Exploring perceived factors influencing cross-system collaboration between Child welfare and behavioral Health: A...

Parental substance use disorder (SUD) significantly increases complexity and severity of child maltreatment. Sobriety Treatment and Recovery Teams (START), an evidence-based intervention, has improved unification and reduced recurrence of maltreatment risk through cross-system collaboration between child welfare and behavioral health organizations. Currently little is known about perceived factors influencing successful collaboration.

This qualitative study identified factors that influenced cross-system collaboration in a state-wide implementation of an integrated social service and behavioral health intervention.

Embedded in an implementation study of Ohio START, this study used semi-structured small group interviews with 104 administrators and frontline providers, and structured focus groups with 26 child welfare caseworkers and family peer mentors.

Virtual small-group interviews were conducted between January 2020 and April 2021, and structured focus groups were conducted in February 2021. To identify barriers and facilitators of cross-system collaboration, thematic analysis was applied to transcripts, using inductive and deductive coding methods.

Overall, participants from both child welfare and behavioral health fields reported positive collaboration experiences and noted improvement in mutual understanding and service provision. Two main barriers emerged: misalignment of treatment requirements and expectations, and varied attitudes toward substance use and treatment. Facilitators included prior established collaboration, dedicated collaboration personnel, and supportive leadership.

Cross-systems alignment of services and expectations, efforts to address stigma and negative perceptions, and leveraging leadership support and dedicated personnel are crucial for successful cross-system collaboration.