Integration Diffusion for SMI Service Delivery

Kimberly R. Isett, Ph.D., Principal Investigator (Columbia University)
Alan R. Ellis, MSW, Project Analyst

The goal of this study was to describe and assess the process by which integration spreads through a multi-sector service delivery network for adults with Serious Mental Illness (SMI). Although calls for integration have been widespread over the past twenty years, a renewed interest in integration has emerged with the New Freedom Commission’s published report, “Achieving the Promise.” Despite past empirical efforts to address the integration levels in service delivery networks, little work has been completed to understand the process by which integration spreads in a network and how we might expect agencies from service sectors other than mental health to react to and interact with the mental health services and clients. This knowledge will aid policy makers and administrators to more effectively implement integration strategies and to create realistic expectations about the cooperation among agencies within their networks. This project used secondary data from the CMHS’ Access to Community Care and Effective Service Supports (ACCESS) program, which provided funds to integrate services in nine sites (with an additional nine comparison sites) for homeless seriously mentally ill adults. Social network data and organizational variables were used in hierarchical linear models to describe the pattern through which integration spread within these nine networks, as well as to evaluate whether any specific combinations of organizational variables serve to facilitate or impede the uptake of integration practices within the networks. Analysis is nearing completion.