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Evaluating performance and change in mental health systems serving children and youth: An interorganizational network approach

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Abstract

Planning for the delivery of community mental health services has evolved from models of services within individual agencies to community-wide systems of care, but development of methodologies for assessing system performance has lagged behind. This article presents one approach to systemlevel assessment by viewing children’s mental health systems as an interorganizational network. Data are presented on two county-based child mental health systems in North Carolina that participated in the Robert Wood Johnson Foundation Mental Health Services Program for Youth. Site-specific data on client referrals, fund exchanges, and information flows were collected at two time points (1991 and 1993) to measure the cohesiveness and concentration of the service system using network k-core analyses. In addition, stakeholder ratings of service adequacy, quality, availability, coordination, and overall demonstration project goal attainment were obtained at both time periods. Findings indicate that the rural system was outperforming the urban system at the time of the first survey, but the urban system caught up over the study interval. There was high agreement between the network and stakeholder ratings of system performance at both time periods. The method of data collection and analysis used in this study provides tools that can be used in a variety of settings to assess service system growth and development.

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References

  1. Stroul BA, Friedman RM:A System of Care for Severely Emotionally Disturbed Children and Youth. Washington, DC: CASSP Technical Assistance Center, Georgetown University Child Development Center, 1986.

    Google Scholar 

  2. Friedman RM, Burns BJ, Behar L: Improving mental health and substance abuse services for adolescents.Administration and Policy in Mental Health 1992; 19:191–206.

    Article  Google Scholar 

  3. Knitzer J.Unclaimed Children. Washington, DC: Children's Defense Fund, 1982.

    Google Scholar 

  4. Burchard JD, Shaefer M: Improving accountability in a service delivery system in children's mental health.Clinical Psychology Review 1992; 12:867–882.

    Article  Google Scholar 

  5. Elliott RL: Applying quality improvement principles and techniques in public mental health systems.Hospital and Community Psychiatry 1994: 45: 439–444.

    PubMed  CAS  Google Scholar 

  6. Duchnowski A, Friedman R: Children’s mental health: Challenges for the nineties.Journal of Mental Health Administration 1990; 17: 3–12.

    Article  PubMed  CAS  Google Scholar 

  7. Malcolm JA: Plans to publish physician specific data.Pennsylvania Medicine 1992; 95: 18–19.

    PubMed  Google Scholar 

  8. Bickman L, Guthrie P, Foster EM, et al.Evaluating Managed Mental Health Services: The Fort Bragg Experiment. New York: Plenum, 1995.

    Google Scholar 

  9. Kutash K, Duchnowski AJ, Meyers J, et al.: Community and neighborhood based services for youth. In: Henggler SW, Santos A (Eds.):Innovative Models of Mental Health Treatment for “Difficult to Treat” Clinical Populations. Washington, DC: American Psychiatric Press, in press.

  10. Beachler M: The mental health services program for youth.Journal of Mental Health Administration 1990; 17: 115–121.

    Article  PubMed  CAS  Google Scholar 

  11. England MJ, Coles RF: Building systems of care for youths with serious mental illness.Hospital and Community Psychiatry 1992; 43: 630–633.

    PubMed  CAS  Google Scholar 

  12. Behar L.:North Carolina’s Mental Health Services Program for Youth: The Children's Initiative. Raleigh: North Caroli Division of Mental Health, Developmental Disabilities and Substance Abuse Services, 1992.

    Google Scholar 

  13. Burns BJ, Farmer EM, Morrissey JP, et al.: Effects of Case Management from the RWJ Children's Initiative in North Carolina. Paper presented at the annual meeting of the American Public Health Association, Washington, DC, November 1, 1994.

  14. Morrissey JP: An interorganizational network approach to evaluating children's mental health service systems. In: Bickman L, Rog D (Eds.):Evaluating Mental Health Services for Children. San Francisco: Jossey-Bass, 1992, pp. 85–98.

    Google Scholar 

  15. Morrissey J, Tausig M, Lindsey M: Community mental health delivery systems: A network perspective.American Behavioral Scientist 1985; 28: 704–720.

    Article  Google Scholar 

  16. Morrissey JP, Colloway M, Bartko WT, et al.: Local mental health authorities and service system change: Evidence from the Robert Wood Johnson Program on Chronic Mental Illness.Milbank Quarterly 1994; 72(1): 49–80.

    Article  PubMed  CAS  Google Scholar 

  17. Provan KG, Milward HB: Toward a theory of interorganizational network effectiveness: A comparative study of network structure, context, and outcomes in community mental health,Administrative Science Quarterly 1995; 40:1–33.

