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Economic Grand Rounds
Published Online: 2 November 2015

The Perfect Storm: Collision of the Business of Mental Health and the Implementation of Evidence-Based Practices

Rebecca E. Stewart, Ph.D., Danielle R. Adams, B.A., David S. Mandell, Sc.D., Trevor R. Hadley, Ph.D., Arthur C. Evans, Ph.D., Ronnie Rubin, Ph.D., Joan Erney, J.D., Geoffrey Neimark, M.D., Matthew O. Hurford, M.D., and Rinad S. Beidas, Ph.D.Authors Info & Affiliations
Publication: Psychiatric Services
Volume 67, Number 2
https://doi.org/10.1176/appi.ps.201500392
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Abstract

Financing has been hypothesized to be an important driver of the implementation of evidence-based practices (EBPs), yet there has been little systematic investigation of financing as a factor in EBP implementation. This column presents findings from a qualitative study of the effects of financial factors on the implementation of EBPs in a large urban publicly funded mental health system. Interviews with 33 agency leaders and 16 policy makers identified financial distress in community mental health agencies, leading to concerns about complex and expensive implementation of EBPs. Stakeholders agreed that the cost of EBP implementation should be shared between the agencies and the system; however, the stakeholders did not agree on how EBPs should be financed.

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Information & Authors

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Cover: Print table, by Frank Lloyd Wright (maker: William E. Nemmers), 1902–1903. White oak. Purchase, Emily Crane Chadbourne Bequest, 1972, the Metropolitan Museum of Art, New York City. Image copyright © The Metropolitan Museum of Art. Image source: Art Resource, New York City.

Psychiatric Services
Volume 67 • Number 2 • February 01, 2016
Pages: 159 - 161
PubMed: 26522680

