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Mixed-Methods Evaluation of Continuous Improvement Efforts for a County Mental Health and Addiction Recovery Board

Abstract

Introduction: Ohio has a behavioral health system of county operated and state-supervised boards that plan, fund, and evaluate mental health and addiction services. This research evaluates the continuous improvement initiatives at Stark County Mental Health and Addiction Recovery Board (StarkMHAR). We examined the following research questions: (1) Were the process improvement initiatives effective in moving the organization(s) toward its goals? (2) Were the productivity initiatives effective in improving productivity across the organizations? (3) Were the workforce development initiatives effective in moving the organization(s) toward its goals? (4) What was the impact of the leadership initiatives on those who participated? 

Methods: A multifaceted mixed-methods evaluation was conducted from August 2020 to December 2023. We collected quantitative data over 4 state fiscal years (SFY) to measure process improvement, productivity, and workforce development. We used survey methods with open and closed-ended questions to evaluate leadership initiatives.

Results: The findings for the 4 focus areas are as follows: (1) Process Improvement: met the goal of reducing clinician documentation error to 3%; showed improvement in other measures but did not meet goals. (2) Productivity: met goals of increase show rate, increasing planned discharges by 2% per agency; some agencies met wait time goals. (3) Workforce Development: met 3 of the 4 goals; did not meet reducing staff turnover. (4) Leadership: participants responded very positively to leadership initiatives.

Conclusion: Results indicate that many of the initiatives were successful in moving the agency toward the goals. COVID-19 had a major impact on the continuous improvement efforts.

Keywords: Evaluation, Mixed-methods, Behavioral health, Continuous improvement, Outcomes

How to Cite:

Lanese, B. G., Kousar, R., Shadmani, K. & Richeson, J., (2026) “Mixed-Methods Evaluation of Continuous Improvement Efforts for a County Mental Health and Addiction Recovery Board”, Ohio Journal of Public Health 8(1), 1-11. doi: https://doi.org/10.18061/ojph.6419

Authors

  • Bethany G. Lanese (College of Public Health, Kent State University)
  • Reema Kousar (College of Public Health, Kent State University)
  • Kiyan Shadmani (McGowan Institute for Regenerative Medicine, University of Pittsburgh School of Medicine)
  • Jen Richeson (Stark County Mental Health and Addiction Recovery)

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