to be a core component of our mental health promotion, prevention, and early intervention work. The present issue provides much guidance regarding how to integrate research findings and evidence into healthcare policy and practice, or in other words, how tomake ‘things’ happen. In the first instance, the need for long-term planning is highlighted by several papers. Woodhead et al. (2021) highlight the value of exercise physiology within youth mental health settings and the need for resourcing and long-term sustainability. Vivekananda et al., (2021) provide a