# Evaluation of Stepping Up Efforts to Improve MH Services and Justice Utilization

> **NIH NIH R01** · GEORGE MASON UNIVERSITY · 2020 · $672,963

## Abstract

The criminal justice system is the largest mental health provider in the U.S., and many jurisdictions are
interested in reducing the use of the justice system for behavioral health issues. This 5-year R01 evaluates
whether the Stepping Up Initiative overcomes barriers to implementation of EBPPs and the impact on key
outcomes, such as increased number of clients receiving behavioral health services, increased use of EBPPs,
and dedicated resources to advance the use of EBPPs. The study uses the CJ Evidence-Based Interagency
Implementation Model (CJ-IIM) and draws on both quantitative and qualitative methods to understand which
dissemination and implementation (D/I) change processes positively impact the expanded use of EBPPs in CJ.
Now is an opportune moment, given that 455 counties have agreed to be part of Stepping Up. Mechanisms of
interest are: 1) Use of and capacity for performance monitoring to guide system reform and development; 2) Use
and functioning of interagency teams; 3) Having common goals and mission across agencies that support
system-wide practices to advance the use of behavioral health services for CJS-involved individuals; and, 4)
System integration (i.e., building an integrated system of care rather than adding one program or training). The
study will survey 455 Stepping Up counties and 455 matched paired target counties (4 respondents per county
including administrators of jail, probation, mental health services, and substance abuse treatment services for
3,640 respondents) at three waves: baseline, 18 months, and 36 months. Qualitative interviews will be conducted
with 90 respondents at three waves to contextualize survey findings. Stepping Up and comparison counties will
be compared on rates of change in engagement of target mechanisms (primary) and rates of change in
implementation effectiveness outcomes (secondary) and describe reform activities occurring over a 36-month
period. Specific aims are to compare Stepping Up and comparison counties on: 1) Target mechanisms including
whether: (a) Stepping Up counties show a faster rate of improvement in hypothesized target mechanisms
between Wave 1 and subsequent assessments (i.e., Waves 2 and 3); and (b) whether engagement of these
mechanisms explains any differences found in key implementation outcomes; 2) Examine implementation
outcomes such as the number of justice-involved clients served with EBPPs, number of behavioral health EBPPs
available to justice-involved individuals, and resources for behavioral health EBPPs for justice-involved
individuals; and, 3) Characterize implementation processes and critical incidents. We will use qualitative data to
triangulate quantitative findings and enrich an understanding of how the target mechanisms work and lead to
outcomes, and explore naturally occurring implementation strategies used in 910 counties that lead to outcomes.
The study will advance D/I science by contributing to an understanding of 1) systemic decision-making processes...

## Key facts

- **NIH application ID:** 10006901
- **Project number:** 5R01MH118680-02
- **Recipient organization:** GEORGE MASON UNIVERSITY
- **Principal Investigator:** JENNIFER E JOHNSON
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $672,963
- **Award type:** 5
- **Project period:** 2019-09-03 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10006901

## Citation

> US National Institutes of Health, RePORTER application 10006901, Evaluation of Stepping Up Efforts to Improve MH Services and Justice Utilization (5R01MH118680-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10006901. Licensed CC0.

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