Facilitators and barriers to implementation of suicide prevention interventions: Scoping review

We know that suicide is preventable, yet hundreds of thousands of people still die due to suicide every year. Many interventions were proven to be effective, and dozens of others showed promising results. However, translating these interventions into new settings brings several challenges. One of the crucial obstacles to success is not anticipating possible barriers to implementation nor enhancing possible benefits of factors facilitating the implementation. While we witnessed great support for suicide prevention activities globally in the past years, implementation barriers and facilitating factors are yet to be comprehensively mapped to help implementation activities worldwide. This scoping review maps current knowledge on facilitators and barriers to the implementation of suicide prevention interventions while using the Consolidated Framework for Implementation Research (CFIR) for classification. We included 64 studies. Barriers and facilitators were most commonly identified in the outer setting CFIR domain, namely in the sub-domain of patient needs and resources, which refers to the way in which these needs and resources are reflected by the reviewed interventions. The second most saturated CFIR domain for facilitators was intervention characteristics, where relative advantage, adaptability and cost of intervention sub-domains were equally represented. These sub-domains refer mostly to how the intervention is perceived by key stakeholders, to what extent it can be tailored to the implementation context and how much it costs. While intervention characteristics domain was the second most common also for barriers, the complexity sub-domain referring to high perceived difficulty of implementation was the most frequently represented. With reference to the results, we recommend adapting interventions to the needs of the target groups. Furthermore, carefully selecting the intervention to suit the target context concerning their adaptability, costs and complexity is vital for a successful implementation. Further implications for practice and research are discussed

Drug related harm reduction in the eu and candidate countries - success and gaps

Background: Evaluation of the state of play of the 2003 Council Recommendation on the prevention and reduction of health-related harms, associated with drug dependence, in the EU and candidate countries and elaboration of proposals for new recommendations. Methods: Analysis of epidemiological data available at the European Monitoring Center for Drugs and Drug Addiction (EMCDDA) using statistical modeling, a general literature review on harm reduction measures, four systematic literature reviews (one on peer naloxone pro-grams) and surveys among decision makers in the field of drug policy and among harm reduc-tion providers (“stakeholders”) using online questionnaires and a gap survey among the na-tional focal points of EMCDDA in EU-countries and candidate countries. Results: It was possible to decrease the number of HIV-infections among drug users substan-tially in most EU countries and candidate countries during the last decade; unfortunately for the numbers of deaths due to overdoses this effect could not be reached. Stakeholders (harm reduction providers) name improvement of needle and syringe exchange and harm reduction in prison as main priorities in order to reduce drug related infectious diseases. Concerning re-duction of mortality they prioritise peer naloxone programs, drug consumption rooms and first aid training of drug users.  Conclusions : The increase of coverage of substitution treatment and of the availability of nee-dle exchange programs in most countries can be seen as successes of harm reduction policy although the coverage especially of the latter still needs improvement. Peer naloxone pro-grams and improvement of harm reduction in (and after) prison are two of 13 recommended actions to improve the situation concerning mortality of opioid users. Continuous political strengthening of harm reduction is necessary

Psychotherapie als Sozialversicherungsleistung - Inanspruchnahme und Finanzierung

Das damalige Bundesministerium für Gesundheit (BMG) beauftragte die Gesundheit Österreich in Anknüpfung an vorangegangene Berichte damit, die aktuelle Versorgung mit gänzlich oder teilweise von den Sozialversicherungsträgern (SV) finanzierter Psychotherapie zu analysieren. Ziel der vorliegenden Studie ist, die unterschiedlichen Versorgungs- und Finanzierungsmodelle in den einzelnen Bundesländern und die Ausgaben und erbrachten Leistungen im Jahr 2014 mit jenen der vergangenen Jahre zu vergleichen. Weitere Inhalte der Studie sind eine Bewertung der Versorgungswirksamkeit der psychotherapeutischen Angebote sowie Empfehlungen hinsichtlich der Weiterentwicklung kassenfinanzierter Psychotherapie. Ein Sonderkapitel widmet sich den Verordnungszahlen und Ausgaben für Psychopharmaka. Vorliegender wissenschaftlicher Ergebnisbericht wurde auf Datenbasis 2014 teilweise überarbeitet

EWR-Regelungen Psychotherapie, Klinische Psychologie, Gesundheitspsychologie, Musiktherapie

Das Bundesministerium für Arbeit, Soziales, Gesundheit und Konsumentenschutz (BMASGK) beauftragte die Gesundheit Österreich GmbH im Jahr 2015, die Dokumentation zu Regelungen und Ausbildungen der Berufsgruppen der Psychotherapie, Klinischen Psychologie und Gesundheitspsychologie sowie Musiktherapie in den EWR-Staaten Deutschland, Frankreich, Großbritannien, Italien sowie in der Schweiz aus den Jahren 2009/2010 (Bednar et al. 2011) zu aktualisieren und um den EWR-Staat Kroatien zu erweitern. Die genannten Berufe sind in Österreich als unabhängige, selbstständige und freie Berufe gesetzlich geregelt. Die gegenständlichen Informationen bilden für das BMASGK eine Entscheidungsgrundlage in Hinblick auf die Zulassung von Bürgerinnen und Bürgern der genannten Länder zur Berufsausübung in diesen Berufen in Österreich. Die vorliegende Arbeit stellt die Recherche-Ergebnisse vergleichend dar und macht sie auch für die interessierte Öffentlichkeit zugänglich: Der Fokus der Informationen liegt auf den rechtlichen Regelungen in den einzelnen Staaten