A framework and guidelines for the implementation of mental health in all policies

Abstract

Mental Health in All Policies (MHiAP) is increasingly recognized as essential for population mental health promotion. Few resources exist, however, to guide MHiAP implementation. Consequently, we conducted a realist scoping review using Pawson’s six-stage approach, searching Google Scholar, PubMed, Cochrane Reviews, and Scopus for publications addressing MHiAP frameworks and implementation strategies. We developed a theoretical implementation framework from the Atlantic Summer Institute policy brief, the Circle of Health model, and community resilience theory, then tested this framework against available literature. Data were analyzed using Atlas.ti. From 830 initial results, 38 publications were retrieved, and 20 included in the analysis. Findings supported our proposed framework: 90% of publications addressed education elements, 85% discussed multi-level commitment strategies, and 80% emphasized coordinated action principles. However, significant implementation gaps were identified, particularly in practical “how-to” guidance (only 20% of publications addressed strategic opportunity utilization), community-level engagement (50% vs. 90% for political commitment), and accountability mechanisms (40% of publications). The framework comprises cyclical, interconnected components of education/awareness-raising, commitment building, and coordinated action, supported by implementation guidelines emphasizing “moments of opportunity,” community-centered approaches, and values-based collaboration. This study presents acomprehensive, evidence-based framework for MHiAP implementation, addressing gaps in practical guidance while building on established theories. Key innovations include strategic approaches to opportunity identification, integration of community resources, and accountability mechanisms. The guidelines provide actionable strategies for policymakers, practitioners, and community leaders to translate MHiAP principles into action. This framework offers essential guidance on operationalizing mental health policy commitments through systematic intersectoral collaboration.