The twenty-first century has witnessed an explosion in studies
on comparative health studies, but mental health remains virtually
ignored. Unlike the well researched topic of health policy, there
is a gap in the marketplace covering mental health policy and
health care policymaking. This book fills that gap; it is a
comparative analysis of the implementation of Assertive Community
Treatment (ACT), an evidence-based practice employed in two states
that promises to empower the well-being of individuals suffering
from mental illness.
Assertive Community Treatment specifically examines the tension
separating the notion of client recovery and evidence-based
programs. Johnson challenges the assumption that practitioners
should rely on evidence-based practices to close the gap between
scientific knowledge and practice. She argues that in an era of
managed care, this encourages state mental health administrators to
adopt policies that are overly focused on outcomes. Programs that
can measure the outcomes of care provided, and evidence-based
practices, have become central aspects of the quality care
agenda.
This study traces the role of policy entrepreneurs throughout
the Assertive Community Treatment policymaking process. By
differentiating mental health in general, qualitative research
increases the chances of observing similarities and differences in
outcomes. Johnson explains why the ACT model was adopted and
implemented. She concludes that there is a clear monopoly by
medical researchers and scientists within Assertive Community
Treatment research, and as a result, too much emphasis is placed on
the roles of policy entrepreneurs as the main innovators in the
agenda and policy formulation stages. Johnson presents a strong
argument for more innovation in the implementation stage.
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