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Figueroa C, Castillo EG, Norquist G, Wells KB, Griffith K, Kadkhoda F, Jones F, Shorter P, Bromley E. A Window of Opportunity: Visions and Strategies for Behavioral Health Policy Innovation. Ethn Dis 2018; 28:407-416. [PMID: 30202194 DOI: 10.18865/ed.28.s2.407] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objective The New York City's Thrive (ThriveNYC) and the Los Angeles County Health Neighborhood Initiative (HNI) are two local policies focused on addressing the social determinants of behavioral health as a preventive strategy for improving health service delivery. On January 29, 2016, leaders from both initiatives came together with a range of federal agencies in health care, public health, and policy research at the RAND Corporation in Arlington, Virginia. The goal of this advisory meeting was to share lessons learned, consider research and evaluation strategies, and create a dialogue between stakeholders and federal funders - all with the purpose to build momentum for policy innovation in behavioral health equity. Methods This article analyzes ethnographic notes taken during the meeting and in-depth interviews of 14 meeting participants through Kingdon's multiple streams theory of policy change. Results Results demonstrated that stakeholders shared a vision for behavioral health policy innovation focused on community engagement and social determinants of health. In addition, Kingdon's model highlighted that the problem, policy and politics streams needed to form a window of opportunity for policy change were coupled, enabling the possibility for behavioral health policy innovation. Conclusions The advisory meeting suggested that local policy makers, academics, and community members, together with federal agents, are working to implement behavioral health policy innovation.
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Affiliation(s)
| | - Enrico G Castillo
- University of California, Los Angeles, David Geffen School of Medicine, Los Angeles County Department of Mental Health, Los Angeles, CA
| | - Grayson Norquist
- Emory University Department of Psychiatry and Behavioral Sciences Chief of Psychiatry Service, Grady Health System, Atlanta, GA
| | - Kenneth B Wells
- Center for Health Services and Society, University of California, Los Angeles, David Geffen School of Medicine at UCLA, Department of Psychiatry & Biobehavioral Sciences; RAND Corporation; University of California, Los Angeles School of Public Health, Los Angeles, CA
| | - Krystal Griffith
- Center for Health Services and Society, University of California, Los Angeles, CA
| | - Farbod Kadkhoda
- Center for Health Services and Society, University of California, Los Angeles, CA
| | - Felica Jones
- Healthy African American Families II, Los Angeles, CA
| | - Priscilla Shorter
- IDEAS Center, The Child Study Center of NYU at NYU Langone Medical Center, Department of Child and Adolescent Psychiatry, NYC, NY
| | - Elizabeth Bromley
- Center for Health Services and Society, University of California, Los Angeles, David Geffen School of Medicine, Department of Psychiatry & Biobehavioral Sciences; Desert Pacific MIRECC Health Services Unit, VA Greater Los Angeles Healthcare System, Los Angeles, CA
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Hoagwood KE, Atkins M, Horwitz S, Kutash K, Olin SS, Burns B, Peth-Pierce R, Kuppinger A, Burton G, Shorter P, Kelleher KJ. A Response to Proposed Budget Cuts Affecting Children's Mental Health: Protecting Policies and Programs That Promote Collective Efficacy. Psychiatr Serv 2018; 69:268-273. [PMID: 29089015 PMCID: PMC5832551 DOI: 10.1176/appi.ps.201700126] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Children stand to lose if the federal government follows through on threats to cut funding for critical safety-net programs that have long supported families and communities. Although cuts directly targeting children's mental health are a great concern, cuts to policies that support health, housing, education, and family income are equally disturbing. These less publicized proposed cuts affect children indirectly, but they have direct effects on their families and communities. The importance of these services is supported by an extensive body of social learning research that promotes collective efficacy-neighbors positively influencing each other-shown to have positive long-term effects on children's development and adult outcomes. In this article, the authors describe two federal programs that by virtue of their impact on families and communities are likely to promote collective efficacy and positively affect children's mental health; both programs are facing severe cutbacks. They suggest that states adopt a cross-system approach to promote policies and programs in general medical health, mental health, housing, education, welfare and social services, and juvenile justice systems as a viable strategy to strengthen families and communities and promote collective efficacy. The overall goal is to advance a comprehensive national mental health policy for children that enhances collaboration across systems and strengthens families and communities, which is especially critical for children living in marginalized communities.
