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Community Mental Health Journal

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01.07.2015 | Original Paper

Leadership and Licensure for Drug Treatment and the Implementation of Co-Occurring Disorder Treatment in Community Mental Health Centers

verfasst von: Erick G. Guerrero, Howard Padwa, Rebecca Lengnick-Hall, Yinfei Kong, Judith L. Perrigo

Erschienen in: Community Mental Health Journal | Ausgabe 5/2015

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Abstract

Using a random sample of 48 outpatient mental health programs in low-income and racial and ethnic minority communities, this study examined directorial leadership, drug treatment licensure, and implementation of evidence-based protocols and practices to address co-occurring mental health and substance abuse disorders (COD). Understanding of findings was enhanced with focus groups at six clinics. Most programs (81 %) offered COD treatment. Directorial leadership was positively associated with COD treatment (β = 0.253, p = 0.047, 95 % CI 0.003, 0.502) and COD supervision and training (β = 0.358, p = 0.002, 95 % CI 0.142, 0.575). Licensure was negatively associated with COD treatment (β = −0.235, p = 0.041, 95 % CI −0.460, −0.010) and COD supervision and training (β = −0.195, p = 0.049, 95 % CI −0.389, −0.001). Although lack of financial integration may limit the effect of licensing on COD treatment implementation, the response of leaders to regulation, funding, and human resources issues may encourage COD treatment practices. Implications for leadership interventions and policy are discussed in the context of health care reform.

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Aarons, G. A. (2006). Transformational and transactional leadership: Association with attitudes toward evidence-based practice. Psychiatric Services, 57(8), 1162–1169. doi:10.1176/ps.2006.57.8.1162.PubMedCentralPubMedCrossRef

Aarons, G. A., Hurlburt, M., & Horwitz, S. M. (2011a). Advancing a conceptual model of evidence-based practice implementation in public service sectors. Administration and Policy in Mental Health and Mental Health Services Research, 38, 4–23. doi:10.1007/s10488-010-0327-7.PubMedCentralPubMedCrossRef

Aarons, G. A., & Sommerfeld, D. H. (2012). Leadership, innovation climate, and attitudes toward evidence-based practice during a statewide implementation. Journal of the American Academy of Child and Adolescent Psychiatry, 51, 423–431. doi:10.1016/j.jaac.2012.01.018.PubMedCrossRef

Aarons, G. A., Sommerfeld, D. H., & Willging, C. E. (2011b). The soft underbelly of system change: The role of leadership and organizational climate in turnover during statewide behavioral health reform. Psychological Services, 8, 269–281. doi:10.1037/a0026196.PubMedCentralPubMedCrossRef

Alegría, M., Page, J. B., Hansen, H., Cauce, A. M., Robles, R., Blanco, C., & Berry, P. (2006). Improving drug treatment services for Hispanics: Research gaps and scientific opportunities. Drug and Alcohol Dependence, 84, S76–S84. doi:10.1016/j.drugalcdep.2006.05.009.PubMedCrossRef

Amaro, H., Arévalo, S., Gonzalez, G., Szapocznik, J., & Iguchi, M. Y. (2006). Needs and scientific opportunities for research on substance abuse treatment among Hispanic adults. Drug and Alcohol Dependence, 84, S64–S75. doi:10.1016/j.drugalcdep.2006.05.008.PubMedCrossRef

Andrulis, D. P., Siddiqui, N. J., Purtle, J. P., & Duchon, L. (2010). Patient Protection and Affordable Care Act of 2010: Advancing health equity for racially and ethnically diverse populations. Washington, DC: Joint Center for Political and Economic Studies.

Barry, C. L., & Huskamp, H. A. (2011). Moving beyond parity—mental health and addiction care under the ACA. New England Journal of Medicine, 365, 973–975. doi:10.1056/NEJMp1108649.PubMedCentralPubMedCrossRef

Bergkvist, L., & Rossiter, J. R. (2007). The predictive validity of multiple-item versus single-item measures of the same constructs. Journal of Marketing Research, 44, 175–184. doi:10.1509/jmkr.44.2.175.CrossRef

Burnam, M. A., & Watkins, K. E. (2006). Substance abuse with mental disorders: Specialized public systems and integrated care. Health Affairs, 25, 648–658. doi:10.1377/hlthaff.25.3.648.PubMedCrossRef

Butler, M., Kane, R. L., McAlpine, D., Kathol, R. G., Fu, S. S., Hagedorn, H., & Wilt, T. J. (2008). Integration of mental health/substance abuse and primary care (AHRQ Publication No. 09-E003). Rockville, MD: Agency for Healthcare Research and Quality.

