Service Network Provan Milward

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Public Management Research Association

Institutional-Level Norms and Organizational Involvement in a Service-ImplementationNetworkAuthor(s): Keith G. Provan and H. Brinton MilwardSource: Journal of Public Administration Research and Theory: J-PART, Vol. 1, No. 4 (Oct.,

1991), pp. 391-417Published by: Oxford University Press on behalf of the Public Management Research AssociationStable URL: http://www.jstor.org/stable/1181744

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Institutional-Level Norms andOrganizational Involvement

In a Service-Implementation Network

Keith G. ProvanUniversity of Kentucky

H. Brinton Milward

University of Arizona

ABSTRACT

Thisarticle,which ocuseson organizationshatserveseriouslymentallyll adults n a singlecommunity,s an attempt o explaintheinvolvementf theseorganizationsn a network f servicedelivery, "service-implementationetwork."Withthe useofaninstitutionalheoryperspectiveourhypotheses eredeveloped,achfocusingon an aspectofan organization'serviceorientationhoughtto reflect ts commitmento andsupportof institutional-levelprofessionalormswithregardo networknvolvement.Datawerecollected n twenty-eightf thethirty-one ealthandsocialserviceagencies hatmadeup theservice-implementationetworkoradultswithseriousmental llnessin onecity.Resultsweregenerallysupportivef thehypotheses,lthough hestrengthof the indingsvarieddependingn whether etworknvolvementwasmeasured seither ervice-linkensityormultiplexity.

The main perspectivethathas guided the study of rela-tions between organizationshas been resource-dependencetheory (Pfefferand Salancik1978).One consequence of thepredominanceof this perspectivehas been a strongfocus inthe organizationtheoryliteratureon resourceneeds as thebasis for interorganizational ies (cf.Aldrich 1979;BojeandWhetten 1981;Levine and White 1961;Provan et al. 1980;Vande Ven and Walker1984).Workin the areahas generally con-cluded that despite a loss of autonomy,organizationsoftendevelop cooperativerelationships with one anotheras a way of

The authors would like to thank themembers of the organization studiesresearch workshop at the Universityof Kentucky and the social organi-zation seminar at the University ofArizona. Special thanks are due toDebra Armstrong, Kunal Banerji, Jack

Knott, Walter Powell, and JerryRoahrig for their help at variousstages of the project. This researchwas made possible by a Summer Re-search Grant received by the firstauthor from the College of Businessand Economics of the University ofKentucky. The grant was made pos-sible by a donation of funds to theCollege by Ashland Oil, Inc.

J-PART, 1(1991):4:391-417

391/Journalof Public AdministrationResearch and Theory



Institutional Norms and Service-ImplementationNetworks

reducingenvironmentaluncertaintyand increasing theircapac-ity to attractthe scarceresourcesneeded to survive and grow.

Despite the value of the resource-dependenceperspective,it generally neglectsa considerationof normativestandards

and legitimized procedures as an explanationof why organi-zations develop and maintaininterorganizational elationships.Such a consideration s particularly mportantwhen focusingon organizationsthat have a strong, commonnormativepro-fessional base and where the link between resource acquisitionand the performanceoutcomes of individual organizationsistenuous, as in the public and not-for-profitsectors (Downs1967;Molnarand Rogers1976).While resource-dependencearguments,broadlydefined, can still be used to guide at leasta partialunderstandingof interorganizationalactivityundersuch conditions,an explanationbased on institutionaltheory

(Dimaggioand Powell 1983;Scott 1987)is particularlyappro-priate,because it stresses the importanceof normativeper-suasion in the formationof interorganizational elations.

This study, by using argumentsgrounded in institutionaltheory,attemptsto explain the extent to which organizationsina single, narrowly specifiedhuman service networkbecomeinvolved with other organizations n that network.The hy-potheses focus on the tie between organizationalservice needsand philosophies,on the one hand, and prevailinginstitu-tional-levelprofessionalnorms that favor strong inter-organizational nvolvement,on the other.

THEORETICAL ACKGROUND

Stronginstitutional-levelpressures-such as the prevailingviews of a dominantprofessionalgroup of governmentplan-ners, funders, and regulators-have been found, in a numberof studies, to influenceorganizations'behaviorinvolving thedelivery of servicesby public and not-for-profitorganizations.Forinstance,Derthick(1970)found that the federalgovern-ment had developed influenceover officialsin state highwayand public welfare departmentsby sponsoringprofessional

associationsand activitiesdevoted to increasingthe profes-sionalismof these state organizations,whose membersthenimplementedprogramslargelypaid for by the federalgovern-ment. In another study, Weiss (1990)found professionalnormsfosteredby the National Instituteof MentalHealth to havebeen very important n the development of the communitymental health agencies of the 1950sand 1960s.She concludedthat changesin the way social problemsare defined can leadto the development of new professionalnorms that can theninfluence changes in the ways in which organizationsdeliverservices.

