Dissemination and implementation of mental health services: the problem, the response, the new science

Although the pace of discovery of new forms of intervention for serious mental illness accelerated rapidly after World War II, their adoption was often only partially successful. Comparing the history of four such interventions that differed in complexity and scope - deinstitutionalization, psychotropic medication, assertive community treatment, and cognitive behavioral therapy - identifies major challenges that implementation efforts must overcome and some of the factors that influence the success of these efforts. Recognition of the difficulty of implementing new mental health interventions stimulated new approaches at the National Institutes of Health and other national organizations to develop the foundation for more systematic implementation research. The chapter concludes with an overview of the new implementation science and a summary of key findings about the implementation process.