Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Hana Sikira
Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Alma Dzubur Kulenovic
Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
Tamara Pemovska
Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK; and WHO Collaborating Centre for Mental Health Services Development, Bart's and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
Unit for Social and Community Psychiatry, Queen Mary University of London, London, UK; and Newham Centre for Mental Health, London, UK
Tamara Radojicic
Clinical Centre of Montenegro, Podgorica, Montenegro
Selman Repisti
Clinical Centre of Montenegro, Podgorica, Montenegro
Miloš Milutinović
University Clinical Centre Mother Teresa Skopje, Skopje, Macedonia
Biljana Blazevska
University Clinical Centre Mother Teresa Skopje, Skopje, Macedonia
Jon Konjufca
Department of Psychology, University of Prishtina ‘Hasan Prishtina’, Prishtina, Kosovo, Albania; and University of Prishtina, Kosovska Mitrovica, Serbia
Department of Psychiatry, University Clinical Center of Serbia, Belgrade, Serbia; and Department of Psychiatry, Clinic for Psychiatry, Clinical Centre of Serbia, Belgrade, Serbia
Bojana Savic
University Clinical Center of Serbia, Belgrade, Serbia
Background DIALOG+ is an evidence-based, generic, cost-saving and easily deliverable psychosocial intervention, adaptable to clinicians’ personal manner of interaction with patients. It was implemented in mental health services in five low- and middle-income countries in South-Eastern Europe during a 12-month randomised-controlled trial (IMPULSE) to improve the effectiveness of out-patient treatment for people with psychotic disorders. Aims To investigate barriers and facilitators to the perceived sustainability of DIALOG+ that has been successfully implemented as a part of the IMPULSE project. Method Three months after the IMPULSE trial's end, perceived sustainability of the DIALOG+ intervention was assessed via a short survey of clinicians and patients who took part in the trial. Quantitative data collected from the survey were analysed using descriptive statistics; content analysis assessed qualitative survey data. The views and experiences of key informants (patients, clinicians and healthcare policy influencers) regarding the sustainability and scale-up of DIALOG+ were further explored through semi-structured interviews. These data were explored using framework analysis. Results Clinicians mostly appreciated the comprehensiveness of DIALOG+, and patients described DIALOG+ meetings as empowering and motivating. The barrier most commonly identified by key informants was availability of financial resources; the most important facilitators were the clinically relevant structure and comprehensiveness of the DIALOG+ intervention. Conclusions Participants showed a willingness to sustain the implementation of DIALOG+. It is important to maintain collaboration with healthcare policy influencers to improve implementation of DIALOG+ across different levels of healthcare systems and ensure availability of resources for implementing psychosocial interventions such as DIALOG+.
