A Critical Examination of the Certified Community Behavioral Health Clinic Model: Provider Perceptions and Themes
本研究通过焦点小组访谈，探讨了两家社区行为健康机构在实施认证社区行为健康诊所模式时的经验，发现该模式改善了服务可及性和护理协调，但面临社区资源不足和长期资金可持续性挑战。
OBJECTIVE: To explore the experiences of providers from two community behavioral health agencies involved in the implementation of Certified Community Behavioral Health Clinics (CCBHCs). STUDY SETTING AND DESIGN: This qualitative study was conducted as part of a larger evaluation of CCBHC implementation outcomes in two community-based behavioral health agencies. Ninety-one participants, including case managers, counselors, care coordinators, and leadership teams from both agencies, participated in focus group discussions to share their experiences regarding the implementation of the CCBHC model within their organizations. DATA SOURCES AND ANALYTIC SAMPLE: Three rounds of focus group discussions were held between 2021 and 2023. A total of 24 focus groups were audio-recorded and transcribed by one of the researchers. Qualitative data was analyzed by two researchers using the systematic text condensation method. PRINCIPAL FINDINGS: Six themes emerged from the focus groups reflecting both positive impacts and implementation challenges. Providers reported the implementation of CCBHCs improved service accessibility and effective care coordination; however, staff noted difficulties connecting clients with essential community resources, including housing and transportation. Both agencies underwent significant organizational transformation, although communication strategies varied by agency size. Finally, providers observed improved communication, client benefits (e.g., reduced hospitalizations), and positive organizational change. Despite these successes, agencies expressed significant concerns about long-term program viability due to reliance on temporary grant funding. CONCLUSION: The CCBHC model of integrated care has expanded significantly in recent years. Most participants reported a positive cultural shift within their agencies following CCBHC implementation. However, limited community resources continue to restrict agencies' ability to address clients' basic needs. Since the CCBHC model was implemented through temporary grant funding, sustainability remains a concern. Both issues underscore the need for policies that increase the availability of community resources and ensure the long-term viability of CCBHCs.