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Published Online: 1 September 2014

A Literature Review of Learning Collaboratives in Mental Health Care: Used but Untested

Abstract

In recent years, the mental health field has made learning collaboratives the centerpiece of efforts to implement training in evidence-based practices. Lasting an average of 14 months, these interventions typically begin with in-person training for two days and can cost more than $100,000 per site. In this literature review of 16 peer-reviewed studies, the authors found minimal evidence of the effectiveness of LCs in mental health settings. They called for more rigorous research to evaluate the utility of these costly endeavors.

Abstract

Objective

Policy makers have increasingly turned to learning collaboratives (LCs) as a strategy for improving usual care through the dissemination of evidence-based practices. The purpose of this review was to characterize the state of the evidence for use of LCs in mental health care.

Methods

A systematic search of major academic databases for peer-reviewed articles on LCs in mental health care generated 421 unique articles across a range of disciplines; 28 mental health articles were selected for full-text review, and 20 articles representing 16 distinct studies met criteria for final inclusion. Articles were coded to identify the LC components reported, the focus of the research, and key findings.

Results

Most of the articles included assessments of provider- or patient-level variables at baseline and post-LC. Only one study included a comparison condition. LC targets ranged widely, from use of a depression screening tool to implementation of evidence-based treatments. Fourteen crosscutting LC components (for example, in-person learning sessions, phone meetings, data reporting, leadership involvement, and training in quality improvement methods) were identified. The LCs reviewed reported including, on average, seven components, most commonly in-person learning sessions, plan-do-study-act cycles, multidisciplinary quality improvement teams, and data collection for quality improvement.

Conclusions

LCs are being used widely in mental health care, although there is minimal evidence of their effectiveness and unclear reporting in regard to specific components. Rigorous observational and controlled research studies on the impact of LCs on targeted provider- and patient-level outcomes are greatly needed.

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Information

Published In

Go to Psychiatric Services
Go to Psychiatric Services

Cover: Girl on a Swing, by Maxfield Parrish. Drawing, oil on paper. The Metropolitan Museum of Art, bequest of Susan Vanderpoel Clark (67.155.3). Image © Metropolitan Museum of Art, New York. Image source: Art Resource. New York.

Psychiatric Services
Pages: 1088 - 1099
PubMed: 24882560

History

Published online: 1 September 2014
Published in print: September 2014

Authors

Details

Erum Nadeem, Ph.D.
Except for Ms. Hill, the authors are with the Department of Child and Adolescent Psychiatry, New York University, New York City (e-mail: [email protected]). Ms. Hill is with the School of General Studies, Columbia University, New York City.
S. Serene Olin, Ph.D.
Except for Ms. Hill, the authors are with the Department of Child and Adolescent Psychiatry, New York University, New York City (e-mail: [email protected]). Ms. Hill is with the School of General Studies, Columbia University, New York City.
Laura Campbell Hill, B.A.
Except for Ms. Hill, the authors are with the Department of Child and Adolescent Psychiatry, New York University, New York City (e-mail: [email protected]). Ms. Hill is with the School of General Studies, Columbia University, New York City.
Kimberly Eaton Hoagwood, Ph.D.
Except for Ms. Hill, the authors are with the Department of Child and Adolescent Psychiatry, New York University, New York City (e-mail: [email protected]). Ms. Hill is with the School of General Studies, Columbia University, New York City.
Sarah McCue Horwitz, Ph.D.
Except for Ms. Hill, the authors are with the Department of Child and Adolescent Psychiatry, New York University, New York City (e-mail: [email protected]). Ms. Hill is with the School of General Studies, Columbia University, New York City.

Funding Information

National Institute of Mental Health10.13039/100000025: P30 MH090322
: K01MH083694

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