Engagement with diverse stakeholders, including policy makers, care providers and service users and communities, is essential for successful implementation of global mental health interventions. Despite being a fundamental factor in the implementation process, evidence about challenges and drivers to stakeholder engagement is limited in the global mental health literature. We conducted semi-structured qualitative interviews with 29 recipients of Grand Challenges Canada Global Mental Health funding to assess barriers and drivers to global mental health implementation across a portfolio of projects. We used framework analysis to identify key themes related to implementation barriers and drivers. This paper reports on barriers and drivers to stakeholder engagement, with results related to capacity development and service delivery reported elsewhere in this journal. Barriers and drivers to stakeholder engagement were identified across four themes: (1) Contextual Considerations, (2) Resources, (3) Participation, Uptake and Empowerment, and (4) Stigma. While complex contextual challenges create barriers, mechanisms such as formative research can facilitate a deeper contextual understanding that supports effective implementation planning. Limited financial and human resources and competing priorities can lead to substantial challenges. Investing in and leveraging existing local resources and expertise can help to mitigate these barriers. The challenge of achieving active participation from stakeholders and diverging expectations about the nature of participation were identified as barriers, while providing opportunities for meaningful participation and empowerment acted as drivers. Stigma at the institutional, community and individual level was also identified as a substantial barrier to engagement. The findings of this study are relevant to implementers in global mental health. They also have implications for global mental health funding agencies and policy organizations, who can support improved stakeholder engagement by investing in high-quality formative research, supporting capacity building for policy engagement, investing in longer-term funding schemes to support sustainable partnerships and scale-up, thus fostering successful engagement and supporting effective implementation of global mental health innovations.

中文翻译：

---

利益相关者参与全球精神卫生项目的障碍和驱动因素

与包括政策制定者，护理提供者以及服务使用者和社区在内的不同利益相关者的参与对于成功实施全球精神卫生干预措施至关重要。尽管这是实施过程中的基本因素，但有关全球精神卫生文献中有关挑战和利益相关方参与的驱动因素的证据有限。我们对29个加拿大挑战赛全球精神卫生基金的接受者进行了半结构化的定性访谈，以评估在一系列项目中实施全球精神卫生的障碍和动因。我们使用框架分析来确定与实施障碍和驱动因素有关的关键主题。本文报告了利益相关者参与的障碍和驱动因素，与能力发展和服务交付有关的结果在本期刊的其他地方进行了报道。利益相关者参与的障碍和驱动因素涉及四个主题：（1）上下文相关的考虑因素；（2）资源；（3）参与，吸收和授权；以及（4）污名。尽管复杂的上下文挑战会带来障碍，但​​诸如形成性研究之类的机制可以促进对上下文的更深入理解，从而支持有效的实施计划。有限的财力和人力资源以及相互竞争的优先事项可能导致重大挑战。投资和利用现有的当地资源和专业知识可以帮助减轻这些障碍。利益相关者积极参与和对参与性质的期望不一的挑战被确定为障碍，同时提供有意义的参与和授权的机会。在机构，社区和个人层面上的污名也被认为是参与的重大障碍。这项研究的发现与全球心理健康的实施者有关。它们还对全球精神卫生筹资机构和政策组织产生影响，它们可以通过投资于高质量的形成性研究，支持政策参与的能力建设，投资于长期筹资计划以支持可持续的伙伴关系和扩大规模，来支持利益相关者参与度的提高。从而促进成功参与并支持全球精神卫生创新的有效实施。社区和个人层面也被认为是参与的重大障碍。这项研究的发现与全球心理健康的实施者有关。它们还对全球精神卫生筹资机构和政策组织产生影响，它们可以通过投资于高质量的形成性研究，支持政策参与的能力建设，投资于长期筹资计划以支持可持续的伙伴关系和扩大规模，来支持利益相关者参与度的提高。从而促进成功参与并支持全球精神卫生创新的有效实施。社区和个人层面也被认为是参与的重大障碍。这项研究的发现与全球心理健康的实施者有关。它们还对全球精神卫生筹资机构和政策组织产生影响，它们可以通过投资于高质量的形成性研究，支持政策参与的能力建设，投资于长期筹资计划以支持可持续的伙伴关系和扩大规模，来支持利益相关者参与度的提高。从而促进成功参与并支持全球精神卫生创新的有效实施。