The twenty-first century has witnessed an explosion in studies on comparative health studies, but mental health remains virtually ignored. Unlike the well researched topic of health policy, there is a gap in the marketplace covering mental health policy and health care policymaking. This book fills that gap; it is a comparative analysis of the implementation of Assertive Community Treatment (ACT), an evidence-based practice employed in two states that promises to empower the well-being of individuals suffering from mental illness.
Assertive Community Treatment specifically examines the tension separating the notion of client recovery and evidence-based programs. Johnson challenges the assumption that practitioners should rely on evidence-based practices to close the gap between scientific knowledge and practice. She argues that in an era of managed care, this encourages state mental health administrators to adopt policies that are overly focused on outcomes. Programs that can measure the outcomes of care provided, and evidence-based practices, have become central aspects of the quality care agenda.
This study traces the role of policy entrepreneurs throughout the Assertive Community Treatment policymaking process. By differentiating mental health in general, qualitative research increases the chances of observing similarities and differences in outcomes. Johnson explains why the ACT model was adopted and implemented. She concludes that there is a clear monopoly by medical researchers and scientists within Assertive Community Treatment research, and as a result, too much emphasis is placed on the roles of policy entrepreneurs as the main innovators in the agenda and policy formulation stages. Johnson presents a strong argument for more innovation in the implementation stage.
Table of Contents
List of Tables
I. Assertive Community Treatment:
Evidence-Based Practice or Managed Recovery?
II. Medical Elites and Evidence-Based Practices:
Yesterday and Today
III. Process of Innovation: Theoretical Perspectives
IV The Role of the State Offi ce of Mental Health
in the Adoption and Implementation of Assertive
Community Treatment in New York
V. NAMI-Oklahoma's Role in the Adoption and Expansion
of Assertive Community Treatment in Oklahoma
VI. How Model Fidelity, Medicaid, and Legislative
Ambiguity Infl uence Inconsistent Policy Outcomes
in New York and Oklahoma
VII. Street-Level Entrepreneurs: Promoting Recovery
despite Political and Economic Challenges