The Role of State Mental Health Authorities in Promoting Improved Client Outcomes through Evidence-Based Practice

University of Kansas School of Social Welfare, 1545 Lilac Lane, Lawrence, KS, USA.
Community Mental Health Journal (Impact Factor: 1.03). 07/2005; 41(3):347-63. DOI: 10.1007/s10597-005-5008-8
Source: PubMed


The role of state mental health authorities (SMHA) is critical to implementing and sustaining evidence-based practices. This paper describes the seven major tasks of SMHA's that comprise that role and provides examples from states which have been actively pursuing evidence-based practices.

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    • "ased practice model or intervention and provide scales for ascertaining the degree of adherence. It has been noted that such measures can be used to establish clear standards, monitor meaningful performance of programs over time, improve performance, and document the relationship between adherence to a model and outcomes (Bond et al. 2000; Rapp et al. 2005)."
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    ABSTRACT: To evaluate group supervision implementation fidelity in the Strengths Model of case management within one adult mental health service. A fidelity audit was undertaken to analyse data across three service settings-residential and community-during the initial three months, utilising instruments developed by Rapp and Goscha (The Strengths Model: Case management with people with psychiatric disabilities, vol 2. Oxford University Press, New York, 2006). Very high fidelity for group supervision was achieved for group interaction (74.8 %), client work (77 %) and by case managers (90 %). A standardised approach to group supervision process and documentation greatly supported fidelity in implementation. The Rapp and Goscha tools had utility as both learning aids and audit instruments.
    Community Mental Health Journal 06/2013; 49(3):331-337. DOI:10.1007/s10597-012-9546-6 · 1.03 Impact Factor
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    • "The NYOSMH EBP Project: Educational Model for Workforce Development The New York State Office of Mental Health (NYSOMH) responded to the call to implement EBPs more widely by launching a state level Evidence Based Practice Project. The Project sought to implement the six core practices for adults with severe mental illnesses by reforming its state mental health system, including multiple policy and funding changes (Carpinello et al. 2002; Rapp et al. 2005). One component of the project specifically addressed the need for a trained workforce to deliver these new empirically supported mental health interventions. "
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    ABSTRACT: Within the different arenas of social work practice, community based mental health is among the most advanced in terms of defining a set of evidence based practices (EBPs). Social workers play a major role in the delivery of community based mental health and are at the forefront of efforts to implement these practices through state and federal initiatives. One such initiative is The New York Office of Mental Health Evidence Based Project, which is designed to increase the knowledge and skills related to evidence-based practice among New York’s mental health human services workforce. The project had a social work component, which trained students in implementing EBP’s through specially designed curricula and field placements. The students participating in the project encountered numerous challenges in the field including lack of agency “buy-in” and infrastructure support; inadequate training and resources; poor supervision; and provider resistance. From the multilevel perspectives of educator, clinician and researcher, this paper addresses these challenges and makes recommendations to facilitate the implementation of EBPs.
    Clinical Social Work Journal 12/2011; 39(4). DOI:10.1007/s10615-010-0309-y · 0.27 Impact Factor
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    • "Inclusion of functioning as an outcome indicator has the potential to improve our evaluative frameworks for EBTs not only by improving the scientific method of judging our treatments, but also by potentially enhancing the relevance of resulting evidence summaries for mental health stakeholders in a number of ways (Chorpita 2001; Rapp et al. 2005). First, it is often not the symptoms, but the disruption Adm Policy Ment Health or interference that creates hardships for youth and results in identification and treatment seeking (Bird et al. 1990). "
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    ABSTRACT: We examined the effects of redefining standards of evidence for treatments targeting childhood mental health problems by expanding outcomes beyond symptom reduction to include functioning. Over 750 treatment protocols from 435 randomized controlled trials were rated based on empirical evidence. Nearly two-thirds (63.9%) demonstrated at least a minimum level of evidence for reducing symptoms; however, only 18.8% of treatments demonstrated evidence for reducing functional impairment. Of those treatments with empirical support for symptom reduction, the majority did not demonstrate empirical support for improvement in functioning because measures of functioning were not included in the studies in which these treatments were tested. However, even when measures of functioning were included, it was much more difficult for treatments to achieve improvement. Among treatments that achieved improvement in functioning, the most notable were Collaborative Problem Solving for disruptive behavior and Cognitive Behavioral Therapy plus Medication for traumatic stress because they demonstrated no support for symptom reduction but good support for improvement in functioning. Results are discussed within the context of evaluating the standards of evidence for treatments and the opportunity to move towards a multidimensional framework whose utility has the potential to exceed the sum of its parts.
    Administration and Policy in Mental Health and Mental Health Services Research 11/2011; 38(6):440-58. DOI:10.1007/s10488-010-0332-x · 3.44 Impact Factor
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