Framework for Developing an Intervention at the Macro Level

Framework for Developing an Intervention at the Macro Level

Framework for Developing an Intervention at the Macro Level

Designing the Intervention

The Intervention Hypothesis

The intervention being developed in this paper is mental health access and treatment facilities for adults living in St. Paul’s, North Carolina. Many individuals, both professionals in St. Paul’s have discovered that their area lacks care for adults suffering from mental disorders and deem it prudent to establish facilities that can provide the care.

The Working Hypothesis of Etiology

The following factors are identified from the analysis of the problem, population, and arena:

  1. There are no mental care services and facilities in the area
  2. Alternative mental care facilities are located far from the area and there are no transportation systems like public transport
  3. There are only 151 mental health professionals available in the area to serve a population of 100,000

The following problems have developed:

  1. A rise in the number of adults suffering from mental health conditions
  2. Many of the people suffering from mental health conditions are unwilling to seek care elsewhere
  3. Limited access to therapeutic care for people with mental health challenges

Working Intervention Hypothesis

If the following interventions are implemented for people suffering from mental health conditions in St. Paul’s:

  1. The establishment of a sufficient number of mental health care facilities
  2. The number of mental health professionals is increased
  3. Increase public awareness regarding the importance of seeking medical care when suffering from mental conditions
  4. Ensuring that the established mental health care facilities and services are accessible to the population

The following outcomes will be witnessed;

  1. The number of patients suffering from mental health conditions will decline
  2. The number of people accessing mental health support will increase
  3. The number of people seeking the support of mental health care professionals and visiting the established facilities will increase
  4. The locals will be motivated to seek medical care for mental problems because the services are accessible

Building Support

The intervention of increasing access to mental health care within St. Paul’s region to curb mental health conditions will only be successful if all stakeholders are involved in this process. The rising cases of mental health illnesses in this area affects a large number of individuals. As a result, efforts must be made to win the support of different individuals and organizations, thereby, increase the success of this intervention.


Initiator System

The National Alliance on Mental Illness (NAMI) North Carolina branch is a critical member of the initiator system because it is an organization managing mental health conditions. St. Paul town’s management is an important iniator system since it has been managing and funding the control of mental health conditions. It has been employing social workers and responding to the patients’ needs.

The Chief of Police and other police officers are the critical initiator systems since he is one of the individuals who are conversant with the trends of mental health conditions in St. Paul’s area. This official and his staff have records of mental health crime-related cases that have been reported to his office, therefore, he can provide with statistics of the cases and identify the individuals suffering from the conditions (Xiong, 2018). The Chief of Police can help in determining the number of mental health care facilities and health care personnel based on the records he possesses.

Adult Protective Services staff and other health professionals like social workers are also members of the initiator system because they have been doing home visits for many of the mental health patients in the area. They are professionals who have records of mental health patients in the area and can identify the people who will benefit from the intervention being developed.  Also, they are mental health professionals who understand how mental health conditions can be managed. Similar to the Chief of Police, the Adult Protective Services can help in determining the appropriate number of the mental health care centers required to meet the patents’ needs and the number of mental health professions who can manage the situation in the area. The families of the patients suffering from mental health conditions are also important members of the initiator system because they are the caregivers of the patients at home. They know the history of the patients’ condition and will be the people presenting the patients for care.

Change Agent Systems

The implementation of this intervention will be led and coordinated by the Mayor, Board of Commissioners, City manager, and City Council. These individuals govern the area, therefore, they have control of what happens in their area (Town of St Pauls, 2019). Other people who should be members of the change agent systems include St. Paul town’s management and The Chief of Police because they will provide guidance to this program as they have the records of mental health patients and understand their needs. Also, the National Alliance on Mental Illness (NAMI) North Carolina branch should be involved because it is an organization with the sole responsibility of managing mental health conditions (Gurnon, 2018).

The Client System

Individuals with mental health conditions are the key members of the client system because they need care and treatment for their condition. The families of the patients are the secondary beneficiaries of this intervention because they will benefit from this program and get relieved the burden of taking care of their sick family members (Manderscheid et al., 2010). They will also be relieved the burden of costs they incur seeking care for their family members in other towns.

 The Support System

The local communities belong to the support system because they will help in determining where mental health care facilities will be installed. Some of the locals will donate their land for the facilities. There will be collaboration among the local administration in St. Paul’s, North Carolina administration and the Federal government. These departments will provide monetary and material support for this program.

The Controlling System

The Mayor of St. Paul’s, North Carolina, Gerard J. Weindel, will approve the establishment of mental health care programs in St. Paul’s area. Other organs and individuals involved in the formalization of the program include the City Council’s Board of Commissioner, The National Alliance on Mental Illness (NAMI) North Carolina branch, and the police under the leadership of Chief of Police will be central in the formalization of this intervention.