392/J-PART, October 1991




Withinsociology and organizationtheory,institutional-level factors have been explicitlyrecognized as ways to explainsimilarpatterns of behavioracrossorganizations(see Scott1987for a review). Forinstance,DiMaggio and Powell (1983)concluded that institutional-level actors,such as the pro-fessional ties thatspan an organizationalfield, often leadorganizationsperformingsimilartasks to be structuredthesame way. Thisphenomenon was termed "institutional so-morphism."Similaritiesamong organizationsresulting frominstitutional-level nfluenceswere thought to occur for reasonsof coercion,mimicry,or professional normsregardlessofwhether or not organizationalperformancewould improve asa directresult of adoptinga new form.

Tolbertand Zucker(1983)reached a similarconclusionwhen they examined the adoptionof civil service reformby

cities and statesbetween 1880and 1935.They found:

earlyadoption of civil servicereform-before 1915-appears to reflectefforts to resolve specificproblemsconfrontingmunicipaladministra-tions, while lateradoption is rootedinsteadin the growing legitimacyof civil serviceprocedures,with the diffusionof societalnormsservingto define local structure. p. 22)

Adoption of civil service reformincreasinglywas seen as asign of a city's progressiveness.Adoption soon became arequirement o receive state and federalfunding, to receivefavorablebond ratings,or to gain membershipin nationalprofessionalorganizations.Thus, institutional-levelnorms wereseen as a major forcebehind changes in structureand behaviorat the local level.

While institutional-levelpressures can lead to the diffu-sion of structural nnovations,like civil service, they can alsolead to the development of a commonmindset, particularlyamong professionalswithin the same organizationalfield. Forinstance,Warrenet al. (1974)found a common "institutionalthought structure" mong communityorganizations n ninedifferentcities. The thought structureextended to how

problemsshould be addressed, to entry rules for new organi-zations, and to premisesregardingthe natureof the socialproblemsof the organizations'clientele.

More recently,Galaskiewicz(1985;Galaskiewiczand Was-serman1989)found that the amount of funds receivedby non-profit charitableorganizationswas a function of theirrepu-tationamong the communityof corporate-givingprofessionals.It is "throughnetworksthat actorsnegotiate meaningswhichcan give rise to sharedor similarvalues, beliefs and norms"(Galaskiewicz1985,640).Thus,networks of professionalscan





be the infrastructureupon which a common institutionalmind-set is constructed.

Overall, while resource-basedmotives for behavior are notunimportant, nstitutional-levelfactors, particularlythose basedon professionalnorms, can substantially enhance an under-standing of why organizations act as they do. Particularly nthe not-for-profitand public sectors, professionalnorms areimportant in providing guidelines for acceptablemethods ofservice delivery because performancemeasures are so difficultto develop. Since internalneeds and pressures at the organiza-tional level often mean thatinterorganizational ervice ties arenot given high priority,such guidelines are particularlyusefulfor promotingthe interorganizationaldelivery of services.Inmany areas of health and human services, for instance, institu-tional-levelprofessionalnorms serve as a powerful means for

persuading providersthat clients are best served not by anindividual organization or by groups of organizations linkedprimarily for purposes of resourceacquisition, but by a highlyintegratednetwork of servicesprovided by multiple organiza-tions-what is referredto in this study as a "service-implemen-tation network."These networksare a majorform of servicedelivery in such critical areasof the public sectoras housing,drug abuse, employmentand job training, youth services,services to the elderly, and mental health.

SERVICE-IMPLEMENTATIONETWORKS

The idea of a service-implementationnetwork is closelytied to the work of Hjem and Porter(1981, 216).They intro-duced the notion of "implementationtructure,"which theyview as "a cluster of parts of public and private organizations[in which] subsets of members within organizations. . . view aprogram as their primary,or an instrumentally mportant,interest."Their approachoffers a conceptual and methodo-logical basis for the study of relations among organizationsthat is not only differentfrom traditional views but moreaccuratelyreflects the way in which certain health and human

services are implemented.The idea is that since no singleagency provides the entirepackageof related services oftenneeded by clients, multiple services are best delivered inter-organizationallythrougha coordinatedand integratednetworkof organizationsofferingcomponentsof the complete service.While not all clients will need all componentsoffered,clientswith multiple requirementscan receive a variety of servicesfrom the network. Clients may enter the system at any pointand have access to the system as a whole, while agencies stillremainautonomousentities concentratingon manageablepieces of the full service that best fit their specific area of

394/J-PART, October1991




expertise or the niche they have carvedout for themselveswithin a particularcommunity.

Therewill often be a lead or coordinatingagency-like acommunitymental health center or a city office of employment

and training-that will offer a wider rangeof services thanmost of the other agencies in the community and will oftencoordinateservices as a result of a specificmandate from acabinet-leveldepartmentof the state government. It is this leadagency that is usually the primarylocal-leveladvocate of pro-fessional norms that encouragea network of service delivery ofsimilarand coordinated services.Unlike the way in whichmost organizationalnetworks have been conceptualized andstudied in the past, the network itself is viewed, at leastideally, as the unit of service delivery.

