One of the most critical issues in mental health services research is the gap between what is known about effective treatment and what is provided to consumers in routine care. Concerted efforts are required to advance implementation science and produce skilled implementation researchers. This paper seeks to advance implementation science in mental health services by over viewing the emergence of implementation as an issue for research, by addressing key issues of language and conceptualization, by presenting a heuristic skeleton model for the study of implementation processes, and by identifying the implications for research and training in this emerging field.

SummaryThis two-level study of child welfare and juvenile justice case management teams addresses construct, measurement, and composition issues that plague multilevel research on organizational culture and climate. Very few empirical studies have examined both culture and climate simultaneously, and none have provided evidence that culture and climate are distinct or similar constructs. Confirmatory factor analysis (CFA), within-group consistency analysis (r wg ), between-group differences (ICC and eta-squared), and hierarchical linear models (HLM) analysis provide evidence that climate and culture are separate constructs that vary by organizational unit, and are related to work attitudes, perceptions, and behavior. Findings link teamlevel culture and climate to individual-level job satisfaction and commitment, perceptions of service quality, and turnover.

The organizational social context in which mental health services are provided is believed to affect the adoption and implementation of evidence-based practices (EBPs) as well as the quality and outcomes of the services. A fully developed science of implementation effectiveness requires conceptual models that include organizational social context and tools for assessing social context that have been tested in a broad cross-section of mental health systems. This paper describes the role of organizational social context in services and implementation research and evaluates a comprehensive contextual measure, labeled Organizational Social Context (OSC), designed to assess the key latent constructs of culture, climate and work attitudes. The psychometric properties of the OSC measure were assessed in a nationwide study of 1,154 clinicians in 100 mental health clinics with a second-order confirmatory factor analysis of clinician responses, estimates of scale reliabilities, and indices of within-clinic agreement and between-clinic differences among clinicians. Finally, the paper illustrates the use of nationwide norms in describing the OSC profiles of individual mental health clinics and examines the cross-level association of organizational-level culture and climate with clinician-level work attitudes.