Evaluation of Stepping Up Efforts to Improve MH Services and Justice Utilization

Information

  • Research Project
  • 10226069
  • ApplicationId
    10226069
  • Core Project Number
    R01MH118680
  • Full Project Number
    5R01MH118680-03
  • Serial Number
    118680
  • FOA Number
    PAR-18-007
  • Sub Project Id
  • Project Start Date
    9/3/2019 - 4 years ago
  • Project End Date
    7/31/2024 - a month from now
  • Program Officer Name
    AZRIN, SUSAN
  • Budget Start Date
    8/1/2021 - 2 years ago
  • Budget End Date
    7/31/2022 - a year ago
  • Fiscal Year
    2021
  • Support Year
    03
  • Suffix
  • Award Notice Date
    7/12/2021 - 2 years ago
Organizations

Evaluation of Stepping Up Efforts to Improve MH Services and Justice Utilization

The criminal justice system is the largest mental health provider in the U.S., and many jurisdictions are interested in reducing the use of the justice system for behavioral health issues. This 5-year R01 evaluates whether the Stepping Up Initiative overcomes barriers to implementation of EBPPs and the impact on key outcomes, such as increased number of clients receiving behavioral health services, increased use of EBPPs, and dedicated resources to advance the use of EBPPs. The study uses the CJ Evidence-Based Interagency Implementation Model (CJ-IIM) and draws on both quantitative and qualitative methods to understand which dissemination and implementation (D/I) change processes positively impact the expanded use of EBPPs in CJ. Now is an opportune moment, given that 455 counties have agreed to be part of Stepping Up. Mechanisms of interest are: 1) Use of and capacity for performance monitoring to guide system reform and development; 2) Use and functioning of interagency teams; 3) Having common goals and mission across agencies that support system-wide practices to advance the use of behavioral health services for CJS-involved individuals; and, 4) System integration (i.e., building an integrated system of care rather than adding one program or training). The study will survey 455 Stepping Up counties and 455 matched paired target counties (4 respondents per county including administrators of jail, probation, mental health services, and substance abuse treatment services for 3,640 respondents) at three waves: baseline, 18 months, and 36 months. Qualitative interviews will be conducted with 90 respondents at three waves to contextualize survey findings. Stepping Up and comparison counties will be compared on rates of change in engagement of target mechanisms (primary) and rates of change in implementation effectiveness outcomes (secondary) and describe reform activities occurring over a 36-month period. Specific aims are to compare Stepping Up and comparison counties on: 1) Target mechanisms including whether: (a) Stepping Up counties show a faster rate of improvement in hypothesized target mechanisms between Wave 1 and subsequent assessments (i.e., Waves 2 and 3); and (b) whether engagement of these mechanisms explains any differences found in key implementation outcomes; 2) Examine implementation outcomes such as the number of justice-involved clients served with EBPPs, number of behavioral health EBPPs available to justice-involved individuals, and resources for behavioral health EBPPs for justice-involved individuals; and, 3) Characterize implementation processes and critical incidents. We will use qualitative data to triangulate quantitative findings and enrich an understanding of how the target mechanisms work and lead to outcomes, and explore naturally occurring implementation strategies used in 910 counties that lead to outcomes. The study will advance D/I science by contributing to an understanding of 1) systemic decision-making processes in multiple systems with varied goals; and 2) how D/I efforts can target and drive policy and practice reforms.

IC Name
NATIONAL INSTITUTE OF MENTAL HEALTH
  • Activity
    R01
  • Administering IC
    MH
  • Application Type
    5
  • Direct Cost Amount
    554190
  • Indirect Cost Amount
    79176
  • Total Cost
    633366
  • Sub Project Total Cost
  • ARRA Funded
    False
  • CFDA Code
    242
  • Ed Inst. Type
    UNIVERSITY-WIDE
  • Funding ICs
    NIMH:633366\
  • Funding Mechanism
    Non-SBIR/STTR RPGs
  • Study Section
    DIRH
  • Study Section Name
    Dissemination and Implementation Research in Health Study Section
  • Organization Name
    GEORGE MASON UNIVERSITY
  • Organization Department
    NONE
  • Organization DUNS
    077817450
  • Organization City
    FAIRFAX
  • Organization State
    VA
  • Organization Country
    UNITED STATES
  • Organization Zip Code
    220304422
  • Organization District
    UNITED STATES