Sustainability of a Child Mental Health Intervention in Child Welfare Services: Case study

From an implementation science lens, sustaining interventions in large, heterogeneous organizations such as child welfare requires attunement to the inner and outer contexts in which the innovative practice is delivered. This case study describes how one child welfare agency sustained implementation of a modified child mental health intervention since Spring 2019 after formal supports were removed and provides a retrospective look at their experiences. Using qualitative data from interviews with a key informant, this case study employed a priori codes from an existing sustainability framework to organize and understand factors of innovation, adopters, leadership and management, inner context and process, outer context, and outcomes. Findings offer insights for child welfare agencies to consider when sustaining an intervention without research supports, including the intervention’s alignment with the agency’s culture and mission, the agency’s ability to adapt and embed the intervention, and child welfare leadership and staff buy-in to the intervention. Implications for policy, practice, and research are discussed.