Improving Coordination of Addiction Health Services Organizations with Mental Health and Public Health Services.
In this mixed-method study, we examined coordination of mental health and public health services in addiction health services (AHS) in low-income racial and ethnic minority communities in 2011 and 2013. Data from surveys and semistructured interviews were used to evaluate the extent to which environmental and organizational characteristics influenced the likelihood of high coordination with mental health and public health providers among outpatient AHS programs. Coordination was defined and measured as the frequency of interorganizational contact among AHS programs and mental health and public health providers. The analytic sample consisted of 112 programs at time 1 (T1) and 122 programs at time 2 (T2), with 61 programs included in both periods of data collection. Forty-three percent of AHS programs reported high frequency of coordination with mental health providers at T1 compared to 66% at T2. Thirty-one percent of programs reported high frequency of coordination with public health services at T1 compared with 54% at T2. Programs with culturally responsive resources and community linkages were more likely to report high coordination with both services. Qualitative analysis highlighted the role of leadership in leveraging funding and developing creative solutions to deliver coordinated care. Overall, our findings suggest that AHS program funding, leadership, and cultural competence may be important drivers of program capacity to improve coordination with health service providers to serve minorities in an era of health care reform.
School of Social Work, University of Southern California, 655 West 34th Street, Los Angeles, CA 90089. Electronic address: erickgue@usc.edu.
Erick G
EG
Guerrero
School of Social Work, University of South Carolina, SC. Electronic address: candrews@mailbox.sc.edu.
Christina
C
Andrews
Kent School of Social Work, University of Louisville, KY, 40292. Electronic address: lesley.harris@louisville.edu.
Lesley
L
Harris
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Box 71579, 760 Westwood Plaza, Los Angeles, CA 90024. Electronic address: hpadwa@ucla.edu.
Howard
H
Padwa
School of Social Work, University of Southern California, 655 West 34th Street, Los Angeles, CA 90089. Electronic address: yinfeiko@usc.edu.
Yinfei
Y
Kong
School of Social Work, University of Southern California, 655 West 34th Street, Los Angeles, CA 90089. Electronic address: kfenwick@usc.edu.
Karissa Fenwick
KF
M S W
D003695:Delivery of Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data*; D006296:Health Services / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D008605:Mental Health Services / Q000706:statistics & numerical data*; D016730:Program Development / Q000706:statistics & numerical data*; D019966:Substance-Related Disorders / Q000628:therapy*
Coordination; Funding; Leadership; Mental health services; Public health services