Supporting Family Recovery: How Local Behavioral Health Boards Coordinate Child Welfare and Behavioral Health Systems for Parents and Caregivers With Substance Use Disorder.

Abstract

<b>Objectives.</b> To examine (1) the strategies regional public behavioral health boards employ to align county-based public social service agencies with private substance use treatment organizations, (2) regional variations in strategies, and (3) factors that affect community-board relationships. <b>Methods.</b> We conducted a multiple case study of 17 Ohio county-based systems implementing a cross-sector model to support parental substance use disorder (Ohio START). We applied template analyses to 48 small group interviews conducted in 2020-2021 with 104 staff from child welfare and behavioral health organizations and community boards. <b>Results.</b> Participants described direct and indirect ways that boards supported system alignment, funding, brokering of information and relationships, and planning. Reasons for boards not being involved included perceived needlessness and a lack of connection between the board and the community. Rural and Appalachian communities reported various forms of close integration of boards and communities. <b>Conclusions.</b> Behavioral health boards can support cross-system integration by reducing barriers to collaboration and enhancing community capacity to address complex public health issues, especially in resource-limited regions. <b>Public Health Implications.</b> Incorporating a centralized organization could mitigate implementation barriers and promote effectiveness in community collaborations, especially under resource constraints. (<i>Am J Public Health</i>. 2026;116(S3): S202-S209. https://doi.org/10.2105/AJPH.2026.308579).