Research Agenda

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

The Center’s underlying approach is guided by its theory of implementation factors that influence access and utilization of services and supports within systems of care. This theory includes 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 focuses on the identification of field-based systemic organizational practices that offer 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 are 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 will be to identify which systemic organizational practices, rather than clinical practices, operate within systems of care that demonstrate improved access to mental health services. The research questions for this study focus 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 will investigate eight communities; it will use 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 conceptualizes and implements methods interactively across phases, each with expected results and products that contribute to the next phase. Data collection will represent point in time, retrospective and opinion-based information . An inductive approach will guide the study during the first research phase while subsequent phases will use deductive approaches. The study will also contribute to cross-study data collection through Study 1.

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