Dr. Genevieve GrAaf conducts research using interviews and focus groups

As a mental health policy researcher, interviews and focus groups are a critical technique that Dr. Genevieve Graaf of the University of Texas at Arlington’s School of Social Work uses to understand policy making processes and decisions, as well as the intricacies of mental health policy itself. These research tools enable the collection of information that is not readily or easily available, or can help to provide explanation, context, or clarification for information that is public knowledge.

In her most recent study, Dr. Graaf interviewed and conducted focus groups with children’s mental health administrators and policy makers in 32 different states. These interviews focused on understanding how each state organized and funded home and community-based mental health services for children and adolescents with significant emotional or behavioral disorders.  Information was also gathered about the historical, political, and financial factors that shaped state approaches to addressing the needs of this population.

In smaller states, interviews were conducted with one policy informant, due to the small scope of the mental health administration. However, in some larger and more complex states, where policy makers collaborated across a variety of departments—child and family services, Medicaid administrations, juvenile justice divisions—focus groups were required to hear the shared perspectives and information available through a variety of stakeholders. Dr. Graaf used semi-structured interviews in which a set of topics and questions included on the interview protocol guided the discussion, but participants were able to change topics, move through topics out of the planned order, and offer information on topics not included in the interview protocol.  This allowed for data collection to be comprehensive but also include the depth of nuanced and minor details relevant to aims of the study.

By collecting detailed data directly from knowledgeable informants who are involved in state mental health policy making on a daily basis, these interviews and focus groups provide in-depth illustrations of the variation in mental health policy making, mental health administrations, and the financial and governmental structures that exist across and between states.  This type of knowledge can be shared among policy makers across states and nations as inspiration and lessons learned about best practices in the funding and organization of mental health care for children. After completing these interviews and focus groups, and analyzing the data, findings from these interviews and focus groups have been reported in three peer-reviewed journal articles (see for example, Graaf & Snowden, 2019) presented at conferences filled with state mental health policy makers, and shared directly with the state mental health policy makers who participated in the study.  Many participants, when interviewed, asked to see the final report because they were very interested to learn about the practices and strategies used in other states.

The in-depth information collected through these interviews and focus groups can also help to advance further research about the accessibility, effectiveness, and quality of mental health services for children and their families by providing detailed contexts in which to examine further questions. For example, Dr. Graaf used interview and focus group findings to shape her approach to analyzing national quantitative data and enhanced her understanding of those quantitative findings.  Factors that informants reported as shaping their decision making around their children’s mental health policies were used as control variables in her statistical models. Also, findings that were unexpected or surprising could be partially explained by variations across state mental health systems that were reported in interviews and captured through focus groups.