We have learned many lessons throughout the course of the IMPACT research study our subsequent dissemination project. Here are some key lessons learned.

1. Develop a clear vision for the program

The IMPACT Needs Assessment can help with this process

2. Engage leaders and key stakeholders

Influential opinion leaders can be very helpful in managing resistance to practice change.
Leaders and stakeholders can include

• Health plans, government agencies
• Clinic and practice leaders
• Clinicians: primary care and mental health
• Care managers
• Practice management

3. Structural, financial and clinical integration is needed

IMPACT is not co-location of mental health services in primary care; it requires true integration of care.

4. Consider starting small

• A small scale pilot can increase the likelihood of success by helping you identify hurdles that must be addressed.

5. Address local variations

• Incentives and opportunities
• Existing resources (e.g. information systems, quality improvement and patient education resources)
• Barriers and competing demands