Mental health in complex health promotion policy programmes: The contribution of programme evaluations

Abstract

Background: In order to develop policymaking, evaluation is required. The research project studied national health promotion policies concentrating on mental health promotion policy. In this paper the focus is on the position of evaluation. Aim: To explore the position of evaluation in the development of the national public health strategies of England and Finland and particularly with regard to mental health promotion policies. The evaluation phase of the policymaking process is also scrutinised through multiple streams of policy change. Methods: Meta-evaluative approach applying a conceptual framework of policy analysis. Results: Evaluations of national health strategies were executed in both countries. These evaluations entailed multiple tasks; not only to monitor the progress of the targets but to learn for the future in a wider perspective. Aims of mental health policy are not easily turned into quantitative targets and therefore outcome evaluation was not felt to be satisfactory as it lacks focus on process as well as null, perverse, and unintended consequences. Conclusions: While the position of evaluation is almost always more complicated than is assumed in so-called rational policymaking theory, mental health appears to be even more challenging in this respect. Possibilities for alternative evaluation strategies should be studied further.