In this process we will incorporate lessons from the many exemplary and innovative programs that exist within the DMHAS system. Key lessons learned from this dynamic process, based on a practical and inclusive definition of evidence, will inform the Department’s planning in ways that promote developing and sustaining a recovery-oriented system of care.
Purpose: DMHAS, like other state behavioral health agencies, is working to implement Evidence-based Practices (EBPs) wherever possible. However, scientific research is often incomplete and inadequate in many important areas of clinical practice. Additionally, it takes an astounding average of 17 years for new knowledge generated by randomized controlled trails to be incorporated into clinical practice. This unacceptably long science-to-service waiting period has forced behavioral health policymakers to consider using other forms of “evidence” to guide programmatic and resource allocation decisions.
DMHAS is using the following four categories to evaluate levels/types of evidence used to support clinical interventions, program design and systems policy changes.Evidence Based
Example: A series of randomized controlled trials comparing supported employment (also referred to as “IPS, Individual Placement and Support”) with a variety of traditional, “step-wise” vocational programs has clearly established supported employment as a highly effective intervention. This intervention results in significant gains in competitive employment rates, earned income levels, and employment tenure among individuals with severe behavioral health disorders.
Example: As one component of a quality improvement program in a local mental health authority, an in-service training program for providers and consumers/people in recovery was offered regarding the use of strategies to improve the collaborative, person-centered nature of treatment planning. Pre-post data collected prior to and after the training intervention indicated significant improvements in consumer satisfaction and consumers’ level of participation in treatment planning.
Example: MET has been shown to be a highly effective approach for engaging people into treatment. While no studies have examined the use of MET specifically with African American men, based on the overall effectiveness of MET, it is reasonable to extrapolate and pilot this approach within this population. Data from the pilot will determine if extrapolation was an appropriate decision and identify potential MET modifications necessary for the specific population of African American men.
Example: Experience has shown us the importance of Culturally Competent and Recovery-Oriented Care, yet scientific evidence lags behind the expert and values-based and anecdotal consensus regarding the effectiveness of these approaches.
 From a 2001 report published by the Institute of Medicine (IOM), an arm of the National Academy of Sciences, entitled – Crossing the Quality Chasm: A New Health System for the 21st Century
Addiction Treatment Forum
Addiction Treatment Forum article: Evidence-based Addiction Medicine
Centers for the Application of Prevention Technologies
Substance Abuse Mental Health Services Administration
National Guidelines Clearinghouse
Content Last Modified on 1/28/2011 3:32:16 PM