Toward a policy ecology of implementation of evidence-based practices in public mental health settings

Table 1 Summary of Strategies for Policymakers

Level in the Policy Ecology	Strategy
Provider organization	Developing flexible and enhanced reimbursement strategies that accommodate the increased costs of EBP implementation.
	Re-engineering continuing education units to support training in EBPs, auditing and feedback, and disallowing of certain courses for CEU credit.
Regulatory or purchaser agency	Influencing the type of care purchased by changing contracting and bidding procedures.
	Considering expansion of disease management programs as a model for comprehensive EBP implementation.
	Using procedural mechanisms such as prior authorization to support specific EBPs.
	Developing and measuring client-level outcomes to assess the effectiveness of EBPs, and aligning purchasing to the attainment of these outcomes.
Political	Carefully considering enabling legislation to purchase EBPs.
	Legislating mental health parity, and supporting the reduction of stigma and discrimination of individuals with mental health diagnoses.
	Legislating loan forgiveness programs for providers who adopt and promote the use of EBPs.
	Identifying and eliminating structural stigma in all legislation.
	Involving consumer advocates at all levels of implementation.
Social	Reducing stigma and discrimination that can prevent access to needed mental health services, including EBPs.

ISSN: 1748-5908