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Open Access Highly Accessed Research

The organizational social context of mental health services and clinician attitudes toward evidence-based practice: a United States national study

Gregory A Aarons12*, Charles Glisson3, Phillip D Green3, Kimberly Hoagwood45, Kelly J Kelleher6, John A Landsverk2 and The Research Network on Youth Mental Health

Author Affiliations

1 University of California, San Diego, Department of Psychiatry, 9500 Gilman Drive (0812), La Jolla, CA, 92093-0812, USA

2 Child and Adolescent Services Research Center at Rady Children’s Hospital San Diego, 3020 Children’s Way MC-5033, San Diego, CA, 92132, USA

3 Children's Mental Health Services Research Center, Henson Hall, University of Tennessee, Knoxville, TN, 37996, USA

4 New York University School of Medicine, One Park Avenue at East 33rd, 8th Floor, New York, NY, 10016, USA

5 New York State Office of Mental Health, 44 Holland Avenue, Albany, NY, 12229, USA

6 The Ohio State University, Pediatrics and Public Health, 700 Children’s Drive, Columbus, OH, 43205, USA

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Implementation Science 2012, 7:56  doi:10.1186/1748-5908-7-56

Published: 22 June 2012

Abstract

Background

Evidence-based practices have not been routinely adopted in community mental health organizations despite the support of scientific evidence and in some cases even legislative or regulatory action. We examined the association of clinician attitudes toward evidence-based practice with organizational culture, climate, and other characteristics in a nationally representative sample of mental health organizations in the United States.

Methods

In-person, group-administered surveys were conducted with a sample of 1,112 mental health service providers in a nationwide sample of 100 mental health service institutions in 26 states in the United States. The study examines these associations with a two-level Hierarchical Linear Modeling (HLM) analysis of responses to the Evidence-Based Practice Attitude Scale (EBPAS) at the individual clinician level as a function of the Organizational Social Context (OSC) measure at the organizational level, controlling for other organization and clinician characteristics.

Results

We found that more proficient organizational cultures and more engaged and less stressful organizational climates were associated with positive clinician attitudes toward adopting evidence-based practice.

Conclusions

The findings suggest that organizational intervention strategies for improving the organizational social context of mental health services may contribute to the success of evidence-based practice dissemination and implementation efforts by influencing clinician attitudes.

Keywords:
EBPAS; OSC; Evidence-based practice; Evidence-based practice attitude scale; Mental health services; Provider attitudes; Organizational social context; Culture; Climate