Independent Contractors in Public Mental Health Clinics: Implications for Use of Evidence-Based Practices

In Psychiatric Services, Rinad Beidas and colleagues, including Steven Marcus, Trevor Hadley and David Mandell analyze the associations of utilizing independent contractors with clinician knowledge and attitudes toward evidence-based practices (EBP), and organizational culture and climate. They also describe the impact of using independent contractors on mental health services delivery from the perspective of organizational leadership. Community mental health clinics are increasingly utilizing independent contractors to provide clinical services. At the same time, many organizations are participating in initiatives intended to increase implementation of EBP. Beidas and colleagues surveyed 130 therapists in 23 organizations and executive administrators in organizations participating in EBP initiatives. They find that independent contractors had less positive attitudes toward EBPs and scored lower on knowledge of EBPs. Interviews with administrators revealed important themes in using independent contractors. A majority of the administrators identified the financial difficulties of maintaining salaried employees in the current fiscal environment for mental health services as a reason for using independent contractors. Their findings point to the need for further exploration on the consequences of relying on independent contractors to deliver mental health services.