Abstract for: Leveraging SD to study and strengthen acute crisis mental health service systems as systems

In the United States over the past several decades, there has been a substantial shift toward deinstitutionalization for individuals with serious mental illness, without the requisite development of outpatient system supports. As a result, trends of incarceration among this population have increased. Rarely studied as a whole system, low-leverage and policy resistant “solutions” abound. We are striving to work with system stakeholders to develop a comprehensive model of the acute crisis mental health service system, which we plan to use to change conversations around community, state, and national investment to improve mental health outcomes, efficiently. We have begun by attempting to understand the boundary of the acute crisis service system, to develop a shared vocabulary around system components and key variables, and to identify common undesirable mental models and feedback dynamics (embedded in a concept model) that perpetuate problematic system outcomes. We are using this model to open new conversations and to engage with communities around studying their system more holistically, and dynamically. Next steps involve expanding and adapting the model to several regions across the United States.