Chalk, M., Dilonardo, J., Rinaldo, S. G., & Oehlmann, P. (2010). Integrating appropriate services for substance use conditions in health care settings: An issue brief on lessons learned and challenges ahead. Philadelphia, PA: Treatment Research Institute.

Chandler, D. (2009). Implementation of integrated dual disorders treatment in eight California programs. American Journal of Psychiatric Rehabilitation, 12, 330–351. doi:10.1080/15487760903248473.CrossRef

Claus, R., Gotham, H., Harper-Chang, L., Selig, K., & Homer, L. (2007). Leadership style and dual diagnosis capability: Does transformational leadership make a difference? Paper presented at Addiction Health Services Research Annual Conference, Athens, GA.

Croft, B., & Parish, S. L. (2013). Care integration in the Patient Protection and Affordable Care Act: Implications for behavioral health. Administration and Policy in Mental Health and Mental Health Services Research, 40, 258–263. doi:10.1007/s10488-012-0405-0.PubMedCrossRef

D’Aunno, T. (2006). The role of organization and management in substance abuse treatment: Review and roadmap. Journal of Substance Abuse Treatment, 31, 221–233. doi:10.1016/j.jsat.2006.06.016.PubMedCrossRef

Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science, 4, 50. doi:10.1186/1748-5908-4-50.PubMedCentralPubMedCrossRef

Drake, R. E., & Bond, G. R. (2010). Implementing integrated mental health and substance abuse services. Journal of Dual Diagnosis, 6, 251–262. doi:10.1080/15504263.2010.540772.CrossRef

Drake, R. E., Essock, S. M., Shaner, A., Carey, K. B., Minkoff, K., Kola, L., & Rickards, L. (2001). Implementing dual diagnosis services for clients with severe mental illness. Psychiatric Services, 52, 469–476. doi:10.1176/appi.ps.52.4.469.PubMedCrossRef

Drake, R. E., Mueser, K. T., Brunette, M. F., & McHugo, G. J. (2004). A review of treatments for people with severe mental illnesses and co-occurring substance use disorders. Psychiatric Rehabilitation Journal, 27, 360–374. doi:10.2975/27.2004.360.374.PubMedCrossRef

Edwards, J. R., Knight, D. K., Broome, K. M., & Flynn, P. M. (2010). The development and validation of a transformational leadership survey for substance use treatment programs. Substance Use and Misuse, 45, 1279–1302. doi:10.3109/10826081003682834.PubMedCentralPubMedCrossRef

Gill, D. P., Jones, G. R., Zou, G., & Speechley, M. (2012). Using a single question to assess physical activity in older adults: A reliability and validity study. BMC Medical Research Methodology, 12, 20. doi:10.1186/1471-2288-12-20.PubMedCentralPubMedCrossRef

Glaser, B. G., & Strauss, A. L. (1967). The discovery of grounded theory: Strategies for qualitative research. Chicago, IL: Aldine.

Gotham, H. J., Claus, R. E., Selig, K., & Homer, A. L. (2010). Increasing program capability to provide treatment for co-occurring substance use and mental disorders: Organizational characteristics. Journal of Substance Abuse Treatment, 38, 160–169. doi:10.1016/j.jsat.2009.07.005.PubMedCrossRef

Graneheim, U. H., & Lundman, B. (2004). Qualitative content analysis in nursing research: Concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24, 105–112. doi:10.1016/j.nedt.2003.10.001.PubMedCrossRef

Grella, C. E., Gil-Rivas, V., & Cooper, L. (2004). Perceptions of mental health and substance abuse program administrators and staff on service delivery to persons with co-occurring substance abuse and mental disorders. Journal of Behavioral Health Services & Research, 31, 38–49. doi:10.1007/BF02287337.CrossRef

Grella, C. E., & Stein, J. A. (2006). Impact of program services on treatment outcomes of patients with comorbid mental and substance use disorders. Psychiatric Services, 57, 1007–1015. doi:10.1176/ps.2006.57.7.1007.PubMedCentralPubMedCrossRef

Guerrero, E. G. (2013). Enhancing access and retention in substance abuse treatment: The role of Medicaid payment acceptance and cultural competence. Drug and Alcohol Dependence, 132, 555–561. doi:10.1016/j.drugalcdep.2013.04.005.PubMedCrossRef

