Infrastructure Change Is Not Enough: An Evaluation of SAMHSA’s Mental Health Transformation State Incentive Grants

Abstract

Federal investments should take into account evidence that infrastructure changes alone do not necessarily contribute to better consumer outcomes, support operationally defined infrastructure improvements, require that service improvements accompany infrastructure changes, and provide sufficient resources to oversee grantee behaviors. In addition, future evaluation should support evaluation best practices.

Workforce Development and Mental Health Transformation: A State Perspective

“…Of the nine states that received MHT-TIG grants, 39 % of all reported transformation activity involved workforce training (Leff et al 2014). This state and local priority contrasts with the consistently low priority given to workforce issues by policymakers at the federal level (Hoge et al 2013), as evidenced in this instance by the absence of a workforce goal in either the President's New Freedom Commission report (DHHS 2003) or as a federal requirement to address workforce development in the MHT-SIG grant.…”

“…It is important to note that SAMHSA did not clearly articulate the meaning of ''transformation'' or create a logic model for the concept (Leff et al 2014). It did emphasize that changes should address the infrastructure supporting behavioral health service delivery rather than directly funding services.…”

“…The authors of the SAMHSA-funded nationwide MHT-SIG evaluation lamented the absence of a detailed federal logic model for the MHT-SIG initiative and a timely and rigorous evaluation across all states (Leff et al 2014;Manila Consulting Group and HSRI 2011). The lack of evaluation funding for behavioral health workforce interventions has historically hampered the development of a strong evidence base on workforce practices (Hoge et al 2009).…”