Aligning dissemination and implementation science with health policies to improve children’s mental health.

Abstract

The prevalence of mental health problems among children (ages 0 -21) in the United States remains unacceptably high and, post-COVID-19, is expected to increase dramatically. Decades of psychological knowledge about effective treatments should inform the delivery of better services. Dissemination and implementation (D&I) science has been heralded as a solution to the persistent problem of poor quality services and has, to some extent, improved our understanding of the contexts of delivery systems that implement effective practices. However, there are few studies demonstrating clear, population-level impacts of psychological interventions on children. Momentum is growing among communities, cities, states, and some federal agencies to build "health in all policies" to address broad familial, social, and economic factors known to affect children's healthy development and mental health. These health policy initiatives offer a rare opportunity to repurpose D&I science, shifting it from a primary focus on evidence-based practice implementation, to a focus on policy development and implementation to support child and family health and well-being. This shift is critical as states develop policy responses to address the health and mental health impacts of the COVID-19 pandemic on already-vulnerable families. We provide a typology for building research on D&I and children's mental health policy. Public Significance StatementThe prevalence of mental health problems among children remains unacceptably high. Communities, cities, states, and some federal agencies are building "health in all policies" initiatives that address broad familial, social, and economic factors known to affect children's healthy development. These initiatives offer a rare opportunity to repurpose D&I science and shift it from a primary focus on evidence-based practice implementation, to a focus on policy dissemination and implementation.

Impact of the COVID-19 Pandemic on Child and Adolescent Mental Health Policy and Practice Implementation

“…Apart from guidance provided by the Center for Medicaid Studies [ 28 ] and the Substance Abuse and Mental Health Services Administration [ 29 ], SMHAs responded to the crisis “on the fly” as described by one participant, relying on questionable data collected from emergency response services and anecdotal reports of increased need for all forms of mental and behavioral health services. This was in contrast to the development and implementation of pre-pandemic policies that utilized research evidence obtained from intermediary organizations, expert consultants, conferences, and professional networks [ 10 , 20 ].…”

“…A few studies reported increased use of telehealth for mental health services delivery [ 8 , 9 ], but none have examined how successful these efforts have been or what policies have been developed to facilitate implementation. Such information is essential to learn how to prepare for and respond to future public health emergencies [ 10 ].…”

Strategies for implementing music‐based interventions for people with dementia in long‐term care facilities: A systematic review

“…Recent frameworks and typologies show ways in which implementation science could strengthen and be strengthened by policy-centric perspectives. 57,58 As with other nonpharmacological interventions, the provision of music-based interventions in nursing homes has not received sufficient support from policies. For example, in the United States, although music therapy is reimbursable by Medicare, payment is not directly paid in the provision of music therapy and the provision is discretionary.…”

Translating Medicaid policy into practice: policy implementation strategies from three US states’ experiences enhancing substance use disorder treatment

“…Since the 1970s, public administration researchers have enhanced our understanding of how government agencies implement policies and measure implementation success or failure [3]. The emergent area of "health policy implementation science" is employing interdisciplinary approaches to examine variables and strategies that facilitate the adoption of evidence-based practices (EBPs) into clinical and community settings to align policy with practice [4]. This subfield is necessary to advance our understanding of how outer context factors mediate or moderate implementation efforts, including how organizations/agencies (comprised of policymakers, providers and other intermediaries) influence policy implementation processes and the impact of policy on population health outcomes [3,5].…”