Costs to Community Mental Health Agencies to Sustain an Evidence-Based Practice
Abstract
OBJECTIVE: Dissemination of evidence-based practices (EBPs) has become a priority in children's mental health services. Although implementation approaches and initiatives are proliferating, little is known about sustainment of EBPs, but evidence suggests that most EBPs are not sustained for more than a few years. Cost is the most frequently cited barrier to sustainment, yet very little is known about these costs. This study provides a method for quantifying incremental costs of an EBP compared with usual care and preliminary data on the costs in staff time, lost revenue, and other expenses of sustaining an EBP (trauma-focused cognitive-behavioral therapy [TF-CBT]) in community mental health settings. METHODS: Fourteen community mental health agencies (CMHAs) completed a measure developed for this study to collect administrative data on implementation costs to sustain TF-CBT. Survey items captured activities that were related specifically to TF-CBT and that would not otherwise be conducted for usual care, such as TF-CBT training. Staff time in hours was converted to monetary estimates. RESULTS: Costs varied widely across agencies. Preliminary results indicated that agencies spent on average $65,192 per year (2014 U.S.$) on incremental costs for TF-CBT sustainment (excluding costs of external trainers and other support); the average incremental cost per client was $1,896. CONCLUSIONS: The costs to sustain the EBP suggest that maintaining an EBP is a financial burden for CMHAs and that these costs can be a potential barrier to broader EBP uptake. Implications for public policy include providing reimbursement rates and financial incentives to offset potential implementation costs and promote sustainment of EBPs.
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The added costs of implementing and sustaining EBPs are a barrier to their use in healthcare settings.
“Such translation is important, given that the added costs of implementing and sustaining EBPs are a barrier to their use in healthcare settings [4–6].”
From Translating economic evaluations into financing strategies for implementing evidence-based practices (2021) · cites this paper as [6]
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“Thus sustainment costs are especially important to understand because initial implementation costs, although often quite high (11), are typically funded through a time-limited grant that does not support the sustainment costs of the EBP indefinitely.”
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- Authors
- Roundfield, K. D., & Lang, J. M.
- Affiliations
- University of California, San Francisco (US)
- Venue
- Psychiatric Services
- Published
- 2017-09-01
- Volume
- 68
- Issue
- 9
- Pages
- 876-882
- ISSN
- 0022-1597 (ISSN-L)
- 1075-2730
- 1557-9700
- OpenAlex
- W2611448782
- Cited by
- 60
- References
- 19
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 9 · 2023: 6 · 2022: 7 · 2021: 9 · 2020: 9 · 2019: 5 · 2018: 4 · 2017: 2
- FWCI
- 8.83
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychiatric Services (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Health Professions › General Health Professions › Health Sciences Research and Education
- Keywords
- trauma-focused cognitive behavioral therapy, community mental health centers, implementation costs, cost barriers, child mental health services, staff training costs, reimbursement policy, usual care comparison
- MeSH terms
- Community Mental Health Services, Connecticut, Humans, Cognitive Behavioral Therapy, Evidence-Based Practice
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