Safeguarding implementation elements in a national school mental health intervention: implementers’ perspectives

Objective The purpose of this study was to identify and describe implementation determinants that are sensitive when undertaking a school mental health intervention and that require particular attention during implementation. Methods A multisite qualitative study was conducted using a deductive analytical approach. Thirty team members implementing a national preventive school mental health program were interviewed. The interviews were analyzed using content analysis based on pre-established categories from the Consolidated Framework for Implementation Research (CFIR). Results The findings highlight several implementation conditions requiring particular attention, including resources and time; training, feedback and monitoring; structural alignment across organizational levels; school over-intervention; and the recognition of adaptations as plausible elements within an intervention. Discussion This research provides empirical insights regarding the implementation factors of SMH programs within authentic school settings. Furthermore, the qualitative depth achieved through interviews with both implementers and coordinators allows a multi-level understanding of the factors influencing long-term sustainability and the intervention’s ecological validity.