Testing an Organizational Implementation Strategy in Children's Mental Health

测试儿童心理健康的组织实施策略

• 批准号: 7920866
• 负责人: CHARLES A GLISSON
• 金额: $ 61.86万
• 依托单位: UNIVERSITY OF TENNESSEE KNOXVILLE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-25 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7920866
• 关键词: Address; Adopted; Adoption; Attitude; Caregivers; Caring; Child Mental Health; Client; Climate; Clinical Trials; Collaborations; Communities; Community Mental Health Services; Drops; Effectiveness; Evidence based treatment; Experimental Designs; Feedback; Fibrinogen; Freedom; Health Services Accessibility; Health Services Research; Health Technology; Health system; Healthcare; Institute of Medicine (U.S.); Intervention; Job Satisfaction; Learning; Mediating; Mental Health; Mental Health Services; Mental disorders; Methods; Modeling; Monitor; Morale; Muscle Rigidity; National Institute of Mental Health; Organizational Culture; Outcome; Parents; Performance; Plague; Procedures; Process; Reporting; Research; Resistance; Sampling; Series; Services; Social Environment; Strategic Planning; Stress; Structure; Surgeon; Symptoms; System; Technology; Tennessee; Testing; Time; United States National Institutes of Health; Universities; Washington; Work; Youth; base; child mental health service; compliance behavior; design; experience; improved; improved functioning; innovation; new technology; novel; organizational climate; prevent; public health relevance; satisfaction; tool

DESCRIPTION (provided by applicant): The NIMH Strategic Plan seeks novel models and methods for implementing effective mental health services in the community (Strategy 4.1, NIMH, 2008). Related findings by the Institute of Medicine, the President's New Freedom Commission on Mental Health, the Surgeon General, and the National Institutes of Health, as well as a growing body of research describing ineffective community-based mental health services, point to the critical need for strategies to eliminate a variety of barriers to service effectiveness. However, few implementation strategies have been developed to address the broad range of barriers that hinder service outcomes in community mental health agencies and almost no empirical tests of such strategies have been conducted using true experimental designs. As a result, there is much more to learn about strategies that can be used by community-based agencies to improve the way they deliver mental health services. The proposed study will experimentally test the effects of the ARC (for Availability, Responsiveness and Continuity) organizational implementation strategy on the mental health services provided to youth in a sample of 12 community-based mental health agencies in St. Louis, MO. The study will be conducted by the developers of ARC from the University of Tennessee Children's Mental Health Services Research Center (UT CMHSRC) in partnership with the Washington University Center for Mental Health Services Research (WU CMHSR) in St. Louis. The ARC implementation strategy focuses on developing the processes of staff collaboration, participation and improvement-oriented innovation necessary for an organization to implement more effective services by identifying and addressing barriers to effectiveness. Examples of service barriers include problems that plague mental health service systems nationwide, such as the use of ineffective treatment models, staff turnover, client drop-outs from treatment, inefficient referral networks, inaccessible services, and staff resistance to service improvement efforts. We argue that a mental health agency's ongoing capacity to improve the services it provides requires a guided organizational implementation strategy that identifies and addresses such barriers in the organization's social context, service structure and core technology. PUBLIC HEALTH RELEVANCE: The mental health services provided to youth by our nation's community mental health systems are largely unproven or ineffective. Moreover, almost no implementation strategies have been developed and tested to improve the performance of these systems. The proposed study will experimentally test the effects of the ARC (for Availability, Responsiveness and Continuity) organizational implementation strategy on the mental health services provided to youth in a sample of 12 community-based mental health agencies that serve youth in St. Louis, MO.

描述（由申请人提供）：NIMH战略计划寻求新颖的模型和方法来实施社区中有效的心理健康服务（战略4.1，NIMH，2008年）。医学研究所，总统新的心理健康自由委员会，外科医生和美国国立卫生研究院的相关发现以及越来越多的研究机构描述了无效的社区心理健康服务，这表明了对消除各种服务效率障碍的策略的迫切需求。但是，几乎没有制定实施策略来解决阻碍社区心理健康机构中服务成果的广泛障碍，并且几乎没有使用真正的实验设计对此类策略进行的经验测试。结果，还有更多需要了解的策略，这些策略可以被基于社区的机构使用，以改善他们提供心理健康服务的方式。拟议的研究将在实验中测试组织实施策略（用于可用性，响应能力和连续性）对向年轻人提供的心理健康服务的影响，以在密苏里州圣路易斯的12个基于社区的心理健康机构样本中。该研究将由田纳西大学儿童心理健康服务研究中心（UT CMHSRC）的ARC开发商与华盛顿大学心理健康服务研究中心（WU CMHSR）合作。 ARC实施策略着重于开发员工协作，参与和以改进为导向的创新过程，使组织通过确定和解决有效性的障碍来实施更有效的服务。服务障碍的例子包括困扰全国心理健康服务系统的问题，例如使用无效的治疗模型，员工营业额，服务对待，治疗效率低下，推荐网络，无法访问的服务以及员工对服务改善工作的抵制。我们认为，精神卫生机构持续改善其提供的服务的能力需要指导的组织实施策略，以确定并解决组织社会环境，服务结构和核心技术中的这种障碍。公共卫生相关性：我们国家社区心理健康系统向青年提供的心理健康服务在很大程度上未经证实或无效。此外，几乎没有开发和测试实施策略来提高这些系统的性能。拟议的研究将在实验中测试组织实施策略（用于可用性，响应能力和连续性）对向年轻人提供的心理健康服务的影响，以12个为基于社区的心理健康机构提供的样本，这些机构为密苏里州圣路易斯的青年提供服务。