• Emotional or behavioral disorder;
  • mental;
  • mental health promotion;
  • implementation;
  • preventive interventions

PROBLEM:  The purpose of this study was to gain an understanding of the barriers and facilitators to implementation of the five overarching recommendations of the Institute of Medicine report and to consider the implications for nursing.

METHODS:  Data were collected through use of a semi-structured interview of purposive sample of 22 key informants regarding the barriers and facilitators to implementation of the report's five major recommendations.

FINDINGS:  The major barriers were competing priorities, lack of infrastructure for implementation, lack of public education regarding mental health and the effectiveness of prevention, stigma, and a paucity of facilitating factors. The facilitators were leadership, flexible resources, linkage to healthcare reform or other legislation, coordination across agencies and governmental levels, and additional research.

CONCLUSIONS:  The discussion focuses on ways of promoting facilitating factors and consideration of nursing's potential contributions in the areas of education, practice, and research.