Supporting Family Recovery: How Local Behavioral Health Boards Coordinate Child Welfare and Behavioral Health Systems...

Objectives. To examine (1) the strategies regional public behavioral health boards employ to align county-based public social service agencies with private substance use treatment organizations, (2) regional variations in strategies, and (3) factors that affect community-board relationships. Methods. We conducted a multiple case study of 17 Ohio county-based systems implementing a cross-sector model to support parental substance use disorder (Ohio START). We applied template analyses to 48 small group interviews conducted in 2020-2021 with 104 staff from child welfare and behavioral health organizations and community boards. Results. Participants described direct and indirect ways that boards supported system alignment, funding, brokering of information and relationships, and planning. Reasons for boards not being involved included perceived needlessness and a lack of connection between the board and the community. Rural and Appalachian communities reported various forms of close integration of boards and communities. Conclusions. Behavioral health boards can support cross-system integration by reducing barriers to collaboration and enhancing community capacity to address complex public health issues, especially in resource-limited regions. Public Health Implications. Incorporating a centralized organization could mitigate implementation barriers and promote effectiveness in community collaborations, especially under resource constraints. (Am J Public Health. 2026;116(S3): S202-S209. https://doi.org/10.2105/AJPH.2026.308579).