Concerns about the quality of mental health services have been raised in recent decades and several studies have indicated that usual care mental health services are often not based on the best evidence. There are numerous reasons for this gap between practice and research for mental health services, ranging from guideline issues, provider factors, consumer factors, lack of appropriate incentives and resources, limitations of capacity for organizational change, as well as social, political, and legal factors. Driven by concerns about how infrequently evidence-based practices (EBPs) are used in everyday practice and the need for practice-based evidence to refine our understanding of how well services operate in the real-world with diverse populations, there are movements within the field to change how research is conducted and increased attention to the application of systematic dissemination and implementation strategies. It is through the attention to these issues that we believe that progress can be made to fundamentally change how mental health services are delivered.
The goals of PBRNs are to identify questions that center on stakeholder’s experience, actively include stakeholders in developing a research study, collecting and analyzing data, and disseminating and implementing research findings. These stakeholders can include consumers, family, practitioners, supervisors, administrators, and engaged community members. Importantly, PBRNs are built with the expectation of continued collaboration, rather than a single project. The processes and feedback loops of the PBRN model and stakeholder-driven processes are outlined in the Figure below. Stakeholder involvement leads to better targeting of important questions, and through the combination of university partners and agency collaborators, PBRNs are able to generate new projects or identify research results that can improve practice and can be rapidly implemented.
PBRNs are designed to build mechanisms (as outlined below) for integrating stakeholder partners into all stages of the proposed project to engage them in research processes. PBRNs have reciprocal relationships between the participating agencies and the university partners for the selection of research topics, instead of the traditional model of the university selecting a research topic and design before bringing it to agencies. In a PBRN, all stakeholders are represented and participate in the leadership, selection, design, and conduct of research. Stakeholder co-learning processes are key as researchers learn how to incorporate stakeholder perspectives and priorities into their research development and stakeholders become educated about the research process. PBRNs require transparency, honesty, and trust in order to have the relationships that lead to successful collaborations over the course of multiple projects.