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Affiliation(s)
- Kimberly Eaton Hoagwood
- Dr. Hoagwood, Dr. Horwitz, Dr. Olin, Ms. Kuppinger, Ms. Burton, and Ms. Shorter are with the Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York. Dr. Atkins is with the Department of Psychiatry, University of Illinois, Chicago. Dr. Kutash is with the Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa. Dr. Burns is with the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina. Ms. Peth-Pierce is with Public Health Communications Consulting, LLC, Cleveland. Dr. Kelleher is with the Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Marc Atkins
- Dr. Hoagwood, Dr. Horwitz, Dr. Olin, Ms. Kuppinger, Ms. Burton, and Ms. Shorter are with the Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York. Dr. Atkins is with the Department of Psychiatry, University of Illinois, Chicago. Dr. Kutash is with the Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa. Dr. Burns is with the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina. Ms. Peth-Pierce is with Public Health Communications Consulting, LLC, Cleveland. Dr. Kelleher is with the Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Sarah Horwitz
- Dr. Hoagwood, Dr. Horwitz, Dr. Olin, Ms. Kuppinger, Ms. Burton, and Ms. Shorter are with the Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York. Dr. Atkins is with the Department of Psychiatry, University of Illinois, Chicago. Dr. Kutash is with the Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa. Dr. Burns is with the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina. Ms. Peth-Pierce is with Public Health Communications Consulting, LLC, Cleveland. Dr. Kelleher is with the Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Krista Kutash
- Dr. Hoagwood, Dr. Horwitz, Dr. Olin, Ms. Kuppinger, Ms. Burton, and Ms. Shorter are with the Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York. Dr. Atkins is with the Department of Psychiatry, University of Illinois, Chicago. Dr. Kutash is with the Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa. Dr. Burns is with the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina. Ms. Peth-Pierce is with Public Health Communications Consulting, LLC, Cleveland. Dr. Kelleher is with the Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - S Serene Olin
- Dr. Hoagwood, Dr. Horwitz, Dr. Olin, Ms. Kuppinger, Ms. Burton, and Ms. Shorter are with the Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York. Dr. Atkins is with the Department of Psychiatry, University of Illinois, Chicago. Dr. Kutash is with the Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa. Dr. Burns is with the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina. Ms. Peth-Pierce is with Public Health Communications Consulting, LLC, Cleveland. Dr. Kelleher is with the Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Barbara Burns
- Dr. Hoagwood, Dr. Horwitz, Dr. Olin, Ms. Kuppinger, Ms. Burton, and Ms. Shorter are with the Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York. Dr. Atkins is with the Department of Psychiatry, University of Illinois, Chicago. Dr. Kutash is with the Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa. Dr. Burns is with the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina. Ms. Peth-Pierce is with Public Health Communications Consulting, LLC, Cleveland. Dr. Kelleher is with the Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Robin Peth-Pierce
- Dr. Hoagwood, Dr. Horwitz, Dr. Olin, Ms. Kuppinger, Ms. Burton, and Ms. Shorter are with the Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York. Dr. Atkins is with the Department of Psychiatry, University of Illinois, Chicago. Dr. Kutash is with the Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa. Dr. Burns is with the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina. Ms. Peth-Pierce is with Public Health Communications Consulting, LLC, Cleveland. Dr. Kelleher is with the Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Anne Kuppinger
- Dr. Hoagwood, Dr. Horwitz, Dr. Olin, Ms. Kuppinger, Ms. Burton, and Ms. Shorter are with the Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York. Dr. Atkins is with the Department of Psychiatry, University of Illinois, Chicago. Dr. Kutash is with the Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa. Dr. Burns is with the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina. Ms. Peth-Pierce is with Public Health Communications Consulting, LLC, Cleveland. Dr. Kelleher is with the Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Geraldine Burton
- Dr. Hoagwood, Dr. Horwitz, Dr. Olin, Ms. Kuppinger, Ms. Burton, and Ms. Shorter are with the Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York. Dr. Atkins is with the Department of Psychiatry, University of Illinois, Chicago. Dr. Kutash is with the Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa. Dr. Burns is with the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina. Ms. Peth-Pierce is with Public Health Communications Consulting, LLC, Cleveland. Dr. Kelleher is with the Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Priscilla Shorter
- Dr. Hoagwood, Dr. Horwitz, Dr. Olin, Ms. Kuppinger, Ms. Burton, and Ms. Shorter are with the Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York. Dr. Atkins is with the Department of Psychiatry, University of Illinois, Chicago. Dr. Kutash is with the Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa. Dr. Burns is with the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina. Ms. Peth-Pierce is with Public Health Communications Consulting, LLC, Cleveland. Dr. Kelleher is with the Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Kelly J Kelleher
- Dr. Hoagwood, Dr. Horwitz, Dr. Olin, Ms. Kuppinger, Ms. Burton, and Ms. Shorter are with the Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York. Dr. Atkins is with the Department of Psychiatry, University of Illinois, Chicago. Dr. Kutash is with the Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa. Dr. Burns is with the Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina. Ms. Peth-Pierce is with Public Health Communications Consulting, LLC, Cleveland. Dr. Kelleher is with the Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio
