Transcript Document

Building Community Partnerships to
Support Integrated Infant Mental
Health Systems of Care
Richard Roberts, Diane Behl, Adrienne Akers
Early Intervention Research Institute
Center for Persons with Disabilities
Utah State University
Logan, UT 84322-6580 USA
www.eiri.usu.edu
EIRI
World Association for Infant Mental Health
July 16-20, 2002
Amsterdam
Early Intervention Research Institute
EIRI
is
an
interdisciplinary
organization
committed to investigating and improving
policies and practices that support the well-being
of at-risk children as well as those with special
needs and their families. We conduct research
and evaluation as well as provide technical
training and assistance at community, state,
national, and international levels.
EIRI
Early Intervention Research Institute
Purpose of the Opening Doors Into
Rural Communities Project (ODRC)
Improve services for children with special needs
and families through a participatory action
research approach and interagency collaboration.
EIRI
Early Intervention Research Institute
Definition of PAR
Participatory Action Research (PAR) is an approach
that encourages researchers and those who will
benefit
from
the
research
(families,
providers,
policymakers) to work together as full partners in all
phases of the research.
EIRI
Early Intervention Research Institute
Participatory Action Model
of Research/Evaluation
Consumers/
Family Voices
Program/
Provider/
Staff
Researchers/
Evaluators
EIRI
Early Intervention Research Institute
Why Use a PAR Approach?
PAR efforts help to ensure that the results are
meaningful and will make a difference in the lives
of the key stakeholders, particularly children and
families.
EIRI
Early Intervention Research Institute
How Are PAR Teams
Involved?
The PAR team as a whole:




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Determines the research questions
Designs research project, including evaluation tools
Carries out the research activities
Analyzes and interprets the data
Shares results in meaningful ways with stakeholders
EIRI
Early Intervention Research Institute
ODRC Work in
Lewiston, Idaho
Goal: To integrate mental health services into the
system of care for young children and their
families.
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Early Intervention Research Institute
Lewiston’s Community Focus
 Children with mental health needs often did not qualify for
disability programs
 Intensive, specialized services were lacking
 No systematic process to follow up on referrals
 Community services were fragmented
 No clear definition of “mental health”
EIRI
Early Intervention Research Institute
ODRC Evaluation Model
Phase I
Phase II
Phase III
Phase IV
Phase V
Develop
Community
Focus
Collect
Baseline
Data
Action
Plan
Measure
Change
Report
Accomplishments
(Recursive loops suggest the dynamic rather than linear
nature of the plan)
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Early Intervention Research Institute
Ways Families Partner PAR
 Serving as essential members of task force
 Designing questions and methods
 Collecting data and other information
 Interpreting data
 Dissemination
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Early Intervention Research Institute
Keeping Families Engaged
in Interagency Councils:
1. Recruit families through different doors
2. Make sure families know why they are there
3. Value family member’s time
4. Identify different ways families can participate
EIRI
Early Intervention Research Institute
Defining Mental Health as a
Continuum of Care
Self-Contained/DisorderSpecific School Program
Financial Assistance
Mentoring
Therapy/Counseling
Prevention Child
Abuse and Neglect
Interdisciplinary
Team Planning
Incarceration
Foster Care
Parent-to-Parent
EI and Preschool for
Children with Special Needs
Recreational
Opportunities
Family Support
Therapy/
Counseling
Residential
Treatment Center
Respite Care
Institutionalization
Crisis
Intervention
Home Visits
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Early Intervention Research Institute
Inpatient
Hospitalization
ODRC Evaluation Tools
1. Community Map
 Depicts community services/resources and their relationships
2. Community Self-Assessment Survey
 Obtains quantitative information on capacity and coordination
3. Community Service Integration Matrix
 Examines the infrastructure of the community system
4. Family Telephone Survey
 Measures the family perspective regarding services and their needs.
