Strategies for Sustaining Fidelity: A Multi-state Qualitative Analysis in Housing First Programs
This study examines how staff at ‘mature’ (eight or more years in operation) Housing First (HF) programs strategize to sustain EBI fit in different geographic areas in the Mid-Atlantic/Northeastern United States. Six focus groups (FGs) at three purposively selected HF programs were conducted with separate FGs for case managers and supervisors at each site. FG discussions elicited participants’ service approaches and strategies in addressing fidelity amidst ongoing changes affecting each program. Thematic content analysis of FG transcripts was conducted using the five HF fidelity domains (housing choice/structure, sep...
Source: Administration and Policy in Mental Health and Mental Health Services Research - April 22, 2020 Category: Psychiatry Source Type: research

The Family Psychoeducation Fidelity Scale: Psychometric Properties
This study examined psychometric properties and feasibility of theFamily Psychoeducation (FPE) Fidelity Scale. Fidelity assessors conducted reviews using the FPE fidelity scale four times over 18  months at five sites in Norway. After completing fidelity reviews, assessors rated feasibility of the fidelity review process. The FPE fidelity scale showed excellent interrater reliability (.99), interrater item agreement (88%), and internal consistency (mean = .84 across four time points). B y the 18-month follow-up, all five sites increased fidelity and three reached adequate fidelity. Fidelity assessors rated feasibility...
Source: Administration and Policy in Mental Health and Mental Health Services Research - April 22, 2020 Category: Psychiatry Source Type: research

An Innovator and a Disruptor: Leonard Bickman on Program Theory, Null Findings, and Advice to Future Child Mental Health Services Researchers
This article provides an abridged and combined version of a video interview with Len dated April 16, 2019 and written responses to a series of questions posed to Len in advance of the festschrift held in his honor at Johns Hopkins Bloomberg School of Pub lic Health on May 11, 2018. (Source: Administration and Policy in Mental Health and Mental Health Services Research)
Source: Administration and Policy in Mental Health and Mental Health Services Research - April 21, 2020 Category: Psychiatry Source Type: research

Correction to: Measurement Strategies for Evidence-Based Psychotherapy for Posttraumatic Stress Disorder Delivery: Trends and Associations with Patient-Reported Outcomes
The original version of this article unfortunately contained a mistake. The co-author name was incorrectly published with the middle initial in the author list. (Source: Administration and Policy in Mental Health and Mental Health Services Research)
Source: Administration and Policy in Mental Health and Mental Health Services Research - April 19, 2020 Category: Psychiatry Source Type: research

A Systematic Review of Organizational and Workforce Interventions to Improve the Culture and Climate of Youth-Service Settings
AbstractBoth organizational culture and climate are associated with service quality and outcomes across youth-service settings. Increasing evidence indicates capacity of organizational interventions to promote a positive and effective culture and climate. Less is known about common intervention components across studies and service settings. The current systematic review reviewed 9223 citations and identified 31 studies, across six youth-service settings, measuring changes over time in organizational culture and climate following implementation of an organizational or workforce support intervention. Results highlight the p...
Source: Administration and Policy in Mental Health and Mental Health Services Research - April 17, 2020 Category: Psychiatry Source Type: research

Using Complier Average Causal Effect Estimation to Examine Student Outcomes of the PAX Good Behavior Game When Integrated with the PATHS Curriculum
This study reports intent-to-treat (ITT) and CACE findings from a randomized controlled trial (RCT) testing the impacts of the universal PAX Good Behavior Game (PAX GBG) integrated with Promoting A lternative Thinking Strategies (i.e., PATHS to PAX) and PAX GBG only compared to a control. This study used ratings by 318 K-5 teachers of 1526 at-risk children who, at baseline, were rated as displaying the top 33rd percentile of aggressive-disruptive behavior. Leveraging a prior study on these da ta (Berg et al. in Admin Policy Ment Health Ment Health Serv Res 44:558–571,https://doi.org/10.1007/s10488-016-0738-1, 2017), CA...
Source: Administration and Policy in Mental Health and Mental Health Services Research - April 14, 2020 Category: Psychiatry Source Type: research

Tracking Time and Resources Associated with Systems Change and the Adoption of Evidence-Based Programs: The “Hidden Costs” of School-Based Coaching
This study leveraged data from a 40-school randomized controlled trial to understand the cost of coaching to support implementation of evidence-based programs (EBPs) through a multi-tiered system of supports for behavior (MTSS-B) model. Coach activity log data were utilized to generate the annual average, per school, costs of coaching of $8198. The cost of school personnel time for coaching was estimated to be $3028. Data on coach-rated administrator buy-in, school MTSS-B engagement, and implementation infrastructure and capacity were also collected and found to be associated with coaching activities. Notably, coaches did ...
Source: Administration and Policy in Mental Health and Mental Health Services Research - April 12, 2020 Category: Psychiatry Source Type: research

Designing the Future of Children ’s Mental Health Services
AbstractAdvancements in evidence-based psychosocial interventions, digital technologies, and implementation strategies (i.e., health services research products) for youth mental health services have yet to yield significant improvement in public health outcomes. Achieving such impact will require that these research products are easy to use, useful, and contextually appropriate. This paper describes how human-centered design (HCD), an approach that aligns product development with the needs of the people and settings that use those products, can be leveraged to improve youth mental health services. We articulate how HCD can...
Source: Administration and Policy in Mental Health and Mental Health Services Research - April 5, 2020 Category: Psychiatry Source Type: research

