Examining the Impact of Policy on Collaboration in Systems of Care

Since Jane Knitzer’s 1982 report on Unclaimed Children, many states and localities have been developing systems of care to more effectively serve children with serious emotional disturbance. We report on the methods and outcomes of a two-phase study designed to determine the relationship between the mechanisms that have been used to establish systems of care and their resulting levels of collaboration. A national survey of state mental health authorities revealed that, allowing for multiple approaches, 82% of respondents with systems of care used legislation, 15% used inducements, 41% used capacity building and 44% used other means of system change (e.g., blended funding). Cluster analysis was used to select 10 sites for visits. Multiple methods of collecting data at these sites were used including the administration of a scale on collaboration. Data were obtained from 302 respondents. Difference in beliefs about collaboration and collaborative behaviors were found, indicating that level of collaboration may be an important variable to consider in studies of outcomes of systems of care for children and families.