EIRI
Early Intervention Research Institute
Lewiston, Idaho Service Integration Matrix (1999) Baseline Matrix
Service Integration Goal: Improved awareness, coordination, and availability with mental health.
Target Population: 0-5 Part C/Part B children and families.
Outcomes and Accountability: A written interagency policy to support coordinated referral and follow-up.
Key:
1999 baseline
Ideal level
Intensity of Integration Continuum
Informal
No
Connection
Information Sharing
and Communication
Formal
Cooperation and
Coordination
Partners/stakeholders
Shared goals/mission statement
Connections b/w task force
and state agencies
Community task force governance
and authority
Service delivery system/model
Financing and budgeting
EIRI
Information systems/data
management
Early Intervention Research Institute
Collaboration
Consolidation
Integration
Lewiston’s Action Plan
1. Broaden interagency screening to include mental
health
2. Recruit mental health providers to provide training
and consultation
3. Develop a screening coordinator position to ensure
follow-up
4. Increase community awareness of early childhood
mental health
EIRI
Early Intervention Research Institute
Lewiston, Idaho Service Integration Follow-up Matrix (2001)
Service Integration Goal: Improved awareness, coordination, and availability with mental health.
Target Population: 0-5 Part C/Part B children and families.
Outcomes and Accountability: A written interagency policy to support coordinated referral and follow-up.
Key:
1999 baseline
Ideal level
2001 level
Intensity of Integration Continuum
Informal
No
Connection
Information Sharing
and Communication
Formal
Cooperation and
Coordination
Partners/stakeholders
Shared goals/mission statement
Connections b/w task force
and state agencies
Community task force governance
and authority
Service delivery system/model
Financing and budgeting
EIRI
Information systems/data
management
Early Intervention Research Institute
Collaboration
Consolidation
Integration
Benefits of PAR
 Multiple perspectives result in stronger buy-in from task force members
 Family participation ensures that goals translate directly to improved child
and family outcomes
 Products of PAR efforts are designed in a variety of formats to reach the
various audiences (i.e., parents, providers, community- and state-level
policymakers)
 PAR offers a mechanism for identifying & resolving potential conflicts
 Participation of multiple stakeholders results in more creative problem
solving and use resources
 Evaluation methods drive the work plan as well as reveal changes
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Early Intervention Research Institute
Challenges and Solutions of PAR
 PAR efforts take more time than traditional research. Gathering data from multiple
sources, delegating responsibilities, and reaching consensus require greater amounts
of time
 Establish ground rules
 Share/delegate responsibilities
 Pacing the activities so that participants don’t get frustrated with the lengthier process
 Set short-term objectives
 Report and discuss accomplishments regularly
 Communities that lack strong leadership and vision may need more direct facilitation
and coaching through the PAR process
 Identify and utilize strengths of participants
 Offer more direct forms of facilitation and coaching
EIRI
(continued.....)
Early Intervention Research Institute
Challenges and Solutions (continued)
 Additional funding/resources are needed to support the extra planning meetings,
conference calls, stipends for parents
 Establish commitment from agency heads
 Build funds for parent payments & systems building time into grants
 Seek donations from community businesses & organizations
 PAR members must be willing to share the work and the rewards
 Establish commitment from the beginning
 Determine individual strengths and highlight them
 Look to media and professional opportunities for recognition
 Consumers must be strongly represented and heard
 Ensure that multiple parents/consumers participate
 Build opportunities for parent/consumer input into the agenda
 Allow multiple methods for obtaining parent/consumer input
EIRI
Early Intervention Research Institute
Summary of PAR
1. Interagency councils must balance:
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the need for a comprehensive vision
the practical demand to focus on action
2. Barriers to effective collaboration are as much institutional and
political as they are problems with the methods or content of the
evaluation.
3. No matter how rigorous the scientific method used, shifts in political
agendas may determine the fate of many social programs.
EIRI
Early Intervention Research Institute