title: Implementing evidence-based practice in community mental health agencies: a multiple stakeholder analysis.
abstract: OBJECTIVE
  We sought to identify factors believed to facilitate or hinder evidence-based practice (EBP) implementation in public mental health service systems as a step in developing theory to be tested in future studies.
  
  
  METHODS
  Focusing across levels of an entire large public sector mental health service system for youths, we engaged participants from 6 stakeholder groups: county officials, agency directors, program managers, clinical staff, administrative staff, and consumers.
  
  
  RESULTS
  Participants generated 105 unique statements identifying implementation barriers and facilitators. Participants rated each statement on importance and changeability (i.e., the degree to which each barrier or facilitator is considered changeable). Data analyses distilled statements into 14 factors or dimensions. Descriptive analyses suggest that perceptions of importance and changeability varied across stakeholder groups.
  
  
  CONCLUSIONS
  Implementation of EBP is a complex process. Cross-system-level approaches are needed to bring divergent and convergent perspectives to light. Examples include agency and program directors facilitating EBP implementation by supporting staff, actively sharing information with policymakers and administrators about EBP effectiveness and fit with clients' needs and preferences, and helping clinicians to present and deliver EBPs and address consumer concerns.
authors.affiliation: University of California, San Diego, Department of Psychiatry, 9500 Gilman Dr (0812), La Jolla, CA 92093-0812, USA. gaarons@ucsd.edu
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Aarons
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Wells
authors.forename: Karen
authors.initials: K
authors.lastname: Zagursky
authors.forename: Danielle L
authors.initials: DL
authors.lastname: Fettes
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Palinkas
mesh_terms: D000293:Adolescent; D002140:California; D003156:Community Mental Health Services; D003256:Community Participation; D003159:Community-Institutional Relations; D055317:Evidence-Based Practice; D005260:Female; D006801:Humans; D008297:Male; D019982:Organizational Case Studies