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

Abstract

This study examines implementation facilitators and barriers of a statewide roll-out of a measurement feedback system (MFS) in a youth public mental health system. 76 % of all state care coordinators (N = 47) completed interviews, which were coded via content analysis until saturation. Facilitators (e.g., recognition of the MFS's clinical utility) and barriers (e.g., MFS's reliability and validity) emerged paralleling the Exploration, Adoption/Preparation, Implementation, and Sustainment framework outlined by Aarons et al. (Adm Policy Mental Health Mental Health Serv Res, 38:4-23, 2011). Sustainment efforts may leverage innovation fit, individual adopter, and system related facilitators.

Project Synergy: co‐designing technology‐enabled solutions for Australian mental health services reform

“…Recently, a review of the youth mental health workforce found that health professionals consider the assessment and management of risk and safety issues to be critically important and expressed concerns regarding the ability of technology to accurately assess, interpret or communicate such issues back to consumers . In situations where doubts about the appropriateness of technology have been expressed by health professionals (eg, regarding the clinical applicability and utility of technology), this influences their engagement with the technology . Consumer factors such as age, personal attitudes and prior use of technology also influence health professionals’ perceptions regarding use of technology in service .…”

Advancing Implementation Research and Practice in Behavioral Health Systems

“…The aforementioned article by Walker and colleagues (this issue) addresses this phase most explicitly by showing how Geographic Information Systems mapping can be useful in exploring high priority community targets for implementation investments. Kotte and colleagues (this issue) discuss the importance of engaging partners that span inner and outer contexts, and provide a useful example of how a longstanding partnership between the State of Hawaii and the University of Hawaii led to the exploration of more effective ways implementing a measurement feedback system (Bickman, 2008) in child and adolescent mental health services. Saldana and colleagues (this issue) discuss a partnership in which the New York City child welfare system engaged treatment developers to develop and pilot an innovative approach to improving the interactions between supervisors, caseworkers, and caregivers.…”

“…Beidas and colleagues (this issue) provide insights from system leaders, treatment developers, and organizational leaders about the factors that motivate and facilitate the adoption of EBPs; a number of stakeholders reported that they adopted EBPs because it was consistent with their mission to provide the best and most effective care. Kotte and colleagues (this issue) prepared for scaling up a measurement feedback system by piloting it with a smaller sample of care coordinators and conducting focus groups to assess barriers and facilitators to implementation. This helped them to optimize the measurement feedback system in preparation for adopting it statewide.…”

“…The three stakeholder groups converged on the importance of inner (e.g., agency competing demands) and outer context factors (e.g., funding) as barriers and facilitators to implementation. Kotte and colleagues (this issue) and Ross and colleagues (this issue) examine facilitators and barriers to the implementation of a measurement feedback system in the state of Hawaii (Kotte) and Veterans Affairs Canada (Ross). Both of these articles identify characteristics of the innovation as an important factor in successful implementation (Aarons et al, 2011; Rogers, 2003).…”

“…The EPIS framework provides a manageable scope for the special issue, grounds the work in the extant literature, and provides a common language to use across studies. Frameworks were also used effectively within the context of individual studies to provide insight into various implementation phases (e.g., Kotte et al, this issue) and provide conceptual framing for the use of multi-level implementation strategies (Powell et al, this issue). Implementation theories and frameworks serve multiple purposes (see Nilsen, 2015); however, they have been underutilized in implementation research generally (Colquhoun et al, 2013; Davies, Walker, & Grimshaw, 2010) and in behavioral health (Powell, Proctor, & Glass, 2014).…”