Using Implementation Research to Redesign State Systems for Child and Family Behavioral Health: The Business Case for Clinical and Preventive Care

Dissemination-Implementation science, the newest genre for multidisciplinary studies, has emerged over the past decade replete with conceptual models and studies of barriers. This approach has demonstrated limited usefulness for state systems undergoing massive changes consequent to healthcare restructuring that target accountability, costs, metrics and outcomes associated with state behavioral services. Services for children and adolescents are largely overlooked in the rush by health and mental health authorities to accommodate this massive restructuring.

Ironically, the redesign of prevention and intervention services is the most direct way to address the most trenchant and persistent problems facing state systems of care. The gap must be closed between evidence-based care and its instantiation in real world services; driving change via metrics, monitoring and feedback; and addressing critical organizational and leadership issues.

A body of research is emerging that identifies system level, organizational level, provider level, and individual level (child and family) interventions that can dramatically improve outcomes for children and adolescents. Approaches include strategic collaborative interventions, business and leadership support, quality metrics, and data driven monitoring and feedback systems. This presentation will provide examples of each and recommend a research agenda to accelerate practical progress.