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California IDDT Training & Evaluation Grant

Integrated Recovery Implementing IDDT: Lessons Learned Three Year Training & Evaluation Grant Implementation Vicki Smith, MSW, CPRP California Institute for Mental Health January 19, 2007, Sacramento, CA. California IDDT Training & Evaluation Grant.

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California IDDT Training & Evaluation Grant

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  1. Integrated RecoveryImplementing IDDT: Lessons LearnedThree Year Training & Evaluation GrantImplementation Vicki Smith, MSW, CPRP California Institute for Mental Health January 19, 2007, Sacramento, CA

  2. California IDDT Training & Evaluation Grant • California Department of Mental Health was awarded a SAMHSA grant in 2003 to provide training for and evaluation of the implementation integrated dual diagnosis treatment in eight sites in four counties throughout the state • The project was contracted to CiMH for Implementation

  3. Background • RWJ sponsored a convening of mental health professionals and researchers that identified six mental health evidence based practices for adults • SAMHSA commissioned the development of fidelity scales and implementation strategies or these six practices. • Subsequently SAMHSA demonstration funds for implementation of these practices • In 2003, SAMHSA gave funding specifically to provide training and evaluation of the implementation of these practices

  4. Implementation Counties • Eight sites, 7 multicultural; one Latino • Alameda – two community providers (one Latino serving site) • Los Angeles - two county sites • Ventura - two county sites • Stanislaus – two county sites

  5. Why Test Training & Implementation? • Components of the IDDT model have been effective in some studies, but… • in other studies effectiveness was not established • when not effective, implementation has frequently been poor or unsuccessful • is the model or implementation the problem? • “Resource Manual” proposes highly structured approach to implementation

  6. Evaluation Issues: California Grant • 3 general questions California project hopes to answer • can the IDDT model be implemented with high fidelity in a variety of California sites typical of public mental health programs serving persons with severe mental illness? • is the Toolkit helpful? What else is important in making implementation work? • will client outcomes in our programs correlate with the fidelity of implementation of the IDDT model?

  7. Evaluation Issues: California Grant • 2 other more specific research questions • will the IDDT model and the toolkit approach work for clients not from the mainstream culture? • will our design of starting with a program that has already partially implemented the model and then using it to leverage implementation in a less developed program in the same county be successful?

  8. Recommended Dissemination SAMHSA IDDT Resource Manual recommended several strategies to use in implementation: • User friendly manuals, toolkits, references • Education and training • For all levels of stakeholders • pre-service and in-service training for staff

  9. Recommended Dissemination • Improve organizational dynamics • quality improvement model • team leadership • interactive staff training • Dissemination research

  10. California Implementation • Based on CiMH experience with counties of the effectiveness of peer learning, the project employed the Community Development Team as a major strategy for implementation • Key representatives of each county and site participated in a CDT to help develop the progress of the project and sharing of successes and problem solving

  11. County & Site Level Process • Develop County-wide Steering Committee • Introduce and review IDDT intervention model to broad base of stakeholders • Establish baseline • understand training and technical assistance needs of each county • Provide monthly (and the offer of phone consultation) staff training in the practice using a trainer who has provided integrated services • Help manage system change • Development team training in organizational change

  12. Site Visit Teams • The teams that conducted the quarterly site reviews, included: • PI • lead trainer • project manager • cultural competence advisor • evaluator • As we gained more experience the number of reviewers decreased

  13. Modifications • Training and Implementation modifications • The development team reviewed the training and implementation experience and the project made changes as necessary, e.g., • Training was expanded to include project management expertise

  14. Implementation Resource • National Implementation Research Network: http://nirn.fmhi.usf.edu/resources/publications/Monograph/

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