Building a High-Quality Mental Health and Addictions System: How Do Intermediary Organizations Contribute?

While evidence‐based practices (EBPs) are becoming more prevalent in health care, their use in routine practice is highly variable, especially for psychosocial mental health and addictions treatments. Intermediary and purveyor organizations (IPOs) are dedicated to the implementation and spread of EBPs, bridging the science to practice gap. While IPOs have grown considerably in recent years, our understanding of how they work remains limited. The aim of the present descriptive case study was to advance understanding of the structure and operations of IPOs. Case profiles for four IPOs developed for a prior planning project were the study data source. The IPOs were based in the US and Canada, publicly funded, and mandated to implement mental health and addictions EBPs in line with funder expectations. The profiles described the IPO’s relationship to government, role of research, EBPs supported and implementation support strategies. Using a cross-case analysis, the four case profiles were compared. Commonalities and differences were identified. The IPOs supported individual agencies to deliver EBPs and worked with the funder to develop policies and incentives to improve delivery. Core support activities included training, performance monitoring and implementation support, with learning from each informing the other. Given the IPO dual roles of implementation support and evaluation, building trust, and credibility with the agencies was important. IPO capacity to conduct research was variable. IPOs can offer a systematic approach informed by implementation science to build high-quality EBP delivery. Continued study is needed to elucidate core components, demonstrate their value, and improve their work.