In most mental health systems, evidence-based services constitute a small sliver of the service array, in terms of number of services and service expenditures. Although EBPs and other services must coexist, the expectation is that the practices that have a high level of evidence would be the cornerstone of the service array. (p929)

EBP’s cover only some situations’ they are neither cookbooks nor panaceas, and clinical judgment remains critical.

The term “evidence based practice” (when used in providing services to individuals with severe mental illness) comes from a field of research on practices that increase the individual’s ability to be an active member of their community by increasing their social and economic independence. The focus is on the person within his/her environment vs. the symptom or diagnosis.

Historically mental health outcome research has been based on a specific diagnosis and a treatment protocol, evaluating the success or limitations in reducing symptoms of the illness. Examples of empirically validated treatment protocols include cognitive behavioral therapy for individuals with depression. The research demonstrates symptom reduction as an outcome. Dialectical Behavioral Therapy is another treatment protocol that has demonstrated some good outcomes in terms of symptom reduction, and decreased hospitalizations for individuals with Borderline Personality Disorder. In this research approach a specific mental illness is identified, symptom reduction is identified as the outcome, and a specific treatment is studied. The primary focus is on diagnosis, treatment protocol, and symptom reduction.

In 1998 a national consensus panel identified 6 practices that were seen as effective models for individuals with Severe Mental Illness. Effective was identified as increasing the person’s ability to function in the community. Instead of looking at treatment approaches for individuals with specific diagnoses, the focus was on practices that were effective for individuals with a range of diagnoses, but with a commonality of all having a serious mental illness. Since then “tool kits” have been developed to provide “tools” that would help providers implement these practices. Supported Employment is one of the original 6 Evidence Based Practices identified by the consensus panel. The Supported Employment outcomes, like the outcomes of the other 5 EBPs include quality of life measures, competitive Employment in the case of Supported Employment.

A wide range of mental health services and treatment models are needed to meet the needs of Kansans. Evidence Based Practices for the CSS population represents only a segment of the mental health population to be served, and a portion of treatment options to be considered for implementation.