Scaling Up Evidence-Based Practices for Children and Families in New York State: Toward Evidence-based Policies on Implementation for State Mental Health Systems

Abstract

Dissemination of innovations is widely considered the sine qua non for system improvement. At least two dozen states are rolling-out evidence-based mental health practices targeted at children and families using trainings, consultations, webinars, and learning collaboratives to improve quality and outcomes. In New York State (NYS) a group of researchers, policy-makers, providers and family support specialists have worked in partnership since 2002 to redesign and evaluate the children’s mental health system. Five system strategies driven by empirically-based practices and organized within a state-supported infrastructure have been used in the child and family service system with over 2,000 providers: (a) business practices; (b) use of health information technologies in quality improvement; (c) specific clinical interventions targeted at common childhood disorders; (d) parent activation; and (e) quality indicator development. The NYS system has provided a laboratory for naturalistic experiments. We describe these initiatives, key findings and challenges, lessons learned for scaling, and implications for creating evidence-based implementation policies in state systems.

The Consistencies and Vagaries of the Washington State Inventory of Evidence-Based Practice: The Definition of “Evidence-Based” in a Policy Context

“…Evidence-based practice is endorsed by federal policy, foundation and philanthropic initiatives and is being mandated, incentivized or otherwise encouraged by an increasing number of states (Hoagwood et al 2014). Division 12 (Clinical Psychology) of the American Psychological Association first published reviews of empirically-supported treatments (ESTs) for psychiatric disorders in the mid-1990's (Chambless et al 1996).…”

“…The growing discipline of implementation science includes extensive discussion of the systemic elements needed for successful uptake of evidence-based practice, including readiness assessments, training and quality assurance strategies, sustainment planning and various modes of outcome measurement (Aarons et al 2011;Hoagwood et al 2014;Proctor et al 2009;Schoenwald et al 2012;Fixsen et al 2005). Less emphasis is given to discussing the relative merits of different rating criteria for defining which programs are well-supported.…”

Who Supports the Successful Implementation and Sustainability of Evidence-Based Practices? Defining and Understanding the Roles of Intermediary and Purveyor Organizations

“…I n recent years, there has been a proliferation of evidence-based practices (EBPs) in mental health and a continued growth in the field of implementation science, but limited to no research on purveyor and/or intermediary organizations has been conducted (Fixsen, Blase, Metz, & Van Dyke, 2013;Hoagwood et al, 2014). At the federal, state, and local levels, many stakeholders are focusing on developing, disseminating, and implementing practices that are scientifically informed to ensure better quality and outcomes for the populations they serve .…”

Facilitators and Barriers of Implementing a Measurement Feedback System in Public Youth Mental Health

“…As implemented in a variety of healthcare settings, including mental health , MFSs have been found to have a promising impact on outcomes and retention in treatment (Douglas et al 2011;Duncan and Pozehl 2000;Goebel 1997;Tabenkin et al 1995). Despite these known benefits, routine use of MFSs in children's mental health services is rare (Hoagwood et al 2014;Lyon and Lewis 2015) and their use in systems of care remains largely unexplored. Therefore, more research is needed on implementing MFSs in large-scale systems of care.…”