What has been done and the experiences of implementing “Child Talks” in General Psychiatric Clinics for adults at UNN, Tromsø, Norway to ensure that children of mentally ill and substance abusing parents are identified, and that they get the support to which they are entitled by Psychologist Charlotte Reedtz/ Educationalist Camilla Lauritzen/ PhD Karin van Doesum The conference Developing Strength and Resilience in Children 1-2 Nov. 2010 in Oslo

1. The challenges of successful
implementation
Implementing change of practice in mental health care for
adults in Northern Norway
Charlotte Reedtz and Camilla Lauritzen, November 2010

2. Children of mentally ill parents
• Changes in existing legislation January 2010
• The changed Health Personnel Act (§ 10 a) states that
health professionals should help to meet the needs for
information and necessary follow-up for children under
18 years who have parents that receive health care for
mental illnesses, substance abuse disorders or serious
somatic illness or injury.

3. Guidelines (IS-5/2010)
• The guidelines published by Norwegian authorities provide
thorough descriptions of the expectations and the
intention behind the legislation amendments
• A somewhat overwhelming document, listing a number of
new tasks and responsibilities that health care workers
now have

4. How do we successfully implement the
amended legislation?
• Implementation of skills
• Implementation of new practice
Definition: Implementation is a specified set of activities
designed to put into practice an activity or program of
known dimensions (Fixsen et. Al 2005)

5. Project: Children of Mentally ill Parents –
implementing and evaluating changes of
practice within mental health care for adults
• In this project RBUP North focuses on what changes of
practice that will occur within mental health services for
adults as a result of the amendments in legislation as of
2010;
- Implementation of new routines and interventions
- How to achieve systematic changes of practice that can
be maintained over time

6. Our approach to implementation:
• A perspective on innovation
• A focus on the actions of those who convert innovation into
practice
• The essence of implementation is behavior change
• Ideas behind innovations are not self-executive!

7. Implementation model :
Phase 1: Initiate change; network planning/analysis and
mobilize support and partnerships
Phase 2: Adoption. Preparing the organization. Informing
the total staff about the program and research.
Develop schedules for executing change of practice.
Phase 3: Effectuate change of practice
Phase 4: Maintenance and consolidation
(Barry & Jenkins, 2008)

8. Phase 1 - Initiate change;
Project: Children of mentally ill in UNN
A. Descriptive studies of what is needed within the
organization, in this case The University Hospital of
Northern Norway - UNN
B. Description of the local context; Cooperation and dialogue
with participants within UNN.
C. Choose interventions and activities; E.g. check out the
database Youngmind (Ungsinn) at www.ungsinn.uit.no
D. Mobilize support, initiate and formalize cooperation.
Contract. The contract based on the needs within the
organization/UNN. Establish project group. Cooperation
meetings.
E. Establish project group and project management. Set aside
personnel responsible for particular tasks within the
project.

9. Phase 2 - Adoption. Preparing the
organization.
Project: Children of Mentally ill Parents in UNN
A. Informing the total staff about the program and the
research. Develop schedules for executing change of
practice - regarding both research and intervention.
Describe routines and responsibilities.
B. The intervention ”Child Talks” - Training/education

10. Phase 3 - Effectuate change of practice.
Project: Children of Mentally ill Parents in UNN
A. Implementation of registration form
B. Implementation of Child Talks
C. Monitoring the implementation and practice of Child Talks
and registration form. Logbook.
D. Evaluation of training, peer coaching and coaching via
program owner (VFB).

11. Phase 4 - Maintenance and consolidation.
Project: Children of Mentally ill Parents in UNN
A. Evaluation of change of practice within the organization.
B. Evaluation of maintenance of the new practice.

12. The next decade….
• Implementing change of practice is the greatest challenge
of them all (Hollin & McMurran, 2001).
• Innovation takes time!
• Researchers and health care workers need to join forces
in order to prevent health problems in children who have
mentally ill parents.
www.rbup.no/nord
www.ungsinn.uit.no