Behavioral health community indicators: An innovative approach to measuring effective service provision

Through a multi-year process, a community-based participatory research project in Austin, Texas has developed 5 indicators to measure improvement in the community's behavioral health. The project uses methodologies to develop and test hypotheses relating to the following indicators: (1) Percent of individuals with serious mental illness in the county jail; (2) Characteristics of individuals who are readmitted to psychiatric hospital beds within thirty days of discharge; (3) Percent of children in the Austin Independent School District who are removed from school to alternative learning settings; (4) Percent of individuals reporting to emergency Departments with substance use diagnoses; and (5) Percent of individuals presenting to behavioral health settings who report housing instability.

Researchers examined demographic and other data to identify factors that correlated with negative outcomes such as homelessness. They then applied Root Cause Analysis to determine why the relevant service systems failed in these instances. They proposed community-level changes to elements of service provision and measured any resulting movement in the indicator.

To date, researchers have identified strong correlations for several indicators. Case studies have presented clear hypotheses on causes of system failure. Community-based service providers have implemented changes based on the hypotheses and researchers are monitoring the five indicators for change over time. In addition, the participatory research project has galvanized community members and service providers, prompting new collaborations.

This project seeks to understand factors impacting the level of each indicator and interventions the community can implement to decrease the number and improve the behavioral health of the community.