Guerrero, E. G., He, A., Kim, A., & Aarons, G. A. (2014a). Organizational implementation of evidence-based substance abuse treatment in racial and ethnic minority communities. Administration and Policy in Mental Health and Mental Health Services Research, 41, 737–749. doi:10.1007/s10488-013-0515-3.PubMedCrossRef

Guerrero, E. G., Henwood, B., & Wenzel, S. L. (2014b). Service integration to reduce homelessness in Los Angeles County: Multiple stakeholder perspectives. Human Service Organizations Management, Leadership & Governance, 38, 44–54. doi:10.1080/03643107.2013.853009.CrossRef

Guerrero, E. G., & Kao, D. (2013). Racial/ethnic minority and low-income hotspots and their geographic proximity to integrated care providers. Substance Abuse Treatment, Prevention, and Policy, 8, 34. doi:10.1186/1747-597X-8-34.PubMedCentralPubMedCrossRef

Guerrero, E. G., & Kim, A. (2013). Organizational structure, leadership and readiness for change and the implementation of organizational cultural competence in addiction health services. Evaluation and Program Planning, 40, 74–81. doi:10.1016/j.evalprogplan.2013.05.002.PubMedCrossRef

Holmberg, R., Fridell, M., Arnesson, P., & Bäckvall, M. (2008). Leadership and implementation of evidence-based practices. Leadership in Health Services, 21, 168–184. doi:10.1108/17511870810893001.CrossRef

Kaiser Commission on Medicaid and the Uninsured. (2012). The uninsured: A primer: Key facts about Americans without health insurance. Washington, DC: Kaiser Family Foundation. Retrieved from http://kaiserfamilyfoundation.files.wordpress.com/2013/01/7451-08.pdf.

Kidd, P. S., & Parshall, M. B. (2000). Getting the focus and the group: Enhancing analytical rigor in focus group research. Qualitative Health Research, 10, 293–308. doi:10.1177/104973200129118453.PubMedCrossRef

LA Health Action. (2012). Status report on integrating medical care with mental health and substance use disorder services in L.A. County. Retrieved from http://lahealthaction.org/library/LAHA_Integrating_Mental_Health_LA_County.pdf.

Los Angeles County Department of Public Health. (2014). Our partnerships. Retrieved from http://publichealth.lacounty.gov/sapc/partner.htm.

McGovern, M. P., Lambert-Harris, C., McHugo, G. J., Giard, J., & Mangrum, L. (2010). Improving the dual diagnosis capability of addiction and mental health treatment services: Implementation factors associated with program level changes. Journal of Dual Diagnosis, 6, 237–250. doi:10.1080/15504263.2010.537221.CrossRef

McGovern, M. P., Matzkin, A. L., & Giard, J. (2007). Assessing the dual diagnosis capability of addiction treatment services: The Dual Diagnosis Capability in Addiction Treatment (DDCAT) index. Journal of Dual Diagnosis, 3, 111–123. doi:10.1300/J374v03n02_13.CrossRef

Mericle, A. A., Ta Park, V. M., Holck, P., & Arria, A. M. (2012). Prevalence, patterns, and correlates of co-occurring substance use and mental disorders in the United States: Variations by race/ethnicity. Comprehensive Psychiatry, 53, 657–665. doi:10.1016/j.comppsych.2011.10.002.PubMedCentralPubMedCrossRef

Michaelis, B., Stegmaier, R., & Sonntag, K. (2010). Shedding light on followers’ innovation implementation behavior: The role of transformational leadership, commitment to change, and climate for initiative. Journal of Managerial Psychology, 25, 408–429. doi:10.1108/02683941011035304.CrossRef

Minkoff, K. (2001). Developing standards of care for individuals with co-occurring psychiatric and substance use disorders. Psychiatric Services, 52, 597–599. doi:10.1176/appi.ps.52.5.597.PubMedCrossRef

Packard, T. (2009). Leadership and performance in human services organizations. In R. J. Patti (Ed.), Handbook of human services management (2nd ed., pp. 143–164). Thousand Oaks, CA: Sage.

