Enhancing Mental Health Treatment Engagement among Probationers: Adapting an Organizational Linkage Implementation Strategy for Specialty Mental Health Probation

项目摘要/摘要 严重精神疾病患者(SMI)在整个刑事司法系统中的比例不成比例 其中绝大多数人处于缓刑和假释状态。实施循证实践以 使用SMI解决涉及司法的人的需求需要了解以下多层面因素 在心理健康和刑事司法系统中实施影响干预措施以及专门知识 解决这些因素。Tonya Van Deinse博士建议的K01培训计划和研究，在 NIH资助的指导团队的专家指导，将为她提供密集的实质性和 方法培训和研究经验，成为实施复杂的、交叉的 机构干预，以满足涉及司法的SMI患者的需求。专科精神卫生 缓刑(SMHP)是一种循证干预，旨在让患有SMI的人接受治疗和 把他们从刑事司法系统转移开。尽管高保真SMHP可以提高心理健康和 物质使用服务参与，改善精神健康症状，降低再次逮捕率，监禁天数 和缓刑违规，有效实施SMHP取决于上下文，并依赖于 SMHP官员与心理健康服务提供者之间的组织关系。具体而言，SMHP 要求官员加强治疗联系和资源协调，并担任边界扳手 弥合缓刑监督官和心理健康之间的机构间协调和合作差距 服务提供商。鉴于组织间关系在实施SMHP中的重要性， 有必要评估影响其跨机构执行环境的多层次因素，并制定 加强组织间关系的实施战略。本提案改编了现有的 加强缓刑监督官协调、协作和联系能力的实施办法 对患有SMI的缓刑患者进行治疗。这种经过调整的实施方法称为联网以参与 治疗中：在官员-资源协作(NETWORC)内工作，将通过以下方式开发和测试 以下目标：(1)查明阻碍SMHP官员将个人与SMI联系起来的能力的多层次因素 对治疗提供者；(2)对NETWORC实施方法进行过程评估；以及(3) 评估协作实施工具包的有效性、可接受性、适当性和可行性。 这项研究的结果将提供关于适应的可行性和有效性的初步数据 实施战略，并将用于开发Van Deinse博士的后续R01，一个务实的集群 使用多水平分析的随机试验，以检查实施战略对 试用者、军官和组织间级别。

PROJECT SUMMARY/ABSTRACT People with serious mental illnesses (SMI) are disproportionately represented throughout the criminal justice system, the vast majority of whom are on probation and parole. Implementing evidence-based practices to address the needs of justice-involved people with SMI requires an understanding of the multilevel factors that impact intervention implementation in both the mental health and criminal justice systems and the expertise to address these factors. Dr. Tonya Van Deinse’s proposed K01 training plan and research study, under the expert guidance of an NIH-funded mentoring team, will provide her with intensive substantive and methodological training and research experience to become a leading expert in implementing complex, cross- agency interventions to address the needs of justice-involved people with SMI. Specialty mental health probation (SMHP) is an evidence-informed intervention that aims to engage people with SMI in treatment and divert them from the criminal justice system. Although high-fidelity SMHP can increase mental health and substance use service engagement, improve mental health symptoms, and reduce rates of rearrest, jail days and probation violations, effective implementation of SMHP is context-dependent and relies on inter- organizational relationships between SMHP officers and mental health service providers. Specifically, SMHP requires officers to increase treatment linkage and resource coordination and serve as boundary spanners who bridge the interagency coordination and collaboration gap between probation officers and mental health service providers. Given the importance of inter-organizational relationships in implementing SMHP, it is necessary to assess the multilevel factors that impact its cross-agency implementation context and to develop implementation strategies to enhance inter-organizational relationships. This proposal adapts an existing implementation approach to enhance probation officers’ capacity for coordination, collaboration, and linking probationers with SMI to treatment. This adapted implementation approach, to be called Networking to Engage in Treatment: Working within Officer-Resource Collaboratives (NETWORC), will be developed and tested via the following aims: (1) identify multi-level factors that inhibit SMHP officers’ capacity to link individuals with SMI to treatment providers; (2) conduct a process evaluation of the NETWORC implementation approach; and (3) evaluate the efficacy, acceptability, appropriateness, and feasibility of the collaborative implementation toolkit. Findings from this study will provide preliminary data about the feasibility and efficacy of the adapted implementation strategy and will be used to develop Dr. Van Deinse’s subsequent R01, a pragmatic cluster randomized trial using multilevel analyses to examine the impact of the implementation strategy on probationer, officer, and inter-organizational levels.