Legitimacy, Embedding, and Learning: A Framework for Scaling Up Complex Psychosocial Interventions

Jaakko Harkko

No 4kcby_v1, SocArXiv from Center for Open Science

Abstract: Objective: To propose a multi-level framework to facilitate the sustainment and scale-up of complex evidence-based psychosocial interventions across mental health, social care, and employment systems. Methods: Integrative review of 41 empirical studies on contextual determinants of Individual Placement and Support (IPS) sustainment and scale-up, interpreted through implementation science, policy implementation research, and welfare policy literature. Results: Three mechanisms were identified as crucial for sustaining and scaling up: Policy Legitimacy: normative acceptability and institutional compatibility that enables mandates and political-administrative authorization; Policy Embedding: coherence of multi-level, cross-sector governance arrangements that routinise the intervention beyond pilots; and Policy Learning: cumulative implementation evidence infrastructure enabling comparable measurement, feedback, and authorized adaptation. Conclusion: The proposed Legitimacy–Embedding–Learning (LEL) Framework for Scale-Up holds that scaling complex interventions is a configuration challenge within complex systems, rather than a linear dissemination task. The framework may support proactive adaptation when scaling IPS and similar interventions.

Date: 2026-01-06
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Persistent link: https://EconPapers.repec.org/RePEc:osf:socarx:4kcby_v1

DOI: 10.31219/osf.io/4kcby_v1

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