title: Barriers and solutions to implementing metabolic risk assessment in a secondary mental health service.
abstract: OBJECTIVE
  The aim of this study is to understand the barriers and resulting solutions encountered by mental health service staff during the implementation of a metabolic risk assessment programme.
  
  
  METHODS
  Semi-structured qualitative interviews were held with key programme staff. Thematic analysis was performed on the resulting data.
  
  
  RESULTS
  Barriers identified included an existing mindset that care of service users' physical health is not part of Mental Health Service 'core business'; the lack of processes that ensure consistent implementation of risk assessment; and lack of resources in terms of equipment and staff time/manpower. Solutions identified were categorized as: systems and process issues; staff training or education issues; issues requiring attention at an organizational level; and issues relating to service users, their family and communities.
  
  
  CONCLUSIONS
  A valuable programme that contributes to the improved physical health of service users has been developed and implemented. However, a number of barriers to wider adoption were identified. Solutions to a number of these barriers were identified during implementation.
authors.affiliation: Clinical Research and Resource Centre, Mental Health and Addictions, Waitemata District Health Board, Auckland, New Zealand. Lucy.Dunbar@waitematadhb.govt.nz
authors.forename: Lucy
authors.initials: L
authors.lastname: Dunbar
authors.forename: Theo
authors.initials: T
authors.lastname: Brandt
authors.forename: Amanda
authors.initials: A
authors.lastname: Wheeler
authors.forename: Jeff
authors.initials: J
authors.lastname: Harrison
mesh_terms: D000328:Adult; D003156:Community Mental Health Services / Q000379:methods / Q000458:organization & administration* / Q000639:trends; D005260:Female; D006266:Health Education / Q000379:methods; D006801:Humans; D007406:Interview, Psychological / Q000379:methods; D008297:Male; D001523:Mental Disorders / Q000378:metabolism* / Q000628:therapy*; D015397:Program Evaluation / Q000379:methods; D011785:Quality Assurance, Health Care / Q000379:methods; D018570:Risk Assessment / Q000379:methods; D011795:Surveys and Questionnaires