Evaluation of the Implementation of the FLOW Program for Increasing Access to Mental Health Care.

Publisher: Springer Country of Publication: United States NLM ID: 9803531 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1556-3308 (Electronic) Linking ISSN: 10943412 NLM ISO Abbreviation: J Behav Health Serv Res Subsets: MEDLINE

Publication: 2006- : New York, NY : Springer
Original Publication: Northbrook, IL : Thousand Oaks, CA : Association of Behavioral Healthcare Management ; Sage Publications, c1998-

Mental Health Services*/organization & administration ; Health Services Accessibility* ; United States Department of Veterans Affairs* ; Veterans*/psychology ; Primary Health Care*/organization & administration; Humans ; United States ; Male ; Female ; Middle Aged ; Program Evaluation ; Mental Disorders/therapy ; Adult

The FLOW program was designed to facilitate appropriate and safe transitions of patients from specialty mental health (SMH) to primary care (PC) as a method of improving access and reducing appointment burden on veterans who have improved or remitted. In this study, the team evaluated the implementation of FLOW across nine Veterans Affairs (VA) sites using a mixed-methods evaluation in a cluster-randomized stepped wedge trial design. Outcome assessments used data from VA databases, dashboards, and semi-structured interviews and were guided by the Reach, Adoption, Effectiveness, Implementation, and Maintenance (RE-AIM) framework. Across the sites, mean level reach was 1.36% of all specialty mental health patients transitioned to primary care (standard deviation [SD] = 1.05). Mean provider adoption was 10.2% (SD = 8.3%). Approximately 75% of veterans were fully satisfied with their transition and reported shared decision-making in the decision to transition. Rates of transitions did not decrease over the 6-month maintenance period following implementation. These data suggest that FLOW can be successfully implemented and maintained, although there was wide variation in implementation across sites. Future research should examine how to support sites that struggle with implementation.
(© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)

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PEC19-302 Quality Enhancement Research Initiative

Date Created: 20240524 Date Completed: 20240616 Latest Revision: 20240616

20240617

10.1007/s11414-024-09886-3

38789862