Process Improvement in Behavioral Health: Area of Focus

Process improvement in behavioral health is a special area focus area for the Great Lakes Mental Health Technology Transfer Center. 

What is process improvement?

Process improvement can be defined as “changing the way that work is performed so it is more efficient and effective.” 
Initially geared toward manufacturing, process improvement is now widely recognized as a powerful tool for making positive change in any setting.  

How do behavioral health organizations use process improvement?

Behavioral health organizations use process improvement to:

  • Identify and address problems in their work processes
  • Speed up and sustain the adoption of evidence-based practices
  • Reduce barriers to access to and retention in treatment

Examples of process improvement in behavioral health include: 

  • Reducing medication errors, Project Turnabout, Minnesota (Link to full story to follow.) 
  • Streamlining the intake process, Recovery Resources, Ohio: 
    Ohio change team asks: Why are we collecting these forms and why now?
  • Increasing the percentage of time that clients meet treatment objectives, LaCrosse County Comprehensive Community Services, Wisconsin:  (Link to story to follow)


The NIATx model of process improvement

The NIATx model of process improvement was designed specifically for the behavioral health field. 

NIATx began in 2003 as a demonstration project supported by the Robert Wood Johnson Foundation and the Substance Abuse and Mental Health Administration (SAMHSA).Originally, “NIATx” was the acronym for The Network for the Improvement of Addiction Treatment. Today, it is known simply as NIATx to reflect the model's expansion into other areas.

The team that developed the model, led by Dr. David H. Gustafson at the UW-Madison, knew that people seeking behavioral health services face multiple barriers to treatment. In response, the team developed a simple model of process improvement that organizations can use to make their services easy to access, easy to use, and engaging rather than forbidding

“We founded NIATx on the conviction that what inhibits many organizations from delivering the kind of care they’d like to isn’t resources or staff—it’s problematic processes in the work system.”  --David H. Gustafson 

The evidence base for NIATx

In 2007, McCarty et al.[1]wrote a seminal article on the results of this pilot,which showed that small incremental changes in treatment processes can lead to significant improvements in treatment and retention. Since then, more than 30 peer-reviewed articles have added to the evidence base for the NIATx model.

Read the abstract: The Network for the Improvement of Addiction Treatment (NIATx): enhancing access and retention

Focus on simplicity

The NIATx model gives organizations a set of tools for addressing problematic processes in the work system. By identifying the internal practices and processes that inhibit its ability to provide effective, timely care, an organization can make changes to those processes, eliminate or reduce problems, and make progress toward improvement. 

The model consists of:

Watch this 2-minute video to see how it works: 


Learn the NIATx Model: The NIATx Change Leader Academy

The Great Lakes MHTTC offers NIATx Change Leader Academies (CLAs) in each of the states in our region. 
The CLA is a one-day face-to-face workshop followed by three months of virtual peer networking and support from a NIATx coach. 
Read more about the NIATx Change Leader Academy

2019 Great Lakes MHTTC NIATx Change Leader Academy Schedule

NIATx Logo Great Lakes MHTTC is offering NIATx Change Leader Academies in each state in our region in 2019. Please check our website regularly for updates!  

For more information or to schedule a NIATx Change Leader Academy, contact

Lou Kurtz at
Ann Schensky at 


[1]McCarty, D., Gustafson, D. H., Wisdom, J. P., Ford, J., Choi, D., Molfenter, T., ... & Cotter, F. (2007). The Network for the Improvement of Addiction Treatment (NIATx): enhancing access and retention. Drug and alcohol dependence88(2-3), 138-145.