BACKGROUND Intermediaries are organisations or programmes that work between policy-makers and service providers to facilitate effective implementation of evidence-informed policies, programmes and practices. A number of intermediaries now exist in well-established mental health systems; however, research on them, and how they may be optimised to support implementation is lacking. This research seeks to understand the puzzling variation in the system placement of intermediaries supporting policy implementation in the mental health systems of Canada (Ontario), New Zealand and Scotland. METHODS Using a comparative case study approach, the analytic goal was to compare intermediaries across jurisdictions and explain differences in their placement using explanatory frameworks from political science. Data for this analysis were derived from several sources, including key informant interviews, a literature search of published and grey literature on intermediaries and on policy implementation in mental health systems, a review of relevant policy documents and websites, as well as documents and websites relating to the various intermediaries and other interest groups within each system. RESULTS Through the analysis, we argue that the placement of intermediaries supporting policy implementation can be explained through an understanding of the political structures, the policy legacies leading to the current public/private mix of mental health service delivery, and the differing administrative capacities of mental health systems. CONCLUSIONS This research contributes to our growing understanding of policy-related intermediaries supporting implementation at scale and how we might build appropriate infrastructure in systems to support the implementation of policy and achieve better outcomes for citizens.

中文翻译：

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了解实施政策所需的支持：对三个精神卫生系统中中介机构的位置进行比较分析。

背景技术中介机构是在政策制定者和服务提供者之间工作的组织或程序，以促进有效实施以证据为依据的政策，程序和做法。目前，在完善的精神卫生系统中存在许多中介机构。但是，缺乏关于它们的研究以及如何对其进行优化以支持实施。这项研究旨在了解在加拿大（安大略省），新西兰和苏格兰的精神卫生系统中，支持政策实施的中介机构的系统布局令人费解。方法采用比较案例研究的方法，分析目标是比较跨辖区的中介机构，并使用政治学的解释性框架解释中介机构的位置差异。用于此分析的数据来自以下几个来源：主要的知情人访谈，对中介机构和精神卫生系统中政策实施情况的已发表和灰色文献进行文献检索，对相关政策文件和网站以及与之相关的文件和网站的评论每个系统中的各种中介机构和其他利益集团。结果通过分析，我们认为可以通过理解政治结构，导致当前公共/私人精神卫生服务混合的政策遗产以及精神卫生服务行政能力的差异来解释支持政策实施的中介机构的位置。卫生系统。