Alliances to Disseminate Addiction Prevention and Treatment (ADAPT): Assessing the Exchange of Ideas in Alliances Between Juvenile Justice and Community Mental Health Centers

Background/Hypothesis: In the US, over half of youth involved in the juvenile justice system meet criteria for substance use disorder (SUD). Further, SUD is a consistent predictor of recidivism. Thus, significant improvements are needed to assure that justice-involved youth who meet criteria for SUD are screened and referred to care, especially in rural settings. ADAPT, an ongoing, statewide project, employs a learning health system (LHS) model to implement evidence-based practices (EBPs) to develop and improve alliances between juvenile justice (JJ) and community mental health centers (CMHCs). We assessed collaboration, “alliance,” between these systems. Methods: The LHS alliance was assessed with self-report surveys distributed to personnel at 8 county sites. These included the cultural exchange inventory (CEI) measure to assess the process of exchanges in knowledge (beliefs about the process of implementing EBPs), and outcomes of those exchanges (beliefs about the outcome of interagency collaboration), to assess the alliance between JJ and CMHCs. Results: Pre-implementation surveys indicated a significant difference between CMHC respondents (CEI Output M=3.55, SD=1.53) compared to JJ respondents (M=2.89, SD=1.57) about the outcomes of the exchange of ideas [t(190)=2.13, p=0.03]. Both CMHC (CEI Process M=3.93, SD=1.45) and JJ participants (CEI Process M=3.84, SD=1.96) reported similar beliefs about the process of idea exchange t(119)=0.27, p=0.78). Further, participants from low rurality counties (i.e., more urban) reported less favorably to beliefs about the outcomes of collaboration (CEI Output M=3.16, SD=1.62) compared to medium rurality county participants [M=3.76, SD=1.39; t(120)=2.03, p=0.04]. Thus, we find a difference in perception of collaboration both between systems and between counties of varying rurality. Conclusion/Potential Impact: These findings help capture the current barriers to collaboration that exist between JJ and CMHCs before implementation of the LHS framework. Understanding these barriers between systems is essential to better cultivate interagency alliances to improve care for justice-involved youth with SUDs.

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Organizational structure, climate, and collaboration between juvenile justice and community mental health centers: implications for evidence-based practice implementation for adolescent substance use disorder treatment

BMC Health Services Research ◽

10.1186/s12913-020-05777-3 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

A. Johnson-Kwochka ◽

A. Dir ◽

M. P. Salyers ◽

M. C. Aalsma

Keyword(s):

Mental Health ◽

Substance Use ◽

Community Mental Health ◽

Juvenile Justice ◽

Health Centers ◽

Evidence Based ◽

Community Mental Health Centers ◽

Evidence Based Practices ◽

Disorder Treatment ◽

Mental Health Centers

Abstract Background Substance use disorders are prevalent among youth involved with the criminal justice system, however, evidence-based substance use disorder treatment is often unavailable to this population. The goal of this study was to identify barriers to effective implementation of evidence-based practices among juvenile justice and community mental health organizations through the lens of an adopter-based innovation model. Methods In this mixed-methods study, qualitative interviews were conducted with n = 15 juvenile justice staff and n = 14 community mental health staff from two counties implementing substance use services for justice involved youth. In addition, n = 28 juvenile justice staff and n = 85 community mental health center staff also completed quantitative measures of organizational effectiveness including the implementation leadership scale (ILS), organizational readiness for change (ORIC), and the implementation climate scale (ICS). Results Organizationally, staff from community mental health centers reported more “red tape” and formalized procedures around daily processes, while many juvenile justice staff reported a high degree of autonomy. Community mental health respondents also reported broad concern about their capacity for providing new interventions. Staff across the two different organizations expressed support for evidence-based practices, agreed with the importance of treating substance use disorders in this population, and were enthusiastic about implementing the interventions. Conclusions While both community mental health and juvenile justice staff express commitment to implementing evidence-based practices, systems-level changes are needed to increase capacity for providing evidence-based services.

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