Barriers and Facilitators in the Implementation of Measurement-Based Care in Outpatient Behavioral Health in a Safety-Net Hospital.

Measurement-based care (MBC) is an evidence-based practice that can improve the identification of co-occurring mental health conditions and substance use disorders, as well as population differences in care in lower resource settings, through ongoing monitoring of patient-reported symptoms. The curr...

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Published in:Community Mental Health Journal Vol. 62; no. 3; pp. 561 - 571
Main Authors: Dean, Kimberlye, Youn, Soo Jeong, Nakle, Mira, Heller, Sam, Kramer, Joanna, Stone, Mira, Wilens, Timothy E., Marques, Luana, Yule, Amy M.
Format: Article
Published: Springer Nature Apr2026
Subjects:
Online Access:View this record in EBSCOhost
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      dt: Apr2026
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        10.1007/s10597-025-01548-8
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        atl: Barriers and Facilitators in the Implementation of Measurement-Based Care in Outpatient Behavioral Health in a Safety-Net Hospital.
      aug:
        au:
          Dean, Kimberlye
          Youn, Soo Jeong
          Nakle, Mira
          Heller, Sam
          Kramer, Joanna
          Stone, Mira
          Wilens, Timothy E.
          Marques, Luana
          Yule, Amy M.
        affil:
          Massachusetts General Brigham, Boston, United States
          https://ror.org/05qwgg493 Boston University School of Public Health, Boston, United States
          https://ror.org/010b9wj87 Boston Medical Center, Boston, United States
      su:
        United States
        Mental illness treatment
        Health services accessibility
        Mental health services
        Qualitative research
        Focus groups
        Interviewing
        Leadership
        Sound recordings
        Social networks
        Communication
        Psychiatric diagnosis
        Medical care use
        Safety-net health care providers
        Research funding
        Judgment sampling
        Research methodology
        Health outcome assessment
        Data analysis software
        Stakeholder analysis
      sug:
        subj:
          Mental illness treatment
          Health services accessibility
          Mental health services
          Qualitative research
          Focus groups
          Interviewing
          Leadership
          Sound recordings
          Social networks
          Communication
          United States
          Residential Mental Health and Substance Abuse Facilities
          Psychiatric and Substance Abuse Hospitals
          Offices of Mental Health Practitioners (except Physicians)
          Other Individual and Family Services
          Integrated Record Production/Distribution
          Sound recording merchant wholesalers
          Record Production
          Psychiatric diagnosis
          Medical care use
          Safety-net health care providers
          Research funding
          Judgment sampling
          Research methodology
          Health outcome assessment
          Data analysis software
          Stakeholder analysis
      keyword:
        Behavioral Health
        Implementation Science
        Measurement-Based Care
        Medical and Health Sciences Public Health and Health Services
        Safety-Net Hospital
        Behavioral Health
        Implementation Science
        Measurement-Based Care
        Medical and Health Sciences Public Health and Health Services
        Safety-Net Hospital
      ab: Measurement-based care (MBC) is an evidence-based practice that can improve the identification of co-occurring mental health conditions and substance use disorders, as well as population differences in care in lower resource settings, through ongoing monitoring of patient-reported symptoms. The current study examined, as reported by different stakeholders prior to implementation, barriers and facilitators of implementing screening tools to monitor mental health and substance use symptoms in the outpatient behavioral health setting at a safety-net hospital. A purposeful sampling approach was used to recruit stakeholders from two outpatient clinics (child, adult) to participate in individual interviews (clinic leadership) and stakeholder-specific focus groups (clinicians and administrative staff). De-identified transcripts were coded using a directed content analytic approach guided by constructs from the Consolidated Framework for Implementation Research (CFIR). A total of 14 clinicians, 6 clinic leaders, and 4 administrative staff participated in interviews and focus groups. Results indicate stakeholder agreement on specific implementation constructs (e.g., patient needs, networks and communication) and unique perspectives influenced by the stakeholders' day-to-day responsibilities. However, there were inconsistent responses regarding networks and communication across stakeholder groups. Clinicians only identified barriers, clinic leadership only identified facilitators, and administrative staff did not identify communication as a barrier or facilitator. Thus, when implementing MBC within a safety-net behavioral health clinic setting, cohesive communication may be perceived differently by clinicians, clinic leadership, and administrative staff and should be validated across staff roles.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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