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Evaluation & the Health Professions
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Challenges to Implementing and Sustaining Comprehensive Mental Health Service Programs

Paul B. Gold

Medical University of South Carolina

Shirley M. Glynn

Veterans Affairs Greater Los Angeles Healthcare System at West Los Angeles; University of California, Los Angeles, Semel Institute for Neuroscience and Human Behavior

Kim T. Mueser

Dartmouth Medical School; New Hampshire-Dartmouth Psychiatric Research Center

The President's New Freedom Commission recently concluded that the nation's mental health service delivery system is ill equipped to meet the complex needs of persons with mental illness. A major contributor to this service quality crisis has been the longstanding divergence of research efforts and clinical programs. In this article, the authors begin by describing the unique needs of persons with serious and persisting psychiatric disorders and the evolution of the mental health service system that has attempted to meet these needs. They then discuss recent efforts to upgrade services by emphasizing the use of evidence-based practices (EBPs) and the research underlying their development. Next, they describe the difficulties of using traditional research methods to develop and test interventions for persons receiving services at public mental health agencies. Finally, they outline the challenges confronted when trying to disseminate these EBPs to the wider clinical community.

Key Words: evidence-based practice • mental health practice and policy • psychiatric disability • dissemination • implementation

Evaluation & the Health Professions, Vol. 29, No. 2, 195-218 (2006)
DOI: 10.1177/0163278706287345
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