This proposed study addresses a critical link between the mental health workforce crisis and mental health agency readiness to implement evidence-based practice (EBP) in mental health service organizations. The public health significance of this research lies in improving mental health agencies ability to effectively implement and sustain EBPs in real-world community settings, ultimately improving service effectiveness. Research suggests that effective leadership leads to improved organizational climate and that more positive climate is associated with positive staff work attitudes and service provider attitudes toward adopting EBP. States, agencies, and programs are increasingly working to implement EBPs and manager leadership skills are generally not tailored to maximize organizational readiness to implement EBPs. Indeed, the NIMH Division of Services and Intervention Research have identified, as a high priority, the objective of improving the implementation of evidence-based interventions into service settings. EBP implementation represents significant change to work techology and procedures and leadership impacts readiness for change. Yet there has little empirical work on organizational interventions to facilitate EBP implementation. One promising solution to address this critical workforce and public health issue lies in improving leadership in mental health service organizations. First-level leaders are those who supervise staff who interact directly with consumers at the front lines mental health service delivery. This aptly describes many mental health program managers who have administrative, management, and human resources functions, and are also responsible for clinical supervision and leading, implementing, and supervising change in practice including implementing EBPs. Effective leadership inspires and motivates followers and supports effective staff behaviors through reinforcement and exchanges. The proposed work builds on an empirically supported and theoretically sound approach to effective leadership in organizations in order to train first-level leaders to effectively implement EBP. Thus, while there are a number of concerns for the mental health workforce, the present application focuses on improving leadership in order improve mental health organizational readiness to effectively implement EBPs.

Public Health Relevance

The proposed study seeks to develop a leadership intervention to improve leadership knowledge, skills, abilities, and performance of mental health program managers in order to improve workplace climate, and readiness for implementation of evidence-based practice. The study uses a collaborative approach involving program managers, clinicians, agency directors, and subject matter experts and an empirically validated framework to develop the intervention and after curriculum and intervention development, a randomized pilot trial will be conducted to examine key organizational and staff outcomes. This work is important because many efforts to implement evidence-based care fail and this project has the potential to improve the mental health workforce and outcomes for clients.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Exploratory/Developmental Grants (R21)
Project #
Application #
Study Section
Special Emphasis Panel (ZRG1-HOP-X (50))
Program Officer
Chambers, David A
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of California San Diego
Schools of Medicine
La Jolla
United States
Zip Code
Aarons, Gregory A; Ehrhart, Mark G; Torres, Elisa M et al. (2017) The Humble Leader: Association of Discrepancies in Leader and Follower Ratings of Implementation Leadership With Organizational Climate in Mental Health. Psychiatr Serv 68:115-122
Aarons, Gregory A; Ehrhart, Mark G; Moullin, Joanna C et al. (2017) Testing the leadership and organizational change for implementation (LOCI) intervention in substance abuse treatment: a cluster randomized trial study protocol. Implement Sci 12:29
Ehrhart, Mark G; Torres, Elisa M; Wright, Lisa A et al. (2016) Validating the Implementation Climate Scale (ICS) in child welfare organizations. Child Abuse Negl 53:17-26
Aarons, Gregory A; Ehrhart, Mark G; Torres, Elisa M et al. (2016) Validation of the Implementation Leadership Scale (ILS) in Substance use Disorder Treatment Organizations. J Subst Abuse Treat 68:31-5
Ehrhart, Mark G; Aarons, Gregory A; Farahnak, Lauren R (2015) Going above and beyond for implementation: the development and validity testing of the Implementation Citizenship Behavior Scale (ICBS). Implement Sci 10:65
Aarons, Gregory A; Ehrhart, Mark G; Farahnak, Lauren R et al. (2015) Leadership and organizational change for implementation (LOCI): a randomized mixed method pilot study of a leadership and organization development intervention for evidence-based practice implementation. Implement Sci 10:11
Aarons, Gregory A; Ehrhart, Mark G; Farahnak, Lauren R (2014) The Implementation Leadership Scale (ILS): development of a brief measure of unit level implementation leadership. Implement Sci 9:45
Green, Amy E; Albanese, Brian J; Cafri, Guy et al. (2014) Leadership, organizational climate, and working alliance in a children's mental health service system. Community Ment Health J 50:771-7
Aarons, Gregory A; Fettes, Danielle L; Hurlburt, Michael S et al. (2014) Collaboration, negotiation, and coalescence for interagency-collaborative teams to scale-up evidence-based practice. J Clin Child Adolesc Psychol 43:915-28
Ehrhart, Mark G; Aarons, Gregory A; Farahnak, Lauren R (2014) Assessing the organizational context for EBP implementation: the development and validity testing of the Implementation Climate Scale (ICS). Implement Sci 9:157

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