In summary, effective PMHAs
Articulate a vision
Bring stakeholders together
Plan the implementation process
A key element is the PMHA's relationship with the implementing mental health agencies. Experience and some research suggests that the state's PMHA, mental health centers, and hospitals need to agree and commit to implementing new practices. This is may be a new role for these groups and different relationships may need to be formed. The best outcomes occur when:
commissioners and mental health trade associations act in concert with clear definition of roles and responsibilities;
the local agencies and/or their trade association take a clinical and programmatic lead;
the PMHA encourages the initiative and provides key forms of support, including, financial, publicity and other incentives for agencies.
In some states, it is worth noting that present reimbursement systems reward state and federal budgets when Evidence Based Practices are provided, but the additional implementation costs are borne by the local providers. Directives that local providers implement EBPs without additional support or profit-sharing arrangements have tended to increase friction between the state and local levels and have not easily led to success in implementing Evidence Based Practices. Thus, PMHAs should work to assess cost savings to the mental health system and find ways to support provider agencies regarding implementation costs and financial incentives for using Evidence Based Practices such as FPE.
There are a variety of roles the PMHA can play
disseminating information about family psychoeducation
promoting the implementation of family psychoeducation
working in, and developing, partnerships with mental health centers and trade
associations, a key to success in adopting and implementing this approach
providing financial and political support, including fiscal and
exploring profit-sharing to provide equity and incentives for implementing FPE services
Planning for the change
Beyond consensus building, the PMHAs role is planning for, and leading, the change so that the practice will be accepted and sustained. This planning may include such factors as financing incentives, rules changes, contracting processes, human resources development, and assessment of outcomes. Just as important is the consistent communication of the expectation that services will meet current best-practice standards and, thereby, realize the potential benefits for all stakeholders. Presentations and orientation sessions by national EBP clinical leaders have proven essential and quite cost-effective in educating and persuading key stakeholders to commit to implementation.
The challenge of how to sustain the practice needs to be addressed as part of the initial planning process. The PMHA has to develop strategies to address this issue and ensure that it gets attended to so the practice will continue to grow and develop. Finally, the PMHA
Family Psychoeducation Toolkit