Background: This paper presents an evaluation of a pilot program in New Zealand designed to provide integrated psychological therapy services within primary care settings to young adults (aged 18-24) facing mild to moderate mental distress. Employing a unique framework integrating complexity and implementation science with the core values of appreciative inquiry (CIS-A), this evaluation examines the program’s success and challenges.
Method: Utilizing a combination of quantitative and qualitative methods and drawing from diverse data sources, the evaluation emphasizes local innovation and co-design involving service users, young adults, and various care providers across three regions in the lower North Island of New Zealand.
Results: The Piki pilot program significantly enhanced mental health care for its target population. It served 5,307 individuals, offering a range of therapy options, with most recipients undergoing one to three therapy sessions. Of the 730 surveyed service users, 591 (81%) expressed “very satisfied” with the service. The CIS-A framework facilitated rapid feedback, enabling adjustments to emerging issues such as unexpected workload pressures, changes in therapy delivery, and the integration of co-design principles. Noteworthy adaptations included the introduction of peer-to-peer support and a digital resource platform. The framework also guided responses to challenges posed by the COVID-19 pandemic.
Conclusions: This study demonstrates the efficacy of an embedded evaluation in supporting the implementation of an innovative youth mental health program. By leveraging complexity and implementation science within the CIS-A framework, valuable insights were gleaned, with implications for local, national, and international contexts. While focusing on youth mental health, the principles and benefits of applying a complexity and implementation science approach extend to diverse healthcare settings. The CIS-A framework facilitates adaptive innovation and implementation, enabling proactive adjustments and transforming hindsight into foresight.
