SESSION ABSTRACT: Statewide behavioral health reform in New Mexico: Assessing change across system levels

It is rare that a public behavioral health service system undergoes substantial statewide restructuring. In July 2005, the predominantly rural and ethnically-diverse state of New Mexico launched a unique reform in managed behavioral health care. This reform is intended to enhance provider workforce capacity and ensure delivery of consumer-driven, recovery-oriented care to low-income individuals. This panel provides an overview of this initiative, focusing on baseline data, implementation, and preliminary outcomes. We describe an NIMH-funded mixed-methods assessment of the process and impact of system change at multiple analysis levels: organization/management, provider/staff, and service user. Panelists include researchers and state officials who have joined together in a multidisciplinary team in order to evaluate the system redesign. The first presentation reviews redesign efforts, emergent issues associated with the reform, and research methods that drive our assessment. Employing a qualitative research perspective, the second presentation offers insight into the work of providers and staff under the reform, highlighting their experiences and reactions to system change. The third presentation takes a quantitative approach to examine the impact of leadership on organizational climate and subsequent provider intentions to leave their organizations. The fourth presentation uses quantitative and qualitative methods to examine consumer access to care and prescription psychotropic medication use during early stages of system change. The final presentation critically considers our multi-method approach to understanding public policy and suggests directions for future research, clarifying the challenges in reform processes that must be tackled for system change to most effectively benefit consumers.