Designing the Future of Children’s Mental Health Services

Lyon, Aaron R.; Dopp, Alex R.; Brewer, Stephanie K.; Kientz, Julie A.; Munson, Sean A.

doi:10.1007/s10488-020-01038-x

Cited by 59 publications

(43 citation statements)

References 130 publications

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“…1 ), but scholars increasingly warn that implementation research often does not represent typical practice [ 60 ]. Rather than developing and testing highly complex, multi-component implementation strategies to maximize between-group effect sizes, we can pursue a more pragmatic approach that prioritizes lean implementation, efficient use of scarce resources, and usability by providers and provider organizations [ 61 ]. Stakeholder involvement and consideration of financing throughout the research process is critical to avoid the development of implementation strategies that are too complex, and therefore too expensive, to fund in practice.…”

Section: Discussionmentioning

confidence: 99%

Translating economic evaluations into financing strategies for implementing evidence-based practices

et al. 2021

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Background Implementation researchers are increasingly using economic evaluation to explore the benefits produced by implementing evidence-based practices (EBPs) in healthcare settings. However, the findings of typical economic evaluations (e.g., based on clinical trials) are rarely sufficient to inform decisions about how health service organizations and policymakers should finance investments in EBPs. This paper describes how economic evaluations can be translated into policy and practice through complementary research on financing strategies that support EBP implementation and sustainment. Main body We provide an overview of EBP implementation financing, which outlines key financing and health service delivery system stakeholders and their points of decision-making. We then illustrate how economic evaluations have informed decisions about EBP implementation and sustainment with three case examples: (1) use of Pay-for-Success financing to implement multisystemic therapy in underserved areas of Colorado, USA, based in part on the strength of evidence from economic evaluations; (2) an alternative payment model to sustain evidence-based oncology care, developed by the US Centers for Medicare and Medicaid Services through simulations of economic impact; and (3) use of a recently developed fiscal mapping process to collaboratively match financing strategies and needs during a pragmatic clinical trial for a newly adapted family support intervention for opioid use disorder. Conclusions EBP financing strategies can help overcome cost-related barriers to implementing and sustaining EBPs by translating economic evaluation results into policy and practice. We present a research agenda to advance understanding of financing strategies in five key areas raised by our case examples: (1) maximize the relevance of economic evaluations for real-world EBP implementation; (2) study ongoing changes in financing systems as part of economic evaluations; (3) identify the conditions under which a given financing strategy is most beneficial; (4) explore the use and impacts of financing strategies across pre-implementation, active implementation, and sustainment phases; and (5) advance research efforts through strong partnerships with stakeholder groups while attending to issues of power imbalance and transparency. Attention to these research areas will develop a robust body of scholarship around EBP financing strategies and, ultimately, enable greater public health impacts of EBPs.

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Section: Discussionmentioning

confidence: 99%

Translating economic evaluations into financing strategies for implementing evidence-based practices

et al. 2021

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“…Additionally, a future direction of research that may be useful would be widening the search to compare the construct of caregiver satisfaction in other countries to the construct in the United States. In addition, there is significant potential to integrate the new research approaches being used in the field of user-experience (UX) or human-centered design (HCD) to improve the design and delivery of youth MH services; examples include new evidence-based practice databases designed for ease of use by clinicians (e.g., MAP and MATCH; [ 26 ] and [ 86 ], or digital apps—tailored not just for quick sale but designed according to the needs of parents and children with mental health problems [ 58 ]. Using the HCD or user-experience lens to further refine caregiver satisfaction with services might be an important step.…”

Section: Limitationsmentioning

confidence: 99%

Revisiting caregiver satisfaction with children’s mental health services in the United States

Seibel

Peth-Pierce

2021

Int J Ment Health Syst

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Nearly four decades ago, Unclaimed Children documented the gaps in the United States between mental health programs and caregivers’ perspectives about those services for their children. This absence of attention to parent or caregiver perspectives, including their satisfaction with these services, was a key finding of the report, which detailed system failure in caring for youth with mental health needs. Since then, the focus on caregiver satisfaction with children’s mental health services has been largely overlooked in research, and when examined has been mostly included as an indicator of the feasibility of program implementation. In striking contrast, overall healthcare system reforms have highlighted the importance of improving consumer’s direct experience of care. However, caregiver satisfaction remains largely disconnected to these overall health system reforms, even as reforms focus increasingly on value-based, coordinated and integrated care. In this paper, we review literature from 2010 to 2020, revisit the measurement of caregiver satisfaction, identify how and when it is being measured, and delineate a research agenda to both realign it with health system improvements, refine its focus on expectancies and appropriateness, and root it more firmly in the principles of user experience (UX) and human-centered design (HCD).

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“…The current adaptation effort and resulting clinical trial will pull on human-centred design [27][28][29] to develop a strategic intervention model, Summer STRIPES, that overcomes known implementation barriers in schools. If the resulting Summer STRIPES model is effective, we would expect to see positive changes in the following outcomes: GPA, class attendance and ADHD symptoms.…”

Section: Adaptation and Implementation Of Existing Interventionsmentioning

confidence: 99%

Study protocol of a randomised trial of Summer STRIPES: a peer-delivered high school preparatory intervention for students with ADHD

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IntroductionHigh schoolers with attention-deficit/hyperactivity disorder (ADHD) experience substantial impairments, particularly in the school setting. However, very few high school students with ADHD receive evidence-based interventions for their difficulties. We aim to improve access to care by adapting evidence-based psychosocial intervention components to a low-resource and novel school-based intervention model, Summer STRIPES (Students Taking Responsibility and Initiative through Peer Enhanced Support). Summer STRIPES is a brief peer-delivered summer orientation to high school with continued peer-delivered sessions during ninth grade.Methods and analysisParticipants will be 72 rising ninth grade students with ADHD who are randomised to receive either Summer STRIPES or school services as usual. Summer STRIPES will be delivered by 12 peer interventionists in a school setting. Outcomes will be measured at baseline, start of ninth grade, mid-ninth grade and end-of-ninth grade. At each assessment, self, parent and teacher measures will be obtained. We will test the effect of Summer STRIPES (compared with school services as usual) on ADHD symptoms and key mechanisms (intrinsic motivation, extrinsic motivation, executive functions) as well as key academic outcomes during the ninth-grade year (Grade Point Average (GPA), class attendance).Ethics and disseminationFindings will contribute to our understanding of how to improve access and utilisation of care for adolescents with ADHD. The protocol is approved by the institutional review board at Seattle Children’s Research Institute. The study results will be disseminated through publications in peer-reviewed journals and presentations at scientific conferences.Trials registration numberNCT04571320; pre-results.

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Designing the Future of Children’s Mental Health Services

Cited by 59 publications

References 130 publications

Translating economic evaluations into financing strategies for implementing evidence-based practices

Translating economic evaluations into financing strategies for implementing evidence-based practices

Revisiting caregiver satisfaction with children’s mental health services in the United States

Study protocol of a randomised trial of Summer STRIPES: a peer-delivered high school preparatory intervention for students with ADHD

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