Evidence-based Methods in Rural Areas - Knowledge and National Guideline Utilization in Mental Health Service Development

Purpose: To examine how rural municipalities develop services to people with serious mental illness in relation to evidence-based practice and national guidelines. Additional sources of knowledge and strategies used by the municipalities in relation to their development needs were explored as well. Method: Qualitative multiple-case approach, with 43 deep-interviews involving 84 informants representing selected social psychiatric services from 11 sites. Results: National guidelines and evidence-based practices have a limited impact on how rural municipalities develop services to the target group. The municipalities favor other sources of knowledge, including regional networks, pragmatic problem-solving approaches and community-based knowledge. Discussion and conclusion: Most of the informants expressed a need for more systematic and evidence-based knowledge in order to meet their clients' needs. A major challenge to improve the utilization of these methods, is to make adaptions to match the rural municipalities' needs and actual resources without risking the quality of these evidence-based services.