Evidence -based practices and the role of policy entrepreneurs in the adoption and implementation of Assertive Community Treatment (ACT) in New York and Oklahoma.
Item
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Title
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Evidence -based practices and the role of policy entrepreneurs in the adoption and implementation of Assertive Community Treatment (ACT) in New York and Oklahoma.
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Identifier
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AAI3333021
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identifier
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3333021
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Creator
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Johnson, Sandra J.
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Contributor
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Adviser: Christa Altenstetter
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Date
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2008
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Language
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English
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Publisher
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City University of New York.
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Subject
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Political Science, General | Sociology, Public and Social Welfare
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Abstract
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Few studies appear in political science journals addressing mental health per se and even fewer concentrate on mental health policy formulation. Given the rich political complexity and importance of mental health policy, the paucity of political science research in this field is puzzling. This dissertation helps to fill that gap by contributing to the growing body of literature on policy entrepreneurs by examining their role (s) in the policymaking process of Assertive Community Treatment (ACT) in New York and Oklahoma.;As an evidence-based practice, the adoption and implementation of Assertive Community Treatment (ACT) promises to empower the well-being of those individuals suffering from severe mental illness. However, in an era of managed care that encourages state mental health administrators to adopt policy that increasingly relies on programs that can measure the outcomes of care provided, this research suggests that the major impetus behind ACT in Oklahoma and New York was financial savings for both states.;This research also exposes a strong disconnect between researchers and the provider community, suggesting that mainstream political science literature places too much emphasis on the roles of policy entrepreneurs as the main innovators in the agenda and policy formulation stages. Successful implementation of ACT also requires the recognition and knowledge input of the very implementers providing the actual treatment, not merely additional scientific research. This enduring aspect of mental health policy---namely, limited knowledge input---continues because the different forms of knowledge learned in vivo are lost, and practitioners are not involved in the evaluation of program outcomes process.;Without the knowledge input from those providing treatment in vivo, the researchers and scientists responsible for Assertive Community Treatment's "gold standard" will continue to stifle innovation in their attempt to strategically "brand" ACT as a commodity for distribution, while policymakers responsible for the dissemination of ACT in "real world" settings will continue to ignore the unique economic and political realities challenging the program's implementation process. As a result, flawed implementation, rather than flawed policy, will be blamed, much to the detriment of society's most vulnerable population---the severely mentally ill.
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Type
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dissertation
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Source
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PQT Legacy Restricted.xlsx
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degree
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Ph.D.