Research > STEPS > Clinic Systems Project

Clinic Systems Project

A program of the Network on Youth Mental Health, funded by the John D. And Catherine T. MacArthur Foundation

Network director: Dr. John R. Weisz

Project Description

The Clinic Systems Project is a descriptive study of a sample of large community mental health clinics serving a representative sample of counties in the U.S. About 200 clinics are participating. In each clinic, two primary measurement methods will be used to assess service system and service provider organization characteristics pertinent to the adoption and implementation of evidence-based practices. At the service system level, semi-structured interviews will be conducted with directors of the clinics to assess their perspectives on regulations, policies, governance structures within and across pertinent service sectors, and financing structures and mechanisms that influence child mental health treatment in their clinics. As a second approach, within each of the 276 clinic organizations, clinicians who treat children will complete a battery of validated measures. The measures are used to assess organizational constructs known to be associated with service quality and outcomes in other human services sectors (i.e., child welfare, substance abuse, health).

The data collected will enable us to characterize the performance of mental health clinics in organizational domains shown to influence service quality and outcomes and known to support innovation in other disciplines and industries. We will then examine the extent to which mental health clinic performance in these organizational domains varies as a function of system and financing variables. First, the System Project data will inform the development of system, financing, and provider organization criteria to be used in establishing minimum eligibility criteria for systems and clinics to participate future phases of the project. Second, the system and organization level data in conjunction with data derived from clinicians in the Clinic Treatment Project will be used to specify system, organizational and clinician-level interventions and supports that will be needed to facilitate effective larger-scale deployment of evidence-based procedures.

Project Goal

The Clinic Systems Project will examine components of mental health service systems that are expected to impact the adoption, implementation, and effectiveness of evidence-based practices in community clinics. These components include: (1) governance structures within and across service sectors (e.g., mental health, child welfare, juvenile justice, education, health) and the formal and informal linkages between these structures; (2) service financing structures and reimbursement mechanisms; and (3) service provider organizations (in this project, mental health clinics).