Residency training in Massachusetts: a new approach to state-university collaboration.

Traditional state-university collaborations, known as public-academic liaisons (PALs), have resulted in improved quality of service and enhanced residency training. Recent national trends for treating persons with serious mental illness, including moving services from institutional settings to community-based care and emphasizing the use of rehabilitative approaches as well as changes in the health care delivery system itself, have led to preliminary rethinking of some discrete aspects of more traditional approaches. Rather than discrete changes, Massachusetts has responded to these emerging trends with a new and comprehensive initiative that emphasizes one set of statewide standards in these emerging content areas for all residency training programs. Consistent with new practices in health care delivery, this new initiative was fielded through a process of competitive bidding rather than through traditional allocation of service positions. The development, implementation, and initial outcomes of this new approach are presented and implications for mental health administrators are discussed.