What Really Matters in the Implementation of Evidence-based Practices in Community Mental Health? Insight and Recommendations from Experts, Providers, and Clients.

Perceptions of evidence-based practices (EBPs) and implementation are inherent drivers of implementation outcomes. Most studies on implementation perceptions have focused on direct service providers, but clients and EBP experts may offer additional meaningful information about implementing EBPs in community settings. EBP providers (n = 21), EBP experts (n = 12), and clients who received EBPs (n = 6) participated in focus groups to ascertain their perceptions of and experiences with EBP implementation, as part of a program evaluation. Thematic analysis indicated that provider and expert perceptions of EBP implementation in community settings converged around themes of implementation supports and training and client outcomes, along with several subthemes. Client perceptions centered on themes regarding the importance of their personal experiences, their impressions of EBPs, as well as their recommendation for increasing public awareness and use of EBPs. Findings suggest that the perspectives of EBP providers and experts are closely aligned, focusing on system-level, individual-level, and training issues that impact EBP implementation within a public mental health system. The themes that were important to clients were primarily related to their experiences as recipients of an EBP which produced insightful recommendations for promoting EBPs in the community.

Generating Actionable Evidence for School-Based Mental Health Service Delivery: Public-Academic Partnership Based Evaluations.

Public-academic partnership-based program evaluations can generate actionable evidence for policymaking, program design and implementation in improving school-based mental health service delivery. The University of Pennsylvania Center for Mental Health and public behavioral health care agencies in Philadelphia in the United States have evaluated Philadelphia's school mental health programs reimbursable through Medicaid billing since 2008. The variety of evaluations include (1) examining acute mental health service use of children receiving school-based mental health care and Medicaid expenditure, (2) examining children's externalizing and internalizing behaviors to measure school mental health providers' performance, and (3) examining effects of different types of school mental health programs on children's behavioral health functioning, school outcomes, and other out-of-school service use. This paper reports key findings of these evaluations, discusses how programs have been refined based on evaluation results, and shares lessons learned for successful public-academic partnership-based evaluations to promote use of actionable evidence.

Family and legal indicators of child adjustment to divorce among families with young children.

This research used structural equation modeling to examine relations among family dynamics, attorney involvement, and the adjustment of young children (0-6 years) at the time of parental separation. The article presents baseline data (N = 102 nonresidential fathers and N = 110 primary caretaking mothers) from a larger longitudinal study. Results showed that the effects of parental conflict on child outcomes were mediated by paternal involvement, the parent-child relationship, and attorney involvement. A scale assessing parental gatekeeping yielded two significant factors: Spouse's Influence on Parenting and Positive View of Spouse. Paternal involvement was related to children's adaptive behavior, whereas negative changes in parent-child relationships predicted behavior problems. Mothers who experienced greater psychological symptomatology were less likely to utilize an attorney, which in turn predicted greater internalizing problems in their children.