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Hoagwood KE, Olin SS, Storfer-Isser A, Kuppinger A, Shorter P, Wang NM, Pollock M, Peth-Pierce R, Horwitz S. Evaluation of a Train-The-Trainers Model for Family Peer Advocates in Children's Mental Health. J Child Fam Stud 2017; 27:1130-1136. [PMID: 29576726 PMCID: PMC5854741 DOI: 10.1007/s10826-017-0961-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Standardized training and credentialing is increasingly important to states and healthcare systems. Workforce shortages in children's mental health can be addressed through training and credentialing of professional peer parents (called family peer advocates or FPAs), who deliver a range of services to caregivers. A theory-based training program for FPAs targeting skills and knowledge about childhood mental health services (Parent Empowerment Program, or PEP) was developed through a partnership among a statewide family-run organization, state policy leaders, and academic researchers. Prior studies by this team using highly-experienced family peer advocates (who were also co-developers of the training program) as trainers found improvements in knowledge about mental health services and self-efficacy. In 2010, to meet demands and scale the model, a training of trainers (TOT) model was developed to build a cohort of locally-trained FPAs to deliver PEP training. A pre/post design was used to evaluate the impact of TOT model on knowledge and self-efficacy among 318 FPAs across the state. Participants showed significant pre-post (6 month) changes in knowledge about mental health services and self-efficacy. There were no significant associations between any FPA demographic characteristics and their knowledge or self-efficacy scores. A theory-based training model for professional peer parents working in the children's mental health system can be taught to local FPAs, and it improves knowledge about the mental health system and self-efficacy. Studies that evaluate the effectiveness of different training modalities are critical to ensure that high-quality trainings are maintained.
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Affiliation(s)
- Kimberly Eaton Hoagwood
- Department of Child and Adolescent Psychiatry, New York University Child Study Center, New York University School of Medicine, New York, NY USA
| | - S. Serene Olin
- Department of Child and Adolescent Psychiatry, New York University Child Study Center, New York University School of Medicine, New York, NY USA
| | - Amy Storfer-Isser
- Department of Child and Adolescent Psychiatry, New York University Child Study Center, New York University School of Medicine, New York, NY USA
| | - Anne Kuppinger
- Department of Child and Adolescent Psychiatry, New York University Child Study Center, New York University School of Medicine, New York, NY USA
| | - Priscilla Shorter
- Department of Child and Adolescent Psychiatry, New York University Child Study Center, New York University School of Medicine, New York, NY USA
| | - Nicole M. Wang
- Department of Child and Adolescent Psychiatry, New York University Child Study Center, New York University School of Medicine, New York, NY USA
| | - Michele Pollock
- Department of Child and Adolescent Psychiatry, New York University Child Study Center, New York University School of Medicine, New York, NY USA
| | | | - Sarah Horwitz
- Department of Child and Adolescent Psychiatry, New York University Child Study Center, New York University School of Medicine, New York, NY USA
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Wisdom JP, Olin S, Shorter P, Burton G, Hoagwood K. Family Peer Advocates: A Pilot Study of the Content and Process of Service Provision. J Child Fam Stud 2011; 20:833-843. [PMID: 23087591 PMCID: PMC3474363 DOI: 10.1007/s10826-011-9451-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Professional family peer advocates are increasingly employed by public mental health systems to deliver family-to-family support that reduces barriers families face in accessing children's mental health care. These services, however, are neither uniformly available nor standardized. This pilot study describes the process, content and context of family-to-family support services. Simulating a parent seeking services, a trained standardized parent participated as a client in meetings with advocates in four programs and collected data through structured observations, a structured survey, and session audiotapes. The "walk-through" process was determined to be feasible and acceptable to family peer advocates as a way of evaluating services. Four family peer advocates provided an average of 25 services during each 2-session simulation with the standardized parent, including the following: information and educational support, instruction and skills development, emotional and affirmational support, instrumental support, and advocacy. Findings also revealed variability in the range of services provided and identified challenges in aspects of service provision, such as boundaries of advocate roles, availability of confidential service environments, and addressing crises and parent concerns about child safety. This paper provides the first in-depth look at services provided by this emerging workforce.
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Affiliation(s)
- Jennifer P. Wisdom
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive Box 100, New York, NY 10032, USA
| | - Serene Olin
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive Box 100, New York, NY 10032, USA
| | - Priscilla Shorter
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive Box 100, New York, NY 10032, USA
| | - Geraldine Burton
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive Box 100, New York, NY 10032, USA; Families on the Move New York City, Inc., New York, NY, USA; National Alliance for the Mentally Ill, New York City Metro, New York, NY, USA
| | - Kimberly Hoagwood
- Department of Psychiatry, New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive Box 100, New York, NY 10032, USA
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