Diffusion of Innovation: State Factors that Influence the Spread of School Based Mental Health Policies and Programs

A number of trends in adolescent health have increased the importance of mental health services. In 1999, there were about 21 percent of children and adolescents between the ages of 9 and 17 that had a diagnosable mental disorder, causing some functional impairment (US DHHS, 1999). School based mental health (SBMH) has been reported to increase access to services (Armbruster, Gerstein & Fallon, 1997, Weist & Albus, 2004). Seventy-five percent of children who have mental health problems do not receive care (Kataoka, Zhang & Wells, 2002). Of those that receive care, 75 percent receive care from within the school (Burns, et al, 1995). ""SBMH services offer promise in the effort to bridge the gap between service need and service utilization by providing access to underserved populations""(Armbruster & Lichtman, 1999, p.493). However, states vary in their ability to provide services to children in school based mental health settings. This study conducted interviews with participants in nine states that are establishing connections between schools and mental health systems. Information gathered from these states was then used to seek opinions and perceptions of other State Mental Health Directors for Children. The model for this study combined the works of Rogers (1995), Berry and Berry (1990) and Mintrom and Vergari (1998) to examine the factors that influence the diffusion of innovation. The qualitative piece of this research identifies prominent necessities in an innovative SBMH program, factors that facilitate SBMH programs and barriers to innovative SBMH programs. The questionnaires that were sent to each of the state Directors also provided data on perceptions of SBMH innovations. The multivariate analyses included twenty programmatic measures and two per capita spending measures of readiness for innovation in SBMH. The models that were estimated revealed that state resources matter. The professionalism measure also showed a positive association. Bivariate analyses between measures of innovation and Census Divisions revealed some positive associations. The political variables did not show any associations with measures of readiness for innovation in the models

Diffusion of Innovation: State Factors that Influence the Spread of School Based Mental Health Policies and Programs

A number of trends in adolescent health have increased the importance of mental health services. In 1999, there were about 21 percent of children and adolescents between the ages of 9 and 17 that had a diagnosable mental disorder, causing some functional impairment (US DHHS, 1999). School based mental health (SBMH) has been reported to increase access to services (Armbruster, Gerstein & Fallon, 1997, Weist & Albus, 2004). Seventy-five percent of children who have mental health problems do not receive care (Kataoka, Zhang & Wells, 2002). Of those that receive care, 75 percent receive care from within the school (Burns, et al, 1995). ""SBMH services offer promise in the effort to bridge the gap between service need and service utilization by providing access to underserved populations""(Armbruster & Lichtman, 1999, p.493). However, states vary in their ability to provide services to children in school based mental health settings. This study conducted interviews with participants in nine states that are establishing connections between schools and mental health systems. Information gathered from these states was then used to seek opinions and perceptions of other State Mental Health Directors for Children. The model for this study combined the works of Rogers (1995), Berry and Berry (1990) and Mintrom and Vergari (1998) to examine the factors that influence the diffusion of innovation. The qualitative piece of this research identifies prominent necessities in an innovative SBMH program, factors that facilitate SBMH programs and barriers to innovative SBMH programs. The questionnaires that were sent to each of the state Directors also provided data on perceptions of SBMH innovations. The multivariate analyses included twenty programmatic measures and two per capita spending measures of readiness for innovation in SBMH. The models that were estimated revealed that state resources matter. The professionalism measure also showed a positive association. Bivariate analyses between measures of innovation and Census Divisions revealed some positive associations. The political variables did not show any associations with measures of readiness for innovation in the models