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Psychiatry Journal
Volume 2014, Article ID 802983, 9 pages
http://dx.doi.org/10.1155/2014/802983
Research Article

Organizational Factors Influencing Implementation of Evidence-Based Practices for Integrated Treatment in Behavioral Health Agencies

1Center for Rural and Community Behavioral Health, Department of Psychiatry, University of New Mexico, MSC09 5030, Albuquerque, NM 87131, USA
2University of California, San Diego, 9500 Gilman Drive (0812), La Jolla, San Diego, CA 92093-0812, USA
3Pacific Institute for Research and Evaluation, Behavioral Health Research Center of the Southwest, 612 Encino Place NE, Albuquerque, NM 87102, USA

Received 28 October 2013; Accepted 26 January 2014; Published 3 March 2014

Academic Editor: Veit Roessner

Copyright © 2014 Caroline A. Bonham et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. In recent years, New Mexico has prioritized integrated treatment for cooccurring mental health and substance use disorders within its public behavioral health system. This report describes factors likely to be important when implementing evidence-based practices (EBPs) in community agencies. Methods. Our mixed-method research design consisted of observations, semistructured interviews, and surveys undertaken with employees at 14 agencies at baseline and after 18 months. We developed four-agency typologies based on iterative coding and analysis of observations and interviews. We then examined survey data from employees at the four exemplar agencies to validate qualitative findings. Results. Financial resources and strong leadership impacted agency capacity to train providers and implement EBPs. Quantitative analysis of service provider survey responses from these agencies (N = 38) supported qualitative findings and demonstrated significant mean score differences in leadership, organizational climate, and attitudes toward EBPs in anticipated directions. Conclusion. The availability of strong leadership and financial resources were key components to initial implementation success in this study of community agencies in New Mexico. Reliance only on external funding poses risks for sustainment when demoralizing work climates precipitate employee turnover. Strong agency leadership does not always compensate for deficient financial resources in vulnerable communities.