ORIGINAL PAPER A Survey of the Infrastructure for Children’s Mental Health Services: Implications for the Implementation of Empirically Supported Treatments (ESTs) Sonja K. Schoenwald Æ Jason E. Chapman Æ Kelly Kelleher Æ Kimberly Eaton Hoagwood Æ John Landsverk Æ Jack Stevens Æ Charles Glisson Æ Jennifer Rolls-Reutz Æ The Research Network on Youth Mental Health Published online: 14 November 2007 Ó Springer Science+Business Media, LLC 2007 Abstract A structured interview survey of directors of a large national sample (n = 200) of mental health service organizations treating children examined the governance, financing, staffing, services, and implementation practices of these organizations; and, director ratings of factors important to implementation of new treatments and ser- vices. Descriptive analyses showed private organizations financing services with public (particularly Medicaid) funds are prevalent and that employment of professional staff, clinical supervision and training, productivity requirements, and outcomes monitoring are common. Results of random effects regression models (RRMs) evaluating associations between governance, financing, and organizational characteristics and the use of new treatments and services showed for-profit organizations more likely to implement such treatments, and organizations with more licensed clinical staff and weekly clinical supervision in place less likely to do so. Results of RRMs evaluating relations between director ratings of the importance to new treatment and service implementation of three factors—fit with existing implementation practices, infrastructure support, and organizational mission and support—suggest greater importance to public than private organizations of these factors. Implications for EST implementation and future research are described. Keywords Children’s mental health services Á Service system infrastructure Á Clinics and systems Á Research network on youth mental health The implementation of effective mental health treatments and services in community settings are public health prior- ities (Department of Health and Human Services 2006). As reflected in the conceptual model guiding the child STEPs initiative (see Fig. 1), dynamic influences on the imple- mentation of effective treatments likely reside at the level of the service system, implementing organization, individual practitioner, consumer (i.e., families or youth), and treat- ment or service itself (Compton et al. 2005; Ferlie and Shortell 2001; Grol and Grimshaw 1999). National studies of such influences on the implementation of empirically supported treatments (ESTs) in the substance abuse service The Research Network on Youth Mental Health is a collaborative network funded by the John D. and Catherine T. MacArthur Foundation. Network Members at the time this work was performed included: John R. Weisz, Ph.D. (Network Director), Bruce E. Chorpita, Ph.D., Robert Gibbons, Ph.D., Charles Glisson, Ph.D., Evelyn Polk Green, M.A., Kimberly Hoagwood, Ph.D., Peter S. Jensen, M.D., Kelly Kelleher, M.D., John Landsverk, Ph.D., Stephen Mayberg, Ph.D., Jeanne Miranda, Ph.D., Lawrence Palinkas, Ph.D., Sonja K. Schoenwald, Ph.D. S. K. Schoenwald (&) Á J. E. Chapman Family Services Research Center, Medical University of South Carolina, 67 President Street, Ste MC 406, P.O. Box 250861, Charleston, SC 29425, USA e-mail: schoensk@musc.edu K. Kelleher Á J. Stevens Columbus Children’s Hospital and the Ohio State University, Columbus, OH, USA K. E. Hoagwood Columbia University, New York, NY, USA J. Landsverk Á J. Rolls-Reutz Children’s Hospital, San Diego, USA C. Glisson University of Tennessee, Knoxville, TN, USA The Research Network on Youth Mental Health 140 S. Dearborn Street, Chicago, IL 60603-5285, USA 123 Adm Policy Ment Health (2008) 35:84–97 DOI 10.1007/s10488-007-0147-6