Adapting the Fiscal Mapping Process to Improve the Financial Sustainability of Implementation and Mental Health Organizations

About This Grant

Sustainability of evidence-based mental health intervention (EBI) implementation is a challenge to increasing access to mental health services. Funding is a common barrier to sustainment. EBIs, while cost effective, are expensive to implement. The Fiscal Mapping Process is a strategic planning tool designed for behavioral health agencies to plan the financial sustainment of specific EBIs. Financial planning at an organizational level is required to enable mental health implementation and provider organizations to sustainably operate. Without careful consideration, mental health organizations’ business models could unintentionally decrease access to care for some individuals if profit is prioritized or if only certain patient populations are reached. Research is needed to help implementation and mental health organizations identify financing strategies to sustainably increase access to EBIs. The proposed K08 will adapt the Fiscal Mapping Process for implementation and mental health organizations to plan for financial sustainability of their organization (rather than a specific EBI), without sacrificing implementation of EBIs. The study uses human-centered design methods and has three aims: (1) Identify aspects of the Fiscal Mapping Process to adapt for use with implementation and mental health organizations; (2) Iteratively adapt the Fiscal Mapping Process for implementation and mental health organizations; and (3) Assess the preliminary impact and usability of the Fiscal Mapping Process for implementation and mental health organizations financial sustainability. To ensure its successful execution and to build the investigator’s capacity for independent research, the following training aims are proposed: (1) Acquire training in factors that affect the sustainability of EBI implementation, with an emphasis on financing strategies; (2) Develop knowledge of how implementation and mental health organizations function to increase access to EBIs; (3) Deepen expertise in D&I science by learning human-centered design methods; and (4) Deepen expertise of qualitative methods and learn mixed methods approaches. Training and research will be overseen by co-mentors Dr. Rani Elwy (Brown University), Dr. Alex Dopp (Rand Institute), Dr. Aaron Lyon (University of Washington), Dr. Bo Kim (Boston VA), Dr. David Mohr (Northwestern), Dr. William Aldridge (University of North Carolina Chapel Hill), and consultant Dr. Joshua Kemp (Brown University). The project will create a financial planning tool (the adapted Fiscal Mapping Process) to improve organizational financial sustainability while promoting access to evidence-based interventions.