| Enabler | Barrier | Action to address barrier |
---|---|---|---|
Organisation outside group | Â | Lack of senior clinical leadership to support funding of intervention and bipolar disorder nurse specialist | Reappraisal of costs and benefits of intervention in light of research evidence and competing demands for resources |
Insufficient detailed training of crisis resolution and home treatment team, community mental health team, accident and emergency and primary care in early warning sign interventions in bipolar disorder | Investment in training and senior educational and clinical leadership to support such training | ||
Organisation within groups | Â | Lack of understanding of reasons for drop outs from groups. | Research directed at understanding and addressing reasons for drop out from groups. |
Facilitators | Willingness and positive experience of health care professional and patient facilitators working together | Training structure relatively fixed. Insufficient reward and ongoing support for facilitators. | Create a sustainable, and flexible structure for training. Find ways to reward and provide ongoing support for facilitators. Embedding training and support systems within local clinical and education service provision. |
Participant | Shared information giving about local resources | Informal support and psychoeducation largely independent and unknown to local mental health services. | Engage services with working positively with third sector and service user organisations to embrace recovery principles of care. |
Commonalities in dealing with illness | |||
Newly diagnosed learning from older participants | |||
Knowing more about illness | |||
Improvements in agency | |||
Altruism to help others |