兰德-弗雷斯诺县重点行为健康服务评价方法-危机连续体、支持性住房和法医行为健康计划的过程和结果测量（英）

SHANNON D. DONOFRY, DANIEL SICONOLFI, SAMANTHA MATTHEWS, AVAH MOUSAVI, NICOLE K. EBERHARTEvaluation Approaches for Key Fresno County Behavioral Health ServicesProcess and Outcomes Measurement for Crisis Continuum, Supportive Housing, and Forensic Behavioral Health ProgramsPublicly funded behavioral health services include a diverse range of programs and activities. For example, the Fresno County Department of Behavioral Health (DBH) oversees multiple service areas, including crisis continuum services, inpatient services, outpatient services, high-intensity treatment services, child welfare services, school-based services, supportive housing services, psychiatry services, forensic behavioral health services, access points, and other outreach and supportive services (Fresno County DBH, 2024). Within each of these service areas, there is further diversity in the specific programs included with regard to their activities, popula-tions served, and evaluation data. This can present challenges for “apples to apples” comparisons of programs within a given service area and, when appropriate, comparison of programs across service areas to evaluate how programs are performing relative to one another. Without the ability to com-pare program performance, it is difficult to make informed decisions about where to most effec-tively invest limited DBH resources.To facilitate future meaningful comparisons across programs in a given service area, the Fresno County DBH tasked RAND with developing evaluation guidance that could be used to assess mul-tiple, often heterogenous programs within a given service area, with an emphasis on measures of program implementation and outcomes. We sought to identify common activities and components Research Report2KEY RECOMMENDATIONS ■ Where possible, administer a standardized set of measures across programs and service areas to enable comparisons of performance across programs. Cross-cutting process measures that should be collected include characteristics at program entry of individuals served, indicators of service access and utilization and efforts to link individuals to other services, and whether services are delivered in a trauma-informed manner with cultural humility. For outcome measures, the satisfaction of individuals served and their behavioral health symptoms should be assessed across programs and service areas. ■ Programs in the crisis continuum service area should measure the timeliness of crisis response services, involvement of law enforcement in crisis responses, stabilization of mental health symptoms (i.e., reduc-tion in severity of suicidal ideation and psychological distress), subsequent behavioral health crises and emergency service utilization, and criminal justice system involvement of individuals served. ■ Programs in the supportive housing service area should measure fidelity to the supportive housing model, immediate and sustained housing outcomes, employment and income, medical stabilization, functionin