Study 5: Accessibility of Mental Health Services: Identifying and Measuring Organizational Factors Associated with Reducing Mental Health Disparities

The Center's underlying approach was guided by its theory of implementation factors that influence access and utilization of services and supports within systems of care. This theory included an assumption that to be effective, a system of care for children with serious emotional disturbances and their families must be responsive to the community context, including being culturally competent. Systems of care must both acknowledge and incorporate the importance of culture at all levels of functioning to provide optimal access to mental health services for racially/ethnically diverse populations. This study focused on the identification of field-based systemic organizational practices that offered examples of how the concept of cultural competence can be operationalized and implemented within systems of care to improve access to services and supports and reduce mental health disparities.

The overall purposes of this study were to (1) identify and; (2) describe measurable systemic organizational factors associated with increased accessibility for ethnically/racially diverse children with serious emotional/behavioral disorders and their families to an array of quality mental health services/supports; and (3) develop a cultural competence organizational assessment protocol, based on information collected from the field, existing research literature, opinions of experts, and published cultural competence standards and measures.

The particular focus of this study was to identify which systemic organizational practices, rather than clinical practices, operated within systems of care that demonstrated improved access to mental health services. The research questions for this study focused on children and families from four diverse groups (Asian/Pacific Islanders, Latinos/Hispanics, Native Americans and African Americans):

  • Are there observable and measurable field-based organizational practices within systems of care that are associated with improved access and utilization of mental health services by ethnically/racially diverse children with serious emotional disturbances and their families?
  • How do these observable field-based systemic organizational practices compare and contrast with best practices identified in the literature?
  • How are field-based and literature-based practices organized and rated for importance by a national stakeholder group that includes researchers, practitioners and family members?
  • Can the measurement of these factors distinguish between systems of care that have varying systemic organizational capacities for cultural competence?

The study investigated eight communities; it used a four-phased mixed qualitative and quantitative research design, including concept mapping and other methods of stakeholder input, data collection, and data analysis. This design conceptualized and implemented methods interactively across phases, each with expected results and products that contributed to the next phase.

Top of Page