A multi-method assessment of behavioral health care reform in New Mexico

Introduction: We present an overview of an NIMH-funded multi-method evaluation of a precedent-setting state policy reform that is intended to improve the behavioral health service system in New Mexico. The reasons for the reform and its goals and structure are described. Our five-year study, which grew from prior AHRQ-funded research on Medicaid managed care in New Mexico, combines quantitative and qualitative approaches to examine the process of introducing the reform within a rural and multi-ethnic state, and the degree to which the reform enhances access and quality of care for low-income individuals with serious mental illness (SMI). Methods: The research design consists of the following elements: (1) a six-county set of structured and semi-structured interviews with consumers, their social supports (i.e., family and close friends), and the behavioral health agency personnel who serve them at baseline, 18 and 36 months; (2) a statewide survey of clinical directors of agencies that provide treatment to individuals with SMI at baseline and 36 months; (3) semi-structured interviews with key policymakers and community leaders at baseline and 36 months; (4) examination of statewide administrative data; and (5) document review. Measures: The content of our instruments, administrative data examination, and document review are described. Results: Progress to date in data collection and analyses are summarized. Discussion: We highlight the potential value of the project for guiding policy development and system reform in New Mexico and in other states or large systems of public behavioral health care. We also review the limitations of the study design.