The Legacy of Evidence-Based Mental Health Interventions: What Gets Sustained and How

Concerns over the quality of mental health services for children in the United States have led to the creation, dissemination and implementation of evidence-based mental health interventions. However, the impacts of these interventions on the systems in which they are implemented (i.e., practice settings) are unclear. Conceptualizing interventions ecologically as system events (Hawe, Shiell, & Riley, 2009) may provide a more complete understanding of intended and unintended intervention effects. The purpose of this qualitative pilot study, therefore, was to explore the impacts of evidence-based mental health interventions from the perspectives of community-based practitioners. A number of (unintended) effects on clients, staff members and the broader organization emerged. Further, the process by which they were achieved was one of mutual adaptation, in which interventions were modified to improve fit with the implementation system, and the organization changed by interacting with interventions over time. Findings suggest that conceptualizing intervention impacts more broadly will result in improved understanding of intervention-system interactions over time. Implications for re-conceptualizing intervention sustainability and conducting contextualized intervention research are discussed

The Effectiveness of Cultural Adjustment and Trauma Services (CATS): generating practice-based evidence on a comprehensive, school-based mental health intervention for immigrant youth

A collaborative study of Cultural Adjustment and Trauma Services (CATS), a comprehensive, school-based mental health program for traumatized immigrant children and adolescents, was conducted to generate practice-based evidence on the service delivery model across two school districts. Program effectiveness was assessed by testing whether client functioning and PTSD symptoms improved as a result of 7 separate service elements. An array of clinical services including CBT, supportive therapy, and coordinating services were provided to all students, and an evidence-based intervention for trauma, TF-CBT, was implemented with a subset of students. Greater quantities of CBT and supportive therapy increased functioning, while greater quantities of coordinating services decreased symptoms of PTSD. TF-CBT services were associated with both improved functioning and PTSD symptoms, although TF-CBT was implemented with fidelity to the overall comprehensive service model rather than the structured intervention model. Results suggest the comprehensive school-based model was effective, though different service components affected different student outcomes. Implications of these findings for immigrant mental health interventions and implementing structured evidence-based practices into community mental health programs are discussed. Suggestions are made for future research on existing mental health practices with immigrants

Immigrant Youth in U.S. Schools: Opportunities for Prevention

Many of the acculturative struggles of immigrant youth unfold within the school environment. This article advocates for restructuring educational programming and involving immigrant parents to promote the mental health and positive adjustment of immigrant children. Adapted from the source document

The Effectiveness of Cultural Adjustment and Trauma Services (CATS): Generating Practice- Based Evidence on a Comprehensive, School-Based Mental Health Intervention for Immigrant Youth

A collaborative study of Cultural Adjustment and Trauma Services (CATS), a comprehensive, school-based mental health program for traumatized immigrant children and adolescents, was conducted to generate practice-based evidence on the service delivery model across two school districts. Program effectiveness was assessed by testing whether client functioning and PTSD symptoms improved as a result of 7 separate service elements. An array of clinical services including CBT, supportive therapy, and coordinating services were provided to all students, and an evidence-based intervention for trauma, TF-CBT, was implemented with a subset of students. Greater quantities of CBT and supportive therapy increased functioning, while greater quantities of coordinating services decreased symptoms of PTSD. TF-CBT services were associated with both improved functioning and PTSD symptoms, although TF-CBT was implemented with fidelity to the overall comprehensive service model rather than the structured intervention model. Results suggest the comprehensive school-based model was effective, though different service components affected different student outcomes. Implications of these findings for immigrant mental health interventions and implementing structured evidence-based practices into community mental health programs are discussed. Suggestions are made for future research on existing mental health practices with immigrants

Rural Community Stress: Understanding Risk and Building Resilience

This archival publication may not reflect current scientific knowledge or recommendations. Current information available from the University of Minnesota Extension: https://www.extension.umn.edu.Beehler, Sarah; Corcoran, Frederique; McConkey, Monica; Jasken, Jeri; McIntyre, Alison. (2021). Rural Community Stress: Understanding Risk and Building Resilience. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/218195

Grounded Theory of Barriers and Facilitators to Mandated Implementation of Mental Health Care in the Primary Care Setting

Objective. There is limited theory regarding the real-world implementation of mental health care in the primary care setting: a type of organizational coordination intervention. The purpose of this study was to develop a theory to conceptualize the potential causes of barriers and facilitators to how local sites responded to this mandated intervention to achieve coordinated mental health care. Methods. Data from 65 primary care and mental health staff interviews across 16 sites were analyzed to identify how coordination was perceived one year after an organizational mandate to provide integrated mental health care in the primary care setting. Results. Standardized referral procedures and communication practices between primary care and mental health were influenced by the organizational factors of resources, training, and work design, as well as provider-experienced organizational boundaries between primary care and mental health, time pressures, and staff participation. Organizational factors and provider experiences were in turn influenced by leadership. Conclusions. Our emergent theory describes how leadership, organizational factors, and provider experiences affect the implementation of a mandated mental health coordination intervention. This framework provides a nuanced understanding of the potential barriers and facilitators to implementing interventions designed to improve coordination between professional groups