    Article  Google Scholar 

  18. Van de Ven AH, Ferry DL.Measuring and Assessing Organizations. New York: Wiley, 1976.

    Google Scholar 

  19. Bolland J, Wilson J: A Network Approach to the Assessment and Development of Comprehensive Coordination in the Elderly of Community-Based Services to the Elderly. University of Alabama, Institute for Social Science Research, unpublished.

  20. Alter C, Hage J:Organizations Working Together. Newbury Park, CA: Sage, 1993.

    Google Scholar 

  21. Aldrich H, Herker D: Boundary spanning roles and organization structure.Academy of Management Review 1977 2(2):217–230.

    Article  Google Scholar 

  22. Tushman M, Scanlan T: Boundary spanning individuals: Their role and information transfer and their antecedents.Academy of Management Journal 1981; 24: 289–305.

    Article  Google Scholar 

  23. Levine S, White PE: Exchange as a conceptual framework for the study of interorganizational relations.Administrative Science Quarterly 1961; 5:583–601.

    Article  Google Scholar 

  24. Calloway, M, Morrissey JP, Paulson RI: Accuracy and reliability of self-reported data in interorganizational networks.Social Networks 1993; 15:377–398.

    Article  Google Scholar 

  25. Marsden PV: Network data and measurement,Annual Review of Sociology 1990; 16:435–463.

    Article  Google Scholar 

  26. Kadushin C: The friends and supporters of psychotherapy: On social circles in urban life.American Sociological Review 1966; 31: 786–802.

    Article  PubMed  CAS  Google Scholar 

  27. Wasserman S, Faust K:Social Network Analysis: Methods and Applications. Cambridge: Cambridge University Press, 1994.

    Google Scholar 

  28. Borgatti S, Everett M, Freeman L:UCINET IV Version 1.0. Columbia, SC: Analytic Technologies, 1992.

    Google Scholar 

  29. Morrissey J, Ridgely S, Goldman H, et al.: Assessments of community mental health support systems: A key informant approach.Community Mental Health Journal 1994; 30: 565–579.

    Article  PubMed  CAS  Google Scholar 

  30. Dillman DA: Mail and other self-administered questionnaires. In: Rossi P, Wright J, Anderson A (Eds.):Handbook of Survey Research. Orlando, FL: Academic Press, 1983; pp. 359–377.

    Google Scholar 

  31. Galaskiewicz J, Shatin D: Leadership networking among neighborhood human service organizations.Administrative Science Quarterly 1981; 26:434–448.

    Article  Google Scholar 

  32. Goldman HH, Morrissey JP, Ridgely MS: Evaluation of the Robert Wood Johnson Foundation Program on Chronic Mental Illness.Milbank Quarterly 1994; 72: 37–47.

    Article  PubMed  CAS  Google Scholar 

  33. Lehman AF, Postrado LT, Roth D, et al.: Continuity of care in client outcomes in the Robert Wood Johnson Foundation Program on Chronic Mentall Illness.Milbank Quarterly 1994; 72:105–122.

    Article  PubMed  CAS  Google Scholar 

  34. Randolph, FL: Improving service systems through systems integration: The ACCESS program.American Rehabilitation, in press.

  35. Friedman R, Burns B: The evaluation of the Fort Bragg Demonstration Project: An alternative interpretation of the findings.Journal of Mental Health Administration 1996; 23: 128–136.

    Article  PubMed  CAS  Google Scholar 

  36. Bickman L: Reinterpreting the Fort Bragg evaluation findings: The message does not change.Journal of Mental Health Administration 1996; 23:137–145.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Cecil Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 725 Airport Rd., CB 7590, 27599-7590, Chapel Hill, NC

    Joseph P. Morrissey Ph.D. (Deputy Director), Matthew C. Johnsen Ph.D. (is a research assistant professor of psychiatry and a research fellow) & Michael O. Calloway Ph.D. (is a research assistant professor of psychiatry and a research fellow)

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  1. Joseph P. Morrissey Ph.D.
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  2. Matthew C. Johnsen Ph.D.
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  3. Michael O. Calloway Ph.D.
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Additional information

This article was prepared for presentation at the annual meeting of the American Public Health Association, Washington DC, in November 1994. The study was supported by a research grant from the National Institute of Mental Health (MH48053) to the North Carolina Division of Mental Health, Developmental Disabilities and Substance Abuse Services, Lenore Behar, Ph. D., Principal Investigator, and to the UNC-CH-Duke Program on Mental Health Services Research (MH51410), Joseph Morrissey, Ph.D., Principal Investigator.

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Morrissey, J.P., Johnsen, M.C. & Calloway, M.O. Evaluating performance and change in mental health systems serving children and youth: An interorganizational network approach. The Journal of Behavioral Health Services & Research 24, 4–22 (1997). https://doi.org/10.1007/BF02790476

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