History

Published online: 2 November 2015
Published in print: February 01, 2016

Authors

Details

Rebecca E. Stewart, Ph.D.
Dr. Stewart, Ms. Adams, Dr. Mandell, Dr. Hadley, Dr. Evans, Dr. Hurford, and Dr. Beidas are with the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania (e-mail: [email protected]). Dr. Evans is also with the Philadelphia Department of Behavioral Health and Intellectual disAbility Services. Dr. Hurford is also with the Community Care Behavioral Health Organization, Pittsburgh. Dr. Rubin, Ms. Erney, and Dr. Neimark are with Community Behavioral Health, Philadelphia. Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.
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Danielle R. Adams, B.A.
Dr. Stewart, Ms. Adams, Dr. Mandell, Dr. Hadley, Dr. Evans, Dr. Hurford, and Dr. Beidas are with the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania (e-mail: [email protected]). Dr. Evans is also with the Philadelphia Department of Behavioral Health and Intellectual disAbility Services. Dr. Hurford is also with the Community Care Behavioral Health Organization, Pittsburgh. Dr. Rubin, Ms. Erney, and Dr. Neimark are with Community Behavioral Health, Philadelphia. Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.
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David S. Mandell, Sc.D.
Dr. Stewart, Ms. Adams, Dr. Mandell, Dr. Hadley, Dr. Evans, Dr. Hurford, and Dr. Beidas are with the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania (e-mail: [email protected]). Dr. Evans is also with the Philadelphia Department of Behavioral Health and Intellectual disAbility Services. Dr. Hurford is also with the Community Care Behavioral Health Organization, Pittsburgh. Dr. Rubin, Ms. Erney, and Dr. Neimark are with Community Behavioral Health, Philadelphia. Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.
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Trevor R. Hadley, Ph.D.
Dr. Stewart, Ms. Adams, Dr. Mandell, Dr. Hadley, Dr. Evans, Dr. Hurford, and Dr. Beidas are with the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania (e-mail: [email protected]). Dr. Evans is also with the Philadelphia Department of Behavioral Health and Intellectual disAbility Services. Dr. Hurford is also with the Community Care Behavioral Health Organization, Pittsburgh. Dr. Rubin, Ms. Erney, and Dr. Neimark are with Community Behavioral Health, Philadelphia. Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.
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Arthur C. Evans, Ph.D.
Dr. Stewart, Ms. Adams, Dr. Mandell, Dr. Hadley, Dr. Evans, Dr. Hurford, and Dr. Beidas are with the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania (e-mail: [email protected]). Dr. Evans is also with the Philadelphia Department of Behavioral Health and Intellectual disAbility Services. Dr. Hurford is also with the Community Care Behavioral Health Organization, Pittsburgh. Dr. Rubin, Ms. Erney, and Dr. Neimark are with Community Behavioral Health, Philadelphia. Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.
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Ronnie Rubin, Ph.D.
Dr. Stewart, Ms. Adams, Dr. Mandell, Dr. Hadley, Dr. Evans, Dr. Hurford, and Dr. Beidas are with the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania (e-mail: [email protected]). Dr. Evans is also with the Philadelphia Department of Behavioral Health and Intellectual disAbility Services. Dr. Hurford is also with the Community Care Behavioral Health Organization, Pittsburgh. Dr. Rubin, Ms. Erney, and Dr. Neimark are with Community Behavioral Health, Philadelphia. Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.
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Joan Erney, J.D.
Dr. Stewart, Ms. Adams, Dr. Mandell, Dr. Hadley, Dr. Evans, Dr. Hurford, and Dr. Beidas are with the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania (e-mail: [email protected]). Dr. Evans is also with the Philadelphia Department of Behavioral Health and Intellectual disAbility Services. Dr. Hurford is also with the Community Care Behavioral Health Organization, Pittsburgh. Dr. Rubin, Ms. Erney, and Dr. Neimark are with Community Behavioral Health, Philadelphia. Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.
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Geoffrey Neimark, M.D.
Dr. Stewart, Ms. Adams, Dr. Mandell, Dr. Hadley, Dr. Evans, Dr. Hurford, and Dr. Beidas are with the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania (e-mail: [email protected]). Dr. Evans is also with the Philadelphia Department of Behavioral Health and Intellectual disAbility Services. Dr. Hurford is also with the Community Care Behavioral Health Organization, Pittsburgh. Dr. Rubin, Ms. Erney, and Dr. Neimark are with Community Behavioral Health, Philadelphia. Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.
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Matthew O. Hurford, M.D.
Dr. Stewart, Ms. Adams, Dr. Mandell, Dr. Hadley, Dr. Evans, Dr. Hurford, and Dr. Beidas are with the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania (e-mail: [email protected]). Dr. Evans is also with the Philadelphia Department of Behavioral Health and Intellectual disAbility Services. Dr. Hurford is also with the Community Care Behavioral Health Organization, Pittsburgh. Dr. Rubin, Ms. Erney, and Dr. Neimark are with Community Behavioral Health, Philadelphia. Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.
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Rinad S. Beidas, Ph.D.
Dr. Stewart, Ms. Adams, Dr. Mandell, Dr. Hadley, Dr. Evans, Dr. Hurford, and Dr. Beidas are with the Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania (e-mail: [email protected]). Dr. Evans is also with the Philadelphia Department of Behavioral Health and Intellectual disAbility Services. Dr. Hurford is also with the Community Care Behavioral Health Organization, Pittsburgh. Dr. Rubin, Ms. Erney, and Dr. Neimark are with Community Behavioral Health, Philadelphia. Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.
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Competing Interests

Dr. Neimark owns stock in Pfizer. Dr. Beidas receives royalties from Oxford University Press and has served as a consultant for Kinark Child and Family Services. The other authors report no financial relationships with commercial interests.

Funding Information

Funding for this project was supported by grants K23 MH099179 (to Dr. Beidas) and F32 MH103960 (to Dr. Stewart) from the National Institute of Mental Health.

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