Examining Collaboration Among Child and Family Service Organizations in St. Louis: A Mixed Methods Evaluation

Background and Purpose: Families with child welfare system-involvement often have complex needs that can rarely be met by a single organization. Multi-level collaboration like PACT-STL is paramount to facilitate enhanced service provision and promote positive outcomes. We conducted a social network analysis (SNA), group model building (GMB) sessions, and parent focus groups to examine agency collaboration in our region. Exploring network connections, organization perspectives, and the experiences of parents with lived experience offered insight into barriers to collaboration and the impact of inhibited collaboration on families.

Methods: For the SNA, we surveyed agencies working in: child welfare, healthcare, housing, legal advocacy, home-visiting, mental health, and substance abuse. Participating organizations (n=62) were asked about organizational relationships and level of interaction (e.g., contact, coordination, collaboration). We used network tools in R to examine network structure and number of connections for the contact network (any contact within past month) and the higher-level interaction network (coordination, collaboration). For the GMB, we held 2 virtual workshops with representatives from the maltreatment prevention network (n= 25, n=27; respectively) to assess barriers and facilitators to collaboration. A causal loop diagram was created to reflect participants’ understandings of systemic barriers to collaboration. Additionally, we conducted 4 virtual focus groups with parents/caregivers with lived experience (n=22), asking about their experiences with organizational collaboration. Focus group discussions were transcribed and analyzed for themes in NVivo.

Findings: The SNA showed that the density of the contact network was 0.17, indicating that 17% of possible ties between organizations existed in the network. The clustering of the network was 0.35, indicating that there were many well-connected clusters of organizations in the network. The density and clustering of the network decreased to 0.15 and 0.29, respectively, when considering higher-level interaction that moves beyond contact to at least coordination. In the GMB sessions, participants noted that limited resources (e.g., funding, time) inhibit collaborative efforts and can lead to silos of knowledge/information within organizations. Competition among organizations was also identified as a barrier to collaboration. Participants described the need for openness and accountability to enhance collaboration and build organizational trust, particularly given the context of institutional racism and an uncertain local political climate.

In the focus groups, parents described their experiences with a lack of collaboration among organizations and the impacts on the care they received. Parents noted that agencies at times provided conflicting information and treatment goals. The perceived lack of collaboration and communication among agencies led to gaps in services, delayed progress toward family goals, and a sense of distrust among parents towards organizations.

Conclusions/Implications: Taken together, the SNA, GMB, and focus groups highlight the need for enhanced collaboration in child and family services in our region that better meet the needs of parents. Results underscore the importance of engaging individuals at multiple levels—in both organizations and the larger community. To improve the experiences of children and families and strengthen interagency collaboration, it is essential to elevate the voices of parents and agency leadership to determine areas that warrant change and new solutions.