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Symposia

Dissemination & Implementation Science

Session: Fiscal, Organizational, and End-User Considerations for Improving Use of Evidence in Large Scale Healthcare Systems

2 - (SYM 150) Impact of the Fiscal Mapping Process on Financial Sustainability of Evidence-based Youth Mental Health Treatment Programs: A Pilot Study

Sunday, November 19, 2023
10:30 AM – 12:00 PM PST
Location: Sol Duc (708), Level 7

Background: Sustained delivery of evidence-based treatments (EBTs) is essential to addressing the public health and economic impacts of youth mental health problems, but is complicated by the limited and fragmented funding available to youth mental health service agencies. Strategic planning tools are needed that can guide these service agencies in their coordination of sustainable funding for EBTs. We conducted an initial pilot test of the Fiscal Mapping Process, an Excel-based strategic planning tool that guides efforts to finance the sustainment of EBTs in youth mental health services.

Method: Pilot-testing was completed with 10 youth mental health service agencies over a 12-month period; six agencies focused on sustaining Trauma-Focused Cognitive-Behavioral Therapy and four focused on Parent-Child Interaction Therapy. Service agency representatives received initial training and monthly coaching in use of the Fiscal Mapping Process, and also contributed to the evaluation by completing web-based surveys, focus groups (both internal and with external funding and EBT implementation partners), and a final process mapping exercise. We used case study methods to synthesize all available data (including training and coaching notes and documents shared by agencies), then compare and contrast agency experiences.

Results: Agency experiences with the Fiscal Mapping Process varied. They completed anywhere from 0 to 10 coaching sessions and participated in pilot-testing for an average of 9 months. Findings suggest that the Fiscal Mapping Process works by targeting strategic planning and financial stability, two key capacities for sustaining evidence-based treatment programs, but its impact can be constrained by issues of organizational capacity and environmental support. For example, we found the ideal “use case” for the Fiscal Mapping Process included service agency commitment to sustain the treatment as a dedicated program and availability of clinical managers, financial managers, and senior leadership to contribute to the tool’s use. Participants also suggested that the Fiscal Mapping Process could be easily adapted to other EBTs.

Discussion: Initial evaluation results of the Fiscal Mapping Process are promising. In future work, we plan to integrate the tool into community-based EBT implementation initiatives and comprehensively test its impact on long-term sustainment outcomes across a variety of EBTs.