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Evaluating Behavioral Health Surveillance Systems

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Inputs to the logic model for behavioral health surveillance are staff, data sources, infrastructure, equipment, funding sources, legislative support, partner organization, and tools for data collection. The model starts with activities to develop a surveillance system: identify goals, select and develop case definitions and indicators, link existing data sources, select sites or population coverage, develop and implement a protocol with uniform guidelines, establish pilot for surveillance of behavioral health conditions, assess data quality and utility, develop and test methods for data analysis, analyze data and interpret findings, develop and write surveillance reports, disseminate surveillance results, and develop strategies for sustaining surveillance. This activities lead to outputs: data for ongoing monitoring of trends in behavioral health indicators; surveillance activities; reports and recommendations; increases in evidence-based interventions, planning, and evaluation; and identification of modifiable behavioral risk factors. The short-term outcomes are 1) enhanced knowledge of behavioral health patterns, 2) uniform national or statewide implementation of surveillance programs, 3) patients or clients receive counseling or treatment, and 4) increase in prevention or intervention programs for populations most in need. The short-term outcomes lead to midterm outcomes: 1) identification of access barriers for counseling and treatment facilities; 2) health care systems treat, refer, and improve self-management of behavioral health conditions (eg, substance abuse, mental health); 3) improved community outreach programs; and 4) increase in patient/client knowledge, attitudes, and beliefs. The midterm outcomes lead to long-term outcomes: 1) policy change; 2) reduction in behavioral health conditions (eg, substance misuse, mental health problems); 3) improved infrastructure for managing behavioral health conditions (eg, substance misuse, mental health problems); 4) increase in patient/client knowledge, attitudes, and beliefs about behavioral health conditions; and 5) change in risk behaviors. The 3 levels of outcomes lead to impact to 1) improve quality of life for affected persons; 2) reduce mortality and morbidity related to behavioral health conditions; and 3) reduce the prevalence of behavioral health conditions.

Figure.
Logic model for behavioral health surveillance, adapted and used with permission from World Health Organization, Centers for Disease Control and Prevention, and International Clearinghouse for Birth Defects Surveillance and Research. Source: Birth defects surveillance: a manual for program managers. Geneva (CH): World Health Organization; 2014. http://apps.who.int/iris/bitstream/10665/110223/1/9789241548724_eng.pdf.

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