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Table 1 Intermediary structures in New Zealand, Ontario and Scotland

From: Understanding the supports needed for policy implementation: a comparative analysis of the placement of intermediaries across three mental health systems

Intermediary name Placement in system Year est. Number of staff Approx. annual budget Funding source Location(s) Structure Description Implementation methods
New Zealand
Te Pou o Te Whakaaru Nui (Te Pou) Non-governmental organisation (NGO) 2006 46 $20 million NZD Ministry of Health (primary source) • Auckland • Hamilton • Wellington • Christchurch Travel as needed across the country • Part of Wise Group of community organisations Governance: • Board of directors (7 members) • Clinical sector reference group (26 members) provides advice to ensure clinical and sector partnership feedback is incorporated • 1 of 5 national workforce development centres for mental health • National centre of evidence-based workforce development for the mental health, addiction and disability sectors • Works with range of organisations and people, including service providers (District Health Boards and NGOs), training and education providers, researchers and international experts, to educate the workforce and support improvements to services • Knowledge exchange (e.g. SPARK Evidence into Practice) • Decision support/data systems (collecting and reporting on outcomes and workforce information) • Capacity building of system to access, interpret and implement evidence • Technical assistance (e.g. seclusion and restraint reduction) • Strong focus on collaboration
Ontario, Canada
Ontario Centre of Excellence for Child and Youth Mental Health (OCoE CYMH) Children’s Hospital of Eastern Ontario (CHEO) Service delivery system - hospital 2004 50 $5.9 million CAD Ministry of Child & Youth Services • Ottawa Travel as needed across province Governance: • CHEO hospital board • Strategic advisory council (12 members) provides advice, direction and input on strategic plans, partnership initiatives and high-level operations • Focus on increasing capacity in the child and youth mental health service delivery system to use evidence-based practices, evaluate their work, and to improve their ability to collaborate across systems with the goal of improving services • Implementation science approach (e.g. National Implementation Research Network’s (NIRN) Active Implementation Frameworks) • Knowledge mobilisation • Quality improvement • Performance measurement • Evaluation
Provincial System Support Program Centre for Addiction and Mental Health (CAMH) Service delivery system - hospital 2011 150 $19 million CAD Ministry of Health and Long-Term Care and global hospital budget Provincial office: • Toronto Regional offices: • Kenora • Thunder Bay • Sudbury • Barrie • London • Hamilton • Ottawa • Kingston • Toronto Governance: • CAMH hospital board • Works collaboratively across sectors to move evidence to action to transform mental health and addictions systems in Ontario • Implementation science (e.g. NIRN’s Active Implementation Frameworks) • Knowledge exchange • Information management • Evaluation • Engagement and health equity
School Mental Health Assist (SMH Assist) Hamilton-Wentworth District School Board Service delivery system – school board 2011 13 provincial staff, 72 mental health leaders in schools $2.2 million CAD (figure does not include funding for mental health leaders) Ministry of Education Provincial office: • Hamilton Regional offices: • In all 72 school boards Governance: • Hamilton Wentworth District School Board (Director of Education) • Created to address critical gaps in the organisational capacity and conditions of schools and school boards to provide evidence-informed programming addressing mental health (Short 2016) • Implementation science approach, drawing from NIRN’s Active Implementation Frameworks
Scotland
Quality and Efficiency Support Team and Mental Health Division of Scottish Government Government 2009 (restructured in 2012) 12 N/A Scottish Government • Edinburgh Travel as needed across country Governance: • Mental Health Delivery Team (12 people drawn from multiple agencies) • Scottish government • Focuses on elements of a quality improvement and outcomes framework • Ensures the delivery of commitments relating to measurement of progress and improvement support • Quality improvement - adapted version of Institute for Healthcare Improvement’s Model for Improvement [34] • Monitoring of progress toward Health improvement, Efficiency, Access to treatment, Treatment targets