Identifying gaps in and improving integration of urban behavioral health services through social network analysis

Behavioral health disparities among low-income mothers are well-established. Many low-income mothers receiving public assistance and/or who are involved with the child welfare system experience mental health, substance abuse, and/or intimate partner violence problems individually or in concert that can prevent self-sufficiency and family stability. Evidenced-based programs have been developed to address these disparities at the individual level (e.g. treatment for substance abuse). However, very little work has been done to examine systems-level barriers – e.g. conflicting policies, lack of collaboration or integration among agencies, accessibility and/or affordability of services – experienced by these mothers and which can perpetuate these disparities. This study leverages an innovative blend of social network analysis, survey, and semi-structured interview methodologies to examine both individual and systemic barriers and identify opportunities for better integration among behavior health providers to reduce the disparities experienced by these mothers.

Using social network analysis, the network information received from participants was used to identify existing relationships among system partners, qualify the strength of these relationships, highlight prominent nodes (points of convergence of multiple relationships) and determine potential gaps in the behavioral health system related to low-income mothers. Survey and interview data from agency participants further illuminated perceived systemic barriers and opportunities for greater systemic integration. Survey data from low-income mothers helped determine the prevalence of barriers to self-sufficiency and family stability, as well as perceptions of systems-level barriers.

These findings are presented along with practical implications for both researchers and practitioners looking to improve behavioral health services among low-income mothers.