Mental sundhedsfremme på tværs af sektorer: En undersøgelse af implementeringsprocesser og kapacitetsopbygning i partnerskabet ABC for mental sundhed

Research output: ThesisPh.D. thesis

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In the past few decades, national and international studies have shown significant declines in population mental health and well-being in most parts of the Western world. Among experts and researchers, there is a growing recognition that mental health promotion (MHP), in addition to treatment and prevention,
is important to counteract this trend. MHP aims to strengthen positive aspects of mental health by the application of salutogenic approaches on the individual, group, and societal level. Although the research literature on MHP is increasing, there is currently a need for more research and practice-based knowledge on MHP interventions and practices that are implemented across sectors and professions. In particular, there is a need for investigations into the processes of building the capacity of individuals and
systems to perform key tasks within MHP.

The aim of this thesis is to investigate practices and processes of implementing and building capacity for MHP in a cross-sectoral setting. The empirical object of the investigation are the practices and implementation of initiatives, conducted between 2017 and 2020, within the partnership ABCs of Mental Health. The thesis is based on three individual research studies with the following aims: 
1. To outline the overall characteristics of the MHP initiatives that are based on the ABCframework, and to explore local coordinator and stakeholder perceptions of the implementation processes and the impact of these MHP initiatives. 
2. To explore how, for whom, and under which circumstances the processes of action learning can strengthen MHP capacity in a community setting. 
3. To develop a practice-oriented taxonomy of roles within intersectoral MHP practices, and to investigate the interactions across roles within the implementation of MHP practices

Research study 1 is based on data from a formative process evaluation conducted within the ABCs of Mental Health. Data production ran from 2017 to 2020 and was based on online evaluation questionnaires (a total of 128) from partner organizations, five individual interviews, and 12 group interviews. The informants (n=15) were local project coordinators and stakeholders from four purposefully selected partner organizations. Research study 2 and 3 are based on data produced in relation to the pilot implementation of an action learning program. Data included 18 individual interviews, 10 telephone interviews, two group interviews, observations, and documents. The informants (n=21) were participants of the action learning program and stakeholders from the participating organizations.

The results of research study 1 show that the partner organizations generally applied three strategies within their work that was related to the ABCs of Mental Health: capacity building, campaign activities, and promoting/establishing mentally healthy activities. Also, the study provides insights into a number of central implementation processes, including challenges and potential solutions to these challenges applied by partner organizations. Among others, these challenges revolve around engaging non-health professionals in tasks related to MHP. Overall, the study participants report that engaging in MHP holds the potential to link and bridge administrative tasks, disciplines, and professions.  

The results from the second research study provides insights into how the action learning program generated capacity outcomes. The identified outcomes included implementation of MHP initiatives, personal development among participants, and relational and collaborative development. The study presents nuanced insights into the generation of these outcomes based on the configuration of program mechanisms (e.g. legitimization of specific agendas, learning-by-doing, and collaborations across organizational boundaries) and contextual factors (e.g. participant motivation, organizational support, and existing task descriptions). 

The third research study presents the development of a taxonomy of roles within intersectoral MHP practices. The taxonomy consists of five different roles: 1) decision-maker; 2) MHP specialist; 3) MHP co-ordinator; 4) MHP practitioner; and 5) end-user. Through a case study of the implementation of an action learning program, the study elucidates and exemplifies the interactions across roles. The results illustrate the interrelatedness of all five roles, which supports the notion that all roles are relevant to consider for understanding, planning, and researching MHP practices.

Implications and conlusions 
Altogether, the thesis shows that MHP is a multi-faceted matter that calls for innovation and reorientation of how mental health can be embedded in existing practices – within and across sectors. The results of the thesis illustrate the interplay between sectors and involved roles. Further, the thesis provides practice-oriented insights into the workings of different types of MHP initiatives, including insights into how these initiatives are related and complement each other. Capacity building is suggested to hold much potential for facilitating the development and implementation of MHP initiatives, and therefore should be prioritized in the phases of designing, planning and implementing MHP initiatives.  

Overall, the thesis highlights the need for stakeholders and program planners to consider the various roles within MHP when planning and implementing MHP practices. Furthermore, the results of the thesis highlight the importance and potential of applying a common language and conceptualization of MHP when collaborating across professions, disciplines, and sectors. Outlining the key functions of the involved roles, the proposed taxonomy can be seen as a tool to organize and articulate the key actions within MHP. However, the transferability of the taxonomy needs to be investigated. The insights into capacity building processes may inform planning and implementation activities. In terms of future steps, there is a need for more research into the transverse processes of MHP as a means to expand current knowledge of the implementation processes and how different types of initiatives complement each other within MHP.
Original languageDanish
Awarding Institution
  • University of Southern Denmark
  • Lauridsen, Sigurd, Principal supervisor
  • Rod, Morten Hulvej, Co-supervisor
  • Koushede, Vibeke, Co-supervisor
Date of defence22. Aug 2022
Publication statusPublished - 8. Jul 2022

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