Vote: Publish pending minor changes
[For votes to count, referees must reasonably explain why they voted as they did. Thus, please explain your vote. If you voted to publish pending minor changes, specify each change, why it is needed, and, possibly, how it should/could be done.]
Overall, I thought this was a clear, well-executed study and manuscript that presented meaningful findings on organizational-level influences in the treatment provision of community mental health centers. There are some small changes that could improve the clarity of writing, study justification, and discussion of findings throughout the manuscript.
In multiple places, the authors reference “law” as an organizational-level consideration – I would suggest rephrasing as “legal constraints” since law exists outside of the level of an organization.
On p. 5 (PDF version) – There is an “effect” that should be “affect.”
P. 5 (PDF version) – It would be helpful to relate deinstitutionalization back to legal constraints/legislation.
P. 6 (PDF version) – The author should discuss statewide differences in Medicaid expansion as well.
P. 7 (PDF version) – I think it would be nice to add a section in the methods – or introduction – describing the local context in Indiana in terms of funding, legislation, other state policy, etc.
P. 7 (PDF version) – Can the author clarify the total number of CMHCs (out of which 45 had identified administrators)? If it was not possible to identify the population of CMHCs, this should be acknowledged on p. 7.
P. 17 (PDF version) – This statement did not seem accurate given the percentage relative to other identified challenges: “Legislative funding was also one of the greatest barriers for respondents (n= 6, 9.8%) and can be best described as marginalization through a lack of overall funding for mental health treatment.”
Overall, the discussion focuses primarily on summarizing findings. There is some integration of findings with previous research, but I thought the author could provide more discussion of why specific findings may have emerged and provide implications for research, policy, and practice.