Early Intervention Research Institute Building Community Partnerships to Support Integrated Infant Mental Health Systems of Care Richard Roberts, Diane.

Early Intervention Research Institute

EIRIEIRI

Building Community Partnerships to Support Integrated Infant Mental Health Systems of Care

Building Community Partnerships to Support Integrated Infant Mental Health Systems of Care

Richard Roberts, Diane Behl, Adrienne Akers Richard Roberts, Diane Behl, Adrienne Akers

World Association for Infant Mental HealthJuly 16-20, 2002

Amsterdam

Early Intervention Research InstituteCenter for Persons with Disabilities

Utah State UniversityLogan, UT 84322-6580 USA

www.eiri.usu.edu

Early Intervention Research InstituteCenter for Persons with Disabilities

Utah State UniversityLogan, UT 84322-6580 USA

www.eiri.usu.edu


EIRIEIRI

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 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.


EIRIEIRI

Purpose of the Opening Doors Into Rural Communities

Project (ODRC)

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.

Improve services for children with special needs

and families through a participatory action

research approach and interagency collaboration.


EIRIEIRI

Definition of PARDefinition 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.

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.


EIRIEIRI

Participatory Action Model of

Research/Evaluation

Participatory Action Model of

Research/Evaluation

Consumers/ Family Voices

Program/ Provider/

Staff

Researchers/Evaluators


EIRIEIRI

Why Use a PAR Approach?

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.

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.


EIRIEIRI

How Are PAR Teams Involved?

How Are PAR Teams Involved?

The PAR team as a whole:

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

The PAR team as a whole:

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


EIRIEIRI

ODRC Work in Lewiston, IdahoODRC Work in

Lewiston, Idaho

Goal: To integrate mental health services into

the system of care for young children and their

families.

Goal: To integrate mental health services into

the system of care for young children and their

families.


EIRIEIRI

Lewiston’s Community Focus

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”

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”


EIRIEIRI

Phase I

Develop Community

Focus

Phase V

Report Accomplishments

Phase II

Collect Baseline

Data

Phase III

Action Plan

Phase IV

Measure Change

(Recursive loops suggest the dynamic rather than linear nature of the plan)

ODRC Evaluation Model

ODRC Evaluation Model


EIRIEIRI

Ways Families Partner PAR

Ways Families Partner PAR

Serving as essential members of task force

Designing questions and methods

Collecting data and other information

Interpreting data

Dissemination

Serving as essential members of task force

Designing questions and methods

Collecting data and other information

Interpreting data

Dissemination


EIRIEIRI

Keeping Families Engaged in

Interagency Councils:

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

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


EIRIEIRI

Defining Mental Health as a Continuum of Care

Defining Mental Health as a Continuum of Care

RecreationalOpportunities

Family Support

Mentoring

Parent-to-Parent

Financial Assistance

Prevention ChildAbuse and Neglect

Therapy/Counseling

InterdisciplinaryTeam Planning

Foster Care

InpatientHospitalization

Incarceration

Self-Contained/Disorder-Specific School Program

Home Visits

Respite Care

Therapy/Counseling

Crisis Intervention

Institutionalization

Residential Treatment Center

EI and Preschool for Children with Special Needs


EIRIEIRI

ODRC Evaluation ToolsODRC Evaluation Tools1. Community Map1. Community Map

Depicts community services/resources and their relationships

2. Community Self-Assessment Survey2. Community Self-Assessment Survey Obtains quantitative information on capacity and coordination

3. Community Service Integration Matrix3. Community Service Integration Matrix

4. Family Telephone Survey4. Family Telephone Survey

Examines the infrastructure of the community system

Measures the family perspective regarding services and their needs.


EIRIEIRI

Lewiston, Idaho Service Integration Matrix (1999) Baseline Matrix

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.

No Connection

Information Sharingand Communication

Cooperation andCoordination Collaboration Consolidation Integration

Informal Formal

Intensity of Integration ContinuumKey:1999 baselineIdeal level

Service delivery system/model

Information systems/data management

Shared goals/mission statement

Financing and budgeting

Partners/stakeholders

Connections b/w task forceand state agencies

Community task force governanceand authority


EIRIEIRI

Lewiston’s Action Plan

Lewiston’s Action Plan1. 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

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


EIRIEIRI

Lewiston, Idaho Service Integration Follow-up Matrix (2001)

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.

No Connection

Information Sharingand Communication

Cooperation andCoordination Collaboration Consolidation Integration

Informal Formal

Intensity of Integration Continuum

Service delivery system/model

Information systems/data management

Shared goals/mission statement

Financing and budgeting

Partners/stakeholders

Connections b/w task forceand state agencies

Community task force governanceand authority

Key:1999 baselineIdeal level2001 level


EIRIEIRI

Benefits of PARBenefits 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


EIRIEIRI

Challenges and Solutions of PAR

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

(continued.....)


EIRIEIRI

Challenges and Solutions (continued)

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


EIRIEIRI

Summary of PARSummary of PAR

1. Interagency councils must balance:

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.

Early Intervention Research Institute Building Community Partnerships to Support Integrated Infant Mental Health Systems of Care Richard Roberts, Diane.

Documents

research families

research project

research activities

research questions

mental health services

stakeholders slide

mental health needs

par approach