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The Role of Infrastructure in the Transformation of Child–Adolescent Mental Health Systems

  • Wayne StelkEmail author
  • Elaine Slaton
Original Paper

Abstract

There is a widespread recognition that the mental health system is not effective in meeting the needs of the children, adolescents, and families who seek its services. In response to this recognition, researchers and policy makers are developing and implementing strategies to transform mental health systems. This paper suggests that transformational interventions should not proceed faster than our understanding of the complexities of a mental health system. In a complex system, all component parts are interactive and interdependent. Problems with one component cannot be solved in isolation from other components. The inter-relationships between problems create inter-dependencies; and changes in the balance of these inter-dependencies can cause dramatic shifts in policy priorities, such as when managers of mental health systems respond to budget reductions in a recessionary economy. This paper examines the problem domains in mental health systems that are affected by complexity dynamics, and proposes that a well-built infrastructure is a necessary foundation for structural change in a child–adolescent mental health system. The concept of metastructure is proposed to account for the rule-based processes that govern the actions of agents within a system.

Keywords

Mental health Child–adolescent Complexity Infrastructure Evidence-based practices Participatory decision-making Program evaluation Feedback systems 

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Innovation Management Resources, LLCMarbleheadUSA
  2. 2.Training and EvaluationNational Federation of Families and Children’s Mental HealthRockvilleUSA
  3. 3.MarbleheadUSA

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