Capacity for Delivering Culturally Competent Mental Health Services in New Mexico: Results of a Statewide Agency Survey

Semansky, Rafael M.; Altschul, Deborah; Sommerfeld, David H.; Hough, Richard L.; Willging, Cathleen E.

doi:10.1007/s10488-009-0228-9

Cited by 8 publications

(13 citation statements)

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“…As part of a larger mixed-method study of the latest behavioral health reform in NM (Aarons et al 2011b; Semansky et al 2009, 2012; Willging et al 2009), we employed a qualitative research design supplemented with quantitative measures and analyses to identify and contextualize factors bearing on the work environments of SNIs serving low-income adults with serious mental illness, i.e., schizophrenia, major depression, and bi-polar disorder. We took advantage of the strengths of qualitative and quantitative research, with the goal of determining the extent to which results of the two methodological approaches converged.…”

Section: Methodsmentioning

confidence: 99%

“…Alcohol- and drug-induced death rates per capita rank first and second highest, respectively; the age-adjusted suicide rate ranks second (Xu et al 2010). Seventy-four provider organizations in NM were serving adults with serious mental illness within the public sector at the start of the recent reform (Semansky et al 2009). …”

Section: Methodsmentioning

confidence: 99%

“…We also incorporated organizational-level variables collected as part of the larger NM study to help control for differences in organizational context (Semansky et al 2009, 2012). We included the total number of licensed and unlicensed therapist FTEs (a natural log transformation was used in the analyses to minimize the influence of large values), the percentage of funding received from public/governmental funding sources, whether the SNI was operated as part of a community mental health center (yes = 1/no = 0), and whether the SNI was a for-profit entity (yes = 1/no = 0).…”

Section: Methodsmentioning

confidence: 99%

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The Effects of Behavioral Health Reform on Safety-Net Institutions: A Mixed-Method Assessment in a Rural State

Willging

Sommerfeld

Aarons

et al. 2013

Adm Policy Ment Health

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In July 2005, New Mexico initiated a major reform of publicly-funded behavioral healthcare to reduce cost and bureaucracy. We used a mixed-method approach to examine how this reform impacted the workplaces and employees of service agencies that care for low-income adults in rural and urban areas. Information technology problems and cumbersome processes to enroll patients, procure authorizations, and submit claims led to payment delays that affected the financial status of the agencies, their ability to deliver care, and employee morale. Rural employees experienced lower levels of job satisfaction and organizational commitment and higher levels of turnover intentions under the reform when compared to their urban counterparts.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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The Effects of Behavioral Health Reform on Safety-Net Institutions: A Mixed-Method Assessment in a Rural State

Willging

Sommerfeld

Aarons

et al. 2013

Adm Policy Ment Health

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“…The current study is part of a larger 5-year, mixed-methods assessment of the impact of system reform on access and quality of care for low-income adults with serious mental illness (Kano, Willging, & Rylko-Bauer, 2009; Hough, Willging, Altschul, & Adelsheim, 2010; Semansky, Altschul, Sommerfeld, Hough, & Willging, 2009; Willging et al, 2009; Willging & Semansky, 2010). The study took place in three rural counties and three counties with metropolitan areas, each chosen for geographic and ethnic diversity.…”

Section: Methodsmentioning

confidence: 99%

The soft underbelly of system change: The role of leadership and organizational climate in turnover during statewide behavioral health reform.

Aarons¹,

Sommerfeld²,

Willging³

2011

Psychological Services

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This study examined leadership, organizational climate, staff turnover intentions, and voluntary turnover during a large-scale statewide behavioral health system reform. The initial data collection occurred nine months after initiation of the reform with a follow-up round of data collected 18 months later. A self-administered structured assessment was completed by 190 participants (administrators, support staff, providers) employed by 14 agencies. Key variables included leadership, organizational climate, turnover intentions, turnover, and reform-related financial stress ("low" versus "high") experienced by the agencies. Analyses revealed that positive leadership was related to a stronger empowering climate in both high and low stress agencies. However, the association between more positive leadership and lower demoralizing climate was evident only in high stress agencies. For both types of agencies empowering climate was negatively associated with turnover intentions, and demoralizing climate was associated with stronger turnover intentions. Turnover intentions were positively associated with voluntary turnover. Results suggest that strong leadership is particularly important in times of system and organizational change and may reduce poor climate associated with turnover intentions and turnover. Leadership and organizational context should be addressed to retain staff during these periods of systemic change.

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“…Critical gaps exist in literature on the uptake of CLAS standards in behavioral healthcare agencies and the effects of state reform on access to and quality of CCS. Only a small number of studies offer insight into the availability of language access services, organizational supports, and other forms of CCS at the agency level (Campbell & Alexander, 2002;Howard, 2003;Semansky, Altschul, Sommerfeld, Hough, & Willging, 2009;Vandervort & Melkus, 2003).…”

Section: Introductionmentioning

confidence: 99%

Culturally Competent Services Within a Statewide Behavioral Healthcare Transformation: A Mixed‐method Assessment

Semansky¹,

Goodkind²,

Sommerfeld

et al. 2013

Journal Community Psychology

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In 2005, New Mexico created a single health plan to administer all publicly-funded behavioral health services. Our mixed-method study combined surveys, document review, and ethnography to examine this reform’s influence on culturally competent services (CCS). Participants were executives, providers, and support staff of behavioral healthcare agencies. Key variables included language access services and organizational supports, i.e., training, self-assessments of CCS, and maintenance of client-level data. Survey and document review suggested minimal effects on statewide capacity for CCS during the first three years of the reform. Ethnographic research helped explain these findings: (1) state government, the managed behavioral health plan and agencies failed to champion CCS; and (2) increased administrative requirements minimized time and financial resources for CCS. There was also insufficient appreciation among providers for CCS. Although agencies made progress in addressing language assistance services, availability and quality remained limited.

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Capacity for Delivering Culturally Competent Mental Health Services in New Mexico: Results of a Statewide Agency Survey

Cited by 8 publications

References 0 publications

The Effects of Behavioral Health Reform on Safety-Net Institutions: A Mixed-Method Assessment in a Rural State

The Effects of Behavioral Health Reform on Safety-Net Institutions: A Mixed-Method Assessment in a Rural State

The soft underbelly of system change: The role of leadership and organizational climate in turnover during statewide behavioral health reform.

Culturally Competent Services Within a Statewide Behavioral Healthcare Transformation: A Mixed‐method Assessment

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