Re-engineering Siloed Systems of Care

Overview

Youth behavioral health, including suicidal behaviors and problematic substance use, are significant public health concerns and are routinely identified by community health departments as a high priority. However, needed services are highly fragmented across multiple systems (e.g., prevention, primary care, schools). Addressing these urgent public health concerns requires decisionmakers to collaborate and coordinate services. System-level planning efforts tend to fail because adopted models are either not informed by evidence, or policy decisions do not have sufficient community buy-in and are poorly implemented.

To address this gap, the CoLab (previously SAJE) created a hybrid approach, “System Codesign,” in which researchers and local decisionmakers form a design workgroup and collaborate to create a tailored and sustainable plan to address community public health issues. This partnership approach allows end users to be actively involved in the design process to help ensure that the outcome meets the needs and expectations of the community. The researcher’s role is to locate and synthesize research findings relevant to the community agency’s goals and assist in integrating these principles within real world programming. This new “System Codesign” approach is built from well-established participatory and implementation frameworks and incorporates evidence-informed standards in research into the energy and creativity of design thinking to support local systems. This model is expected to incorporate evidence, innovation, and local relevance into final system products.

Our research team will assess the acceptability and feasibility of this design process by partnering with the Washington State Healthcare Authority (HCA) to pilot this approach in a rural community in Washington with a high prevalence of youth behavioral health needs, Grays Harbor Co. The design workgroup will include behavioral health, pediatrics, juvenile justice, law enforcement, faith-based organizations, schools, and families/youth. 

Status

This project is currently being implemented in Grays Harbor, WA.

Funding

Funding for this project is provided by the Evidence-Based Practice Institute (EBPI), UW Medicine’s Department of Psychiatry and Behavioral Sciences (PBSCI), and Amerigroup Health.