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Research not just for research's sake

February 1, 2008
by Stephen Christian-Michaels
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A community agency works with academic partners to conduct meaningful research projects

Academic researchers often approach community mental healthcare agencies, such as Family Services of Western Pennsylvania (FSWP), to request access to the populations we serve for study samples. The usual request is for permission to collect data about clients’ characteristics or to recruit individuals for participation in treatment interventions designed in academic settings. Like other agencies, FSWP accepted many of these requests, although they often did not directly relate to our service mission or provide many direct benefits to the majority of clients. Even when the research was useful to our agency or clients, the agreements often fell short of producing findings that could be used to improve quality of care.

With this in mind, we agreed to be part of a National Institute on Mental Health-funded Intervention and Practice Research Infrastructure Support Program (IP-RISP). This “new” way of doing research seemed to present the possibility of a collaboration that would benefit both us and the academic researchers.

The Collaborators

FSWP is a progressive mental health/social service agency serving 7,000 people yearly from an urban/suburban area that includes parts of Pittsburgh and two surrounding counties. The primary academic partners are researchers from the University of Pittsburgh's Department of Psychiatry and School of Social Work. Our mutual interest in discovering barriers to treatment access and ways to improve treatment engagement made us logical partners in developing an agency infrastructure to conduct research on engagement strategies for low-income clients.

The Goals

We received funding to contribute to the enhancement, relevance, and effectiveness of agency services by initiating a research program that would address client and systemic factors contributing to barriers to care. The proposal focused on the impact of unacknowledged differences in the values, assumptions, and priorities of low-income clients, agency clinicians and administrators, and academic researchers. The collaboration spent the past four years examining mental health interventions in our “real-world” setting using quantitative and qualitative research methodologies.

We developed a collaborative academic-agency research infrastructure that would facilitate the agency's ability to participate in research studies—an infrastructure that, in fact, will enable us to conduct our own studies beyond the life of this project. We began a series of collaborative pilot studies targeting underserved low-income populations to improve our understanding of clients’ perspectives and allow us to develop and test the effectiveness of culturally sensitive engagement strategies.

Because so many academic-community agency collaborations fail, we have been conducting an ethnographic study of the partnership to enhance understanding and diminish barriers to collaboration.

Research clearly is not a community agency's primary mission. However, our agency is interested in research, and this collaboration offered an approach that did more than simply advance the university partners’ research mission. We believed research could support our interest in gaining an increased awareness of consumer perspectives of their needs and our services, and help us to decrease premature treatment dropout and improve the cost-effectiveness of care. We also believed that research on these issues would help us to improve services by establishing an agency practice of incorporating systematic evidence into all of our decisions.

We hoped to be a part of generating information that would stimulate new ideas and ways of implementing effective treatments consistent with our local context that would strengthen our role as a leader among community agencies. We believed that an alliance with the university and the research infrastructure would help us to understand and better address specific client needs, while creating an agency culture of ongoing self-examination and performance enhancement.

Beyond the results we might attain through any specific study, we believed that the development of an agency research capacity would contribute to a number of “halo” effects. We believed it would generally improve service quality and outcomes, increase productivity and morale, help us implement more evidence-based treatments, and increase our ability to attract graduate students and professional employees.

Lessons Learned

While a number of challenges are involved in conducting research in an agency setting, we have been able to conduct a range of projects in this initial effort, including studies of:

  • Outpatient engagement

  • Case management

  • Staff morale

  • Incentive pay

  • Program outcome measurement

The table lists a number of lessons we learned in this joint effort that should contribute to the success of this and future collaborations. They are described in further detail below.

Know your partners. This type of collaboration requires a close working relationship between two disparate entities, so it is important to have some idea that the people you are committing to work with are at least somewhat compatible with the agency's mission and goals. Success depends on each partner knowing the other's interests, work style, strengths, and weaknesses. Finding the right partners is not always easy, but it is possible to check out the type of research being done at local universities to determine if those projects are relevant to your agency.

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