Collaboration between mental health and vocational rehabilitation programs for transition-age youth vocational outcomes.

Transition-age youth (TAY) with serious mental health conditions (SMHC) face many challenges as they establish adult employment. Mental health (MH) programs and vocational rehabilitation (VR) programs each provide key supports toward this goal, but collaboration is required. OBJECTIVE: The present study's objective was to assess the extent of collaboration between VR programs and MH programs that serve this age group and to identify interorganizational factors associated with collaboration levels. METHOD: Participants were 100 key informants from VR, and child mental health (CMH), transition-age youth MH (TAYMH), and adult mental health (AMH) programs in communities that received federal funding to improve services for TAY with or at risk of SMHC. Participants completed web surveys that queried four interorganizational factors and employed a modified social network analysis methodology to assess collaboration levels. RESULTS: The interorganizational factor, depth of knowledge, had a strong and consistent association with collaboration levels. There was little difference in MH-VR collaboration levels between MH programs serving different age groups. However, VR programs and CMH programs had both lower depth of knowledge of each other and lower collaboration levels, compared to TAY and AMH programs. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Collaboration between VR and MH programs is instrumental to making sure that TAY with SMHC receive appropriate career development and employment services. Increasing the depth of knowledge that programs have about each other may enhance collaboration and appears particularly needed between VR and CMH programs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Crossing the Age Divide: Cross-Age Collaboration Between Programs Serving Transition-Age Youth.

Programs that serve transition-age youth with serious mental health conditions typically reside in either the child or the adult system. Good service provision calls for interactions among these programs. The objective of this research was to discover programmatic characteristics that facilitate or impede collaboration with programs serving dissimilar age groups, among programs that serve transition-age youth. To examine this "cross-age collaboration," this research used social network analysis methods to generate homophily and heterophily scores in three communities that had received federal grants to improve services for this population. Heterophily scores (i.e., a measure of cross-age collaboration) in programs serving only transition-age youth were significantly higher than the heterophily scores of programs that served only adults or only children. Few other program markers or malleable program factors predicted heterophily. Programs that specialize in serving transition-age youth are a good resource for gaining knowledge of how to bridge adult and child programs.

Community and state systems change associated with the healthy transitions initiative.

People engaged in efforts to improve services to emerging adults with serious mental health challenges have reached the conclusion that service change at the program or agency level is not sustainable without related changes at the systems or policy level. This article focuses on one set of efforts to create intentional system change at both the community and state levels. These changes were pursued by states and communities that received grants under the federally funded Healthy Transitions Initiative (HTI), with the aim of creating more effective services for emerging adults with serious mental health conditions. The article reviews the development of a measure to assess systems change efforts at the state and community levels and describes the findings that emerged when the measure was used to assess the change that occurred in the HTI sites over a period of approximately three and a half years.

Social network analysis of child and adult interorganizational connections.

OBJECTIVE: Because most programs serve either children and their families or adults, a critical component of service and treatment continuity in mental health and related services for individuals transitioning into adulthood (ages 14-25) is coordination across programs on either side of the adult age divide. METHODS: This study was conducted in Clark County, Washington, a community that had received a Partnership for Youth Transition grant from the Federal Center for Mental Health Services. Social Network Analysis methodology was used to describe the strength and direction of each organization's relationship to other organizations in the transition network. Interviews were conducted before grant implementation (n=103) and again four years later (n=99). RESULTS: The findings of the study revealed significant changes in the nature of relationships between organizations over time. While the overall density of the transition service network remained stable, specific ways of connecting did change. Some activities became more decentralized while others became more inclusive as evidenced by the increase in size of the largest K-core. This was particularly true for the activity of "receiving referrals." These changes reflected more direct contact between child and adult serving organizations. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: The two separate child and adult systems identified at baseline appeared more integrated by the end of the grant period. Having greater connectivity among all organizations regardless of ages served should benefit youth and young adults of transition age. This study provides further evidence that Social Network Analysis is a useful method for measuring change in service system integration over time.

Defining "necessary" services and supports: why systems of care must take direction from service-level processes.