“I achieved being an adult”: A Qualitative Exploration of Voluntary Transitions from Permanent Supportive Housing
This study examined how individuals voluntarily leaving permanent supportive housing (PSH) through a Moving On initiative experienced the transition from PSH services to mainstream housing. Participants (N  = 25) were purposively sampled from five supportive housing agencies in a Moving On initiative. A modified grounded theory approach was used to analyze semi-structured, post-move interviews. Participants described the transition from PSH as a process that involved gaining freedom from negative aspects of the PSH environment and a stagnation in services, adjusting to a new environment and the loss of familiar support...
Source: Administration and Policy in Mental Health and Mental Health Services Research - March 29, 2020 Category: Psychiatry Source Type: research

A System of Systems of Mental Health in Cities, Digging Deep into the Origins of Complexity
AbstractMental health in urban environments is often treated from a healthcare provision perspective. Research in recent decades showed that mental illness in cities is a result of dysfunctional coordination between different city systems and structures. Given the nature of the city as a system of systems, this work builds through a participatory method, a general system dynamic model of factors that affect mental health in urban and regional environments. Through this method, we investigated the challenges of the application of such methodology to identify essential factors, feedback loops, and dependencies between system...
Source: Administration and Policy in Mental Health and Mental Health Services Research - March 27, 2020 Category: Psychiatry Source Type: research

Race and Equity in Statewide Implementation Programs: An Application of the Policy Ecology of Implementation Framework
AbstractAlthough the literature is growing regarding large-scale, system-wide implementation programs, the broader political and social contexts, including race and ethnicity, are frequently ignored. Using the Policy Ecology of Implementation framework (Raghavan et al., Implement Sci 3:26, 2008), Minnesota ’s CEMIG is examined to investigate the role of social and political contexts in the implementation process and the barriers they create. Data from 22 interview transcripts from DHS administrators, agency grant managers, university educators, advocacy group representatives, and mental health board members, along with m...
Source: Administration and Policy in Mental Health and Mental Health Services Research - March 18, 2020 Category: Psychiatry Source Type: research

Delegating Clozapine Monitoring to Advanced Nurse Practitioners: An Exploratory, Randomized Study to Assess the Effect on Prescription and Its Safety
AbstractTo test whether: (1) psychiatrists will prescribe clozapine more often if they can delegate the monitoring tasks to an advanced nurse practitioner (ANP), (2) clozapine monitoring by an ANP is at least as safe as monitoring by a psychiatrist. Patients from 23 Dutch outpatient teams were assessed for an indication for clozapine. ANPs affiliated to these teams were randomized to Condition A: clozapine monitoring by an ANP, or Condition B: monitoring by the psychiatrist. The safety of monitoring was evaluated by determining whether the weekly neutrophil measurements were performed. Staff and patients were blinded regar...
Source: Administration and Policy in Mental Health and Mental Health Services Research - March 17, 2020 Category: Psychiatry Source Type: research

Turning Back to Treatment: The Effect of Attendance and Symptom Outcomes on Subsequent Service Use
This study explored whether post-treatment symptom severity moderated the association between session attendance during an initial treatment episode and subsequent mental health service use. Data on attendance, symptom severity, and service use were gathered from an effectiveness trial testing a modular treatment for youth anxiety, depression, disruptive behavior, and traumatic stress. Multilevel logistic regression analyses showed a significant interaction between attendance and post-treatment symptom severity on subsequent service use, such that attendance significantly predicted subsequent service use when post-treatmen...
Source: Administration and Policy in Mental Health and Mental Health Services Research - March 12, 2020 Category: Psychiatry Source Type: research

“Built on Respect and Good Honest Communication:” A Study of Partnerships Between Mental Health Providers and Community Corrections
This study utilized interviews about professionals’ perceptions of their work experiences, analyzed open-endedly to identify major themes. Mental health providers’ themes included appreciation and process of collaboration, individual characteristics and roles, characteristics of collaboration, elements of interprofessional relationships, and involvement of the courts. Community supervision professionals discussed issues pertaining to appreciation and process of collaboration, individual characteristics and roles, when conflict occurs, and the lack of basic knowledge about other professionals. Second, these partnerships...
Source: Administration and Policy in Mental Health and Mental Health Services Research - March 10, 2020 Category: Psychiatry Source Type: research

The Importance of Context: Linking Veteran Outpatients Screening Positive for Housing Instability with Responsive Interventions
This study aims to explore the relationship between the context of screening for housing instability and Veterans ’ access to services, with the goal of ensuring effective processes to address housing instability among Veterans. This study used administrative data from 100,022 Veterans’ electronic medical records and qualitative data collected during in-depth interviews with 22 health care providers and six Homeless Program staff. A mixed effects logistic regression assessed the relationship between Veterans’ screening experiences and connection with services; qualitative data were analyzed using a grounded theory ap...
Source: Administration and Policy in Mental Health and Mental Health Services Research - March 10, 2020 Category: Psychiatry Source Type: research