The Host and Implementing System

The leadership of St. Paul’s town headed by the Mayor and six-member Board of Commissioners will be responsible for sponsoring and carrying out the activities of the change effort. The National Alliance on Mental Illness (NAMI) North Carolina branch, mental health professionals and social workers will be involved in the direct delivery of mental health care to patients suffering from mental conditions.

The Target System

The challenge of the lack of mental health care for people suffering from mental health conditions in St. Paul’s area in North Carolina is the need to be changed so that the patients can recover or their conditions improve. Mental health care institutions and services will be established in the area. The target location is St. Paul’s area in North Carolina. There are no multiple targets to be pursued in this intervention. The mental health care programs will only be established and be made open to all individuals suffering from mental health conditions.

The Action System

The central steering committee that will be key in decision-making processes will comprise the leadership of St. Paul’s area because it will be key in regulating and funding the mental health care programs. The National Alliance on Mental Illness (NAMI) North Carolina branch, mental health professionals, and social workers are also important in decision-making processes because they are professionals and knowledgeable in mental health care. They will give expert advice to St. Paul’s leadership.

System Capacity for Change

There is great support for mental health care programs in St. Paul’s area. The locals will be supportive because they have undergone overwhelming challenges seeking mental health care. As a result, they will support this intervention because it will relieve them the burden of traveling afar. Other individuals such as leadership of St. Paul’s area, the police, the National Alliance on Mental Illness (NAMI) North Carolina branch, mental health professionals, and social workers have been instrumental in supporting mental health care patients and have displayed interest in the success of this intervention.

Availability of Resources to Sustain the Change Effort

There are sufficient resources, both financial, material, and manpower that will sustain this intervention. The leadership of St. Paul’s area is willing to support this program. It has been providing for mental health care and employing social care workers and other professionals. The National Alliance on Mental Illness (NAMI) North Carolina branch will also be instrumental in providing and seeking more support for this intervention. The main resources necessary for the success of this intervention include land to establish the facilities, medication for the patients, health care professionals to provide care to patients, and funds to finance the initiatives.

Outside Opposition to this Intervention

So far, there is no evidence of opposition to this intervention. All people and organizations around this area are supportive of this program.

An Approach to Change

The policy approach that will be undertaken to foster the success of this program is the enactment of policies formalizing funding to the established mental health care. Policies will be enacted to ensure free access to mental health care programs by all, irrespective of individual characteristics such as gender, age, religion, and political affiliation. The programs that will be undertaken to enhance this intervention include the recruitment of a sufficient number of mental health professionals, registration of all patients suffering from mental health conditions in St. Paul’s area, and ensuring that the facilities and personnel providing care are equitably distributed in the area. The projects that will be undertaken include public awareness programs informing the public about the introduction of mental health care in their locality. The project will also educate the locals about the importance of seeking health and professional care when suffering from mental health conditions (Yoshioka et al., 2016). The personnel that will be involved in this intervention will comprise the police, the National Alliance on Mental Illness (NAMI) North Carolina branch, mental health professionals, and social workers. These individuals have been active in helping patients. The practice which will be employed in this initiative will involve social workers visiting the patients at their homes and make them aware that mental health institutions have been established in their area. After knowing that the institutions have been established, the patients and their families will begin visiting the institutions. Similarly, the police will be presenting mental patients they receive to medical care in the institutions.

Approaches in Interaction

The establishment of mental health care in St. Paul’s area will require the input of many stakeholders. The local leadership, the local community, health care professionals and institutions, and the police will be allowed to take part in this intervention. The local administration and institutions involved in the provision of mental health care such as the National Alliance on Mental Illness (NAMI) North Carolina branch will ensure that all important resources such as funding, equipment, and personnel are available. 


Manderscheid, R. W., Ryff, C. D., Freeman, E. J., McKnight-Eily, L. R., Dhingra, S., & Strine, T. W. (2010). Evolving definitions of mental illness and wellness. Preventing Chronic Disease, 7(1), 1-6.

Town of St Pauls. (2019). Retrieved March 25, 2019, from https://www.stpaulsnc.gov/parks

Xiong, C. (2018, September 24). St. Paul police mental health unit doubles social worker staffing. Star Tribune. Retrieved March 26, 2019, from http://www.startribune.com/st-paulpolice-mental-health-unit-doubles-social-worker-staffing/494172011/

Yoshioka, K., Reavley, N. J., Rossetto, A., & Nakane, Y. (2016). Associations between beliefs about the causes of mental disorders and stigmatizing attitudes: Results of a mental health literacy and stigma survey of the Japanese public. International Journal of Mental Health, 45(3), 183-192. doi:10.1080/00207411.2016.1204810


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