A crucial element of the system of care definition is the specification of its purpose, namely, "to ensure access to and availability of necessary services and supports." This article discusses the structures and processes that must be in place so that systems of care can acquire and respond to high-quality information about what services and supports are truly necessary.

Research on transition to adulthood: building the evidence base to inform services and supports for youth and young adults with serious mental health disorders.

Since the mid-1990s, research has established a clear picture of the poor real-life outcomes achieved by transition-age youth and young adults who have been diagnosed with a serious mental health disorder. The purpose of this article is to: (1) introduce the reader to the other eight articles in this special issue on Transition to Adulthood Research; (2) illustrate how each is contributing to the research base available to more fully understand these challenges as well as guide the creation of developmentally appropriate and effective services and supports for youth and young adults and their families; and (3) suggest future directions for continuing to advance this field of research and program implementation to improve outcomes though practice and policy improvements.

Grounded theory and backward mapping: exploring the implementation context for wraparound.

Within children's mental health, there is an increasing demand for wider implementation of wraparound and other interventions that can provide comprehensive, individualized, family-driven care. Unfortunately, implementation has proven difficult because these approaches do not necessarily flourish within traditionally organized agencies and systems. This has highlighted the need for information about how mental health agencies and systems must evolve if they are to provide a hospitable implementation environment for these interventions. A first step in developing this information is through research that advances conceptual and theoretical understanding of the impact of contextual factors on implementation. At the same time, there is an immediate need for practical information to guide decision making and policy development in settings where implementation is being undertaken. This article describes a study of wraparound implementation that used a combination of qualitative strategies to meet both of these needs simultaneously. It is argued that these strategies are particularly well suited to the study of emerging practices that reflect-and help drive-transformation in mental health systems.

The African American Wellness Village in Portland, Ore.

More than 80% of African Americans in Oregon reside in the Portland metropolitan area; African Americans comprise 1.7% of the state's population. Although relatively small, the African American population in the state experiences substantial health disparities. The African American Health Coalition, Inc was developed to implement initiatives that would reduce these disparities and to promote increased communication and trust between the African American community and local institutions and organizations. One of these initiatives is an annual Wellness Week featuring an African American Wellness Village. The Wellness Village uses a model of cultural sensitivity to provide access to free health screenings, links between health care organizations and African American community members, and health education and information. The African American Health Coalition, Inc obtained a Racial and Ethnic Approaches to Community Health (REACH) 2010 grant to sustain this programming. The Wellness Village is supported by five major sponsors; annual attendance has ranged from 700 to 900 participants. The African American Health Coalition's evaluation of the event indicates that more than 50% of respondents identify the Wellness Village as the only place that they receive health screenings. Participants with access to screenings elsewhere report that a culturally sensitive environment that inspires trust is the reason they prefer the screenings offered at the Wellness Village. Culturally sensitive health fairs such as the Wellness Village may play an important role in bringing preventive health screenings to African American communities. Collaboration between black and white health care providers is critical in this effort. Partnerships must be built at multiple levels, including institutions to provide financial resources and in-kind donations, community members to assist with outreach and recruitment, and health care professionals to conduct screenings and services.

Wellness Within REACH: mind, body, and soul: a no-cost physical activity program for African Americans in Portland, Oregon, to combat cardiovascular disease.

Wellness Within REACH (WWR) aims to saturate the heart of the African-American community in Portland, Oregon, with culturally appropriate physical activity opportunities. The purpose of this project is to develop and implement no-cost physical activities to increase the number of African Americans leading active lifestyles, while shifting the community norm. Certified African-American instructors conduct exercise classes at community venues. A pre- and post-questionnaire is administered to participants attending exercise classes each quarter, to assess frequency of attendance, lifestyle changes, and attitudes over time. To date, more than 700 individuals have participated in the WWR classes. Participants (58%) in a recent sample (N=75) reported exercising more now than in the 6 months prior to joining the program. Community members are bringing members of their social networks to try classes otherwise not available or affordable to them. By centering classes around the culture of this specific community, WWR has become a "movement" of healthy, active living.