Structure and change in child mental health service delivery networks

Abstract

This article presents an empirical approach which views mental health service systems as interorganizational networks. Data are reported on two county-based child mental health systems in North Carolina that participated in the Robert Wood Johnson Foundation (RWJF) Mental Health Services Program for Youth. Analyses are based on a structural equivalence approach which groups organizations on the basis of similarity in their patterns of interaction. Site-specific data were collected at two time points (1991 and 1993) to measure the social network structure of these service systems including their density, fragmentation, and centralization. Findings indicate that two interesting changes occurred in these systems of care. First, each system moved in a direction consistent with the goals of the RWJF demonstration program, in that they were better organized by the end of the demonstration. Second, while the two systems started at very different levels of system development, one site made significantly larger gains, such that the systems converged over time toward moderately high levels of system organization at the end of the demonstration. Implications for further research are discussed. © 1996 John Wiley & Sons, Inc.