Infrastructure development in children’s behavioral health systems of care: essential elements and implementation strategies

To improve the outcomes of children’s behavioral health systems, states must invest in expanding infrastructure; however, infrastructure is a commonly used and poorly understood concept. This paper aims to provide a definition of infrastructure in the context of state-level children’s behavioral system of care development and describes five essential infrastructure elements: an integrated governance and decision-making structure; structures and processes for blended and braided funding; a central point of access for information, referral, and linkage; workforce development, training, and coaching in effective practices; and data and quality improvement mechanisms. Suggested implementation activities are offered for each of the five proposed infrastructure components. The important role of public-private partnership, particularly with intermediary organizations, is described, and future directions for research and scholarship are proposed.