Padwa, H., Larkins, S., Crevecoeur-MacPhail, D. A., & Grella, C. E. (2013). Dual diagnosis capability in mental health and substance use disorder treatment programs. Journal of Dual Diagnosis, 9, 179–186. doi:10.1080/15504263.2013.778441.PubMedCentralPubMedCrossRef

Palinkas, L. A., Aarons, G. A., Horwitz, S., Chamberlain, P., Hurlburt, M., & Landsverk, J. (2011). Mixed method designs in implementation research. Administration and Policy in Mental Health and Mental Health Services Research, 38, 44–53. doi:10.1007/s10488-010-0314-z.PubMedCentralPubMedCrossRef

Pating, D., & Gould, B. (2008). Mental Health Services Oversight and Accountability Commission report on co-occurring disorders: Transforming the mental health system through integration. Retrieved from http://www.mhsoac.ca.gov/docs/Committees/CODReportFinal.pdf.

Polinsky, M. L., Hser, Y.-I., & Grella, C. E. (1998). Consideration of special populations in the drug treatment system of a large metropolitan area. Journal of Behavioral Health Services & Research, 25, 7–21. doi:10.1007/BF02287496.CrossRef

Roman, P. M., Abraham, A. J., & Knudsen, H. K. (2011). Using medication-assisted treatment for substance use disorders: Evidence of barriers and facilitators of implementation. Addictive Behaviors, 36, 584–589. doi:10.1016/j.addbeh.2011.01.032.PubMedCentralPubMedCrossRef

Sacks, S., Chandler, R., & Gonzales, J. (2008). Responding to the challenge of co-occurring disorders: Suggestions for future research. Journal of Substance Abuse Treatment, 34, 139–146. doi:10.1016/j.jsat.2007.03.008.PubMedCentralPubMedCrossRef

Sacks, S., Chaple, M., Sirikantraporn, J., Sacks, J. Y., Knickman, J., & Martinez, J. (2013). Improving the capability to provide integrated mental health and substance abuse services in a state system of outpatient care. Journal of Substance Abuse Treatment, 44, 488–493. doi:10.1016/j.jsat.2012.11.001.PubMedCrossRef

Sterling, S., Chi, F., & Hinman, A. (2011). Integrating care for people with co-occurring alcohol and other drug, medical, and mental health conditions. Alcohol Research & Health, 33, 338–349.

Substance Abuse and Mental Health Services Administration. (2007). The epidemiology of co-occurring substance use and mental disorders (COCE Overview Paper 8, HHS Publication No. SMA 07-4308). Rockville, MD: Author.

Substance Abuse and Mental Health Services Administration. (2012). Dual diagnosis capability in mental health treatment (DDCMHT) index. Rockville, MD: Author.

Substance Abuse and Mental Health Services Administration. (2013). Results from the 2012 National Survey on Drug Use and Health: Mental health findings (NSDUH Series H-47, HHS Publication No. SMA 13-4805). Rockville, MD: Author. Retrieved from http://www.samhsa.gov/data/NSDUH/2k12MH_FindingsandDetTables/2K12MHF/NSDUHmhfr2012.htm.

US Census Bureau. (2009). Census Bureau releases state and county data depicting nation’s population ahead of 2010 census [press release]. Retrieved from https://www.census.gov/newsroom/releases/archives/population/cb09-76.html.

Weisner, C., Mertens, J., Parthasarathy, S., Moore, C., & Lu, Y. (2001). Integrating primary medical care with addiction treatment: A randomized controlled trial. Journal of the American Medical Association, 286, 1715–1723. doi:10.1001/jama.286.14.1715.PubMedCentralPubMedCrossRef

Wells, K., Klap, R., Koike, A., & Sherbourne, C. (2001). Ethnic disparities in unmet need for alcoholism, drug abuse, and mental health care. American Journal of Psychiatry, 158, 2027–2032. doi:10.1176/appi.ajp.158.12.2027.PubMedCrossRef

Young, N. K., & Grella, C. E. (1998). Mental health and substance abuse treatment services for dually diagnosed clients: Results of a statewide survey of county administrators. Journal of Behavioral Health Services & Research, 25, 83–92. doi:10.1007/BF02287503.CrossRef

Titel: Leadership and Licensure for Drug Treatment and the Implementation of Co-Occurring Disorder Treatment in Community Mental Health Centers
verfasst von: Erick G. Guerrero
Howard Padwa
Rebecca Lengnick-Hall
Yinfei Kong
Judith L. Perrigo
Publikationsdatum: 01.07.2015
Verlag: Springer US
Erschienen in: Community Mental Health Journal / Ausgabe 5/2015
Print ISSN: 0010-3853
Elektronische ISSN: 1573-2789
DOI: https://doi.org/10.1007/s10597-015-9886-0

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