Mental Health Services Dynamics & Dilemmas Map

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Current version of Mental Health Services Dynamics & Dilemmas Map
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Background

Setting for the map
This map was created for a task force appointed by the Board of Supervisors of Multnomah County. The problem is that there are many separate and distinct agencies that are a part of the care delivery system in Multnomah County. They receive their funding from many separate federal, state, county, and private funding streams. The problem was to explore the possibilities for a greater integration and improvement of these services.

Initial problems in the task force process
The task force was composed of approximately 20 agency managers, professionals (e.g. nurses, doctors, and case managers), advocates, and members of the community. Early in the project, the initial problem faced by the members of the task force was to understand the problem the county was facing. Each of them knew something about the problems from their own experience. But, they needed to see all of the different major agencies and sectors. They needed to understand what the problems were as seen by different sectors. They needed to see what was causing the problems. They each brought their own backgrounds and experiences to the task force and literally needed to "get on the same page."

The map
The map was designed to be able to portray all of the relevant data on a single page. The sectors and agencies are portrayed as irregular shaped areas. The key phenomena and events are described informally. The major problems are highlighted in yellow boxes. They are connected to their apparent causes by arrows. Relevant data appear in the sector boxes as needed to convey the scope and size of services.

Results
The map went through several versions as the task force met to integrate their thoughts about the problems of integration of services. The map was not, however, thought of as a product by itself, but only an artifact that helped the process of the task force to achieve their common understandings so they could proceed to their main task which was developing the priorities for system-wide change.

Use
The map was used as the interim report to the supervisors. The board of supervisors received the report with appreciation that they could "see what the problems are" without having to read a 60 page report.

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