Glisson and colleagues have conducted a number of studies in which they demonstrated that organizational climate (engagement, functionality, stress) and culture (proficiency, rigidity, resistance) can contribute to or interfere with the successful adoption, implementation, and delivery of mental health (MH) and child welfare services to youth. Based on this research, they have developed and begun testing ARC (Availability, Responsiveness, and Continuity), a setting-level intervention that should produce positive changes in organizational functioning and youth outcomes. The intervention will be implemented in 26 Tennessee service delivery programs that serve youth (ages 8–17) in 4 kinds of mental health treatment settings. Frontline staff at these organizations will be trained by ARC program staff in the use of the ARC manual. The primary research participants are the 210 staff in the settings and the 1,075 caretakers of the youth served by the MH programs. The study uses a cluster randomized design: half of the 26 programs will be assigned to the ARC organizational intervention condition and half to treatment-as-usual. Glisson will use the Organizational Social Context (OSC) measure to examine changes in climate and culture. Measures developed by the research team will also tap youth and caregiver perceptions of availability, responsiveness, and continuity of services, as well as the quality of the alliance between providers and caregivers, caregiver satisfaction with services, youth MH symptom level, and treatment compliance.
Can an organizational intervention alter the culture and climate of mental health service programs for youth and result in improvements in staff attitudes, services delivered, and outcomes for recipients?