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Johnson-Kwochka A, Dir A, Salyers MP, Aalsma MC. Organizational structure, climate, and collaboration between juvenile justice and community mental health centers: implications for evidence-based practice implementation for adolescent substance use disorder treatment. BMC health services research. 2020 Oct 8; 20(1):929.
BACKGROUND: Substance use disorders are prevalent among youth involved with the criminal justice system, however, evidence-based substance use disorder treatment is often unavailable to this population. The goal of this study was to identify barriers to effective implementation of evidence-based practices among juvenile justice and community mental health organizations through the lens of an adopter-based innovation model. METHODS: In this mixed-methods study, qualitative interviews were conducted with n? = 15 juvenile justice staff and n? = 14 community mental health staff from two counties implementing substance use services for justice involved youth. In addition, n? = 28 juvenile justice staff and n? = 85 community mental health center staff also completed quantitative measures of organizational effectiveness including the implementation leadership scale (ILS), organizational readiness for change (ORIC), and the implementation climate scale (ICS). RESULTS: Organizationally, staff from community mental health centers reported more "red tape" and formalized procedures around daily processes, while many juvenile justice staff reported a high degree of autonomy. Community mental health respondents also reported broad concern about their capacity for providing new interventions. Staff across the two different organizations expressed support for evidence-based practices, agreed with the importance of treating substance use disorders in this population, and were enthusiastic about implementing the interventions. CONCLUSIONS: While both community mental health and juvenile justice staff express commitment to implementing evidence-based practices, systems-level changes are needed to increase capacity for providing evidence-based services.