Evidence map›Paper›PMID 38720309›Full record

ArticleBMC health services research2024

Facilitators of and barriers to County Behavioral Health System Transformation and Innovation: an interview study.

Xin Zhao, Rachel Varisco, Judith Borghouts, Elizabeth V Eikey, David Safani, Dana B Mukamel, Stephen M Schueller, Dara H Sorkin

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Article in BMC health services research, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Xin ZhaoDepartment of Psychiatry and Behavioral Sciences, University of Washington, Seattle, USA. alisa.zhao@seattlechildrens.org.
Rachel VariscoDepartment of Medicine, University of California, Irvine, USA.
Judith BorghoutsDepartment of Medicine, University of California, Irvine, USA.
Elizabeth V EikeyHerbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, USA.
David SafaniDepartment of Psychiatry and Human Behavior, University of California, Irvine, USA.
Dana B MukamelDepartment of Medicine, University of California, Irvine, USA.
Stephen M SchuellerDepartment of Psychological Science, University of California, Irvine, USA.
Dara H SorkinDepartment of Medicine, University of California, Irvine, USA.

Funding

University of California Health Participation in the National COVID Cohort Collaborative (N3C)UL1TR001414 · NCATS · UNIVERSITY OF CALIFORNIA-IRVINE · PI COOPER, DAN M, VILAIN, ERIC J. · 2015 to 2023
$35.1M
NCATS NIH HHS UL1 TR001414
6 · The paper itself

Abstract

backgroundInadequate and inequitable access to quality behavioral health services and high costs within the mental health systems are long-standing problems. System-level (e.g., fee-for-service payment model, lack of a universal payor) and individual factors (e.g., lack of knowledge of existing resources) contribute to difficulties in accessing resources and services. Patients are underserved in County behavioral health systems in the United States. Orange County's (California) Behavioral Health System Transformation project sought to improve access by addressing two parts of their system: developing a template for value-based contracts that promote payor-agnostic care (Part 1); developing a digital platform to support resource navigation (Part 2). Our aim was to evaluate facilitators of and barriers to each of these system changes.

methodsWe collected interview data from County or health care agency leaders, contracted partners, and community stakeholders. Themes were informed by the Consolidated Framework for Implementation Research.

resultsFive themes were identified related to behavioral health system transformation, including 1) aligning goals and values, 2) addressing fit, 3) fostering engagement and partnership, 4) being aware of implementation contexts, and 5) promoting communication. A lack of fit into incentive structures and changing state guidelines and priorities were barriers to contract development. Involving diverse communities to inform design and content facilitated the process of developing digital tools.

conclusionsThe study highlights the multifaceted factors that help facilitate or hinder behavioral health system transformation, such as the need for addressing systematic and process behaviors, leveraging the knowledge of leadership and community stakeholders, fostering collaboration, and adapting to implementation contexts.

Indexed as

Health Services AccessibilityMental Health ServicesCaliforniaHumansInterviews as TopicOrganizational InnovationQualitative ResearchBehavioral healthDigital resource navigationPayor-agnostic careSystem transformationValue-based payment

Identifiers

PMID38720309
PMCPMC11080221

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.