ASPIRE findings on MBCT in the NHS published
How accessible is MBCT in the NHS, what are the facilitators and barriers to its implementation, and how we can support the NHS in making MBCT accessible?
A new report on the ASPIRE study, led by Joanne Rycroft-Malone, Professor of Implementation & Health Services Research at Bangor University and OMC Director Willem Kuyken has just been published.
The ASPIRE project was a two-phase qualitative, exploratory and explanatory study conducted to describe the existing provision of Mindfulness-Based Cognitive Training (MBCT) in the UK NHS, develop an understanding of the perceived costs and benefits of MBCT implementation, and explore the barriers and critical success factors for enhanced accessibility.
The evidence was synthesised from multiple data sources to create an explanatory framework of the how and why of implementation, and to co-develop an implementation resource with key stakeholders.
The study concluded that although access to MBCT across the UK is improving, it remains very patchy.
It found that having champions for MBCT with skill, drive and determination was essential to making it more widely available, but their success depended on whether or not they were able to secure support and commitment from leaders, managers and commissioners.
All the sites involved in the study faced pressures that made it difficult to implement new services such as MBCT. These pressures include meeting service targets, financial pressures and changes in the organisation. MBCT is more likely to be available in sites that can successfully navigate around these issues by aligning MBCT to address those pressures and targets.
Making MBCT available is a journey that can take a number of years and can have many peaks and troughs, and the ability to cope with those is dependent on the skills and actions of the individuals involved and on the resources they have around them (financial, practical and relevantly trained and incentivised staff) and how they are mobilised.
This study provides an explanatory framework that helps us understand what facilitates and supports sustainable MBCT implementation. The findings are being used to develop an online, freely available, implementation plan. This will provide guidance and support to individuals or teams wishing to make MBCT available in their services or further sustain provision that already exists.
The project was covered in a recent blog from the NIHR dissemination centre: Preventing Depression with Mindfulness-Based Cognitive Therapy: From Evidence to Practice.
Read the full report, Accessibility and implementation in the UK NHS services of an effective depression relapse prevention programme: learning from mindfulness-based cognitive therapy through a mixed-methods study, published in Health Services and Delivery Research Volume: 5, Issue:14, April 2017. The report was co-authored with Rob Anderson, Rebecca Crane, Andy Gibson, felix Gradinger, Heledd Owen Griffiths and Stewart Mercer.
“Even if a psychosocial intervention has compelling aims, has been shown to work, has a clear theory-driven mechanism of action, is cost-effective and is recommended by a government advisory body, its value is determined by how widely available it is in the health service.”
Willem Kuyken and Rebecca Crane (Centre for Mindfulness Research and Practice at Bangor University)