Additionally,in a service-implementationnetwork,organ-izations may only be partiallyinvolved. A majorpresumptionof most theoryand researchon interorganizational elationsisthat organizationsevelop links with other organizations. orinstance,in her recentattemptto categorizethe researchoninterorganizational elationsinto six criticalcontingenciesofrelationshipformation,Oliver (1990,24243) assumed an or-ganization-to-organization erspective,even though she grantsthat subunit interorganizational elations can and do appear.The implicationis that a given link is established by and forthe benefit of the entireorganizationand the full organization

is committed to and involved with its linkagepartners.Whilethere may be some validity to this view when studying broadorganizational ssues such as the acquisition of certainresources,especially funding, it is not always relevant forexplainingthe many linkages organizationsmaintainthat aremore narrowly focused. In particular,not-for-profitand publicsectoragencies often deliver multiple services,many of whichare quite different from each other. Forexample,a singlehuman service agency may serve some clients who are blind,some who are drug and alcoholabusers,some who are men-tally ill, and some youths frombrokenfamilies.Thus, separatelinkage

networks will often be established and maintained foreach broadtype of service an agency provides;overlap amongthese networksmay be either minimal or coincidental(seeExhibit1). Service-specific inks will be particularlyprevalentwhen ties are developed and maintainedby serviceprofessionalswhose commitmentto the service and to clientrecipients,based on common educationand training,is oftenhigher than it is to the organizationthat employs theprofessional(Hall 1986).





Exhibit 1

Organizational Versus Service-Implementation Networks*

Health and Human Services Offered

Seriously Drug Youth PhysicallyMentally Rehabili- Character Handi- Service

Organizations Ill Adults tation Building capped Aged n ...

Agency A X X XAgency B X X XAgency C X XAgency D X XAgency E X X

Agency Z X X

*All of the agencies listed are connected to one another, either directly or indirectly, and are thus

part of the community's general health and human services organizational network. Networkmembers may also be linked through nonservice ties such as information sharing or board inter-locks. Only agencies A, C, and E are part of the community's service-implementation network forseriously mentally ill adults.

MENTALHEALTHIMPLEMENTATIONNETWORKS

One service area in which a strongimplementation-networkphilosophy is reasonablywell establishedis thecommunity-baseddelivery of healthand social services to

adults who are seriously mentally ill (SMI).Prior to the 1960s,most SMIadults were institutionalized,often receiving lifelongcustodialcare. During the 1960s and early 1970s,however,views toward treatmentshifted toward large-scaledeinstitutionalizingof chronicmental patients into communitysettings far less restrictivethan traditionalstate mentalhospitals (Bassuk and Gerson 1978;Windle and Scully 1976).Despite the passage of nationallegislationproviding incentivesto shift to the new system (Weiss 1990),inadequateplanningand coordinationmeant that most communitieswere unpre-pared to deal with the large numbersof deinstitutionalized

SMIadults who still needed manyof the services formerlyprovided by state institutionsin addition to many new servicesnot previously requiredin an institutionalizedsetting.

To address the problem,the National Instituteof MentalHealth introducedits CommunitySupportProgram n 1977.This initiativewas designed to assist states in planningandimplementingcomprehensive,community-basedservices forthe nationalpopulationof SMI adults who did not needtwenty-four-hour, nstitutionalizedcare.A major goal was toencourageinterorganizationalnvolvementand coordinationat





the communitylevel throughthe development of a system ofservices that treatedpatientswith chronicmentalhealthproblemsand cut acrossorganizationalboundaries.In thisway, the multiple problemsof SMIpatientscould be addressedthroughan integratedset of diverse programsprovided by

many communityagencies (Tessler and Goldman 1982)-inother words, a service-implementationnetwork.Planning,coordination,and local-level integrationwould be guided andencouragedby a core agency, typicallya communitymentalhealthcenter.

Becausefunds were limited (only $20.5million was spenton the program between 1978and 1982),the community-support initiative-like the deinstitutionalizationeffortbeforeit-relied on the creationof a professionallybased normativestrategyintended to influencelocal behaviorthroughresearch,

demonstrations,and establishment of a community-serviceethic among mentalhealthadministratorsand professionals(Morrisseyet al. 1985;Weiss 1990).This strategyemphasizedsuch activities as resourcesharing,jointplanning,and casemanagement as ways of integrating a set of diverse serviceproviders.Because of the general failureof many of theheavily funded "topdown"approaches to programimplemen-tationduring the 1960s and 1970s(O'Toole1986),thecommunity-support nitiativetried to make a virtue out of itslimited resources.In addition, the lack of funds madeprofessionallybased normativepressures far more viable than

resource-based ncentives.

The ideals of the CommunitySupportProgramhave notbeen met;nonetheless,the program'sbasic conceptsaregenerallysupported,at least in theory,among mental healthprofessionals. This endorsementprovides strong institutional-level norms for substantialnetworkinvolvementby individualagencies. The little researchthat has been done in the areahasshown at least modest levels of network involvementamongagencies providing community-basedSMIservices (Gruskyet al. 1985;Morrisseyet al. 1985;Paulson 1987). None of thework

on service-implementationnetworksin mentalhealth orin other areas (cf.Hull and Hjern1987),however, hasaddressed the question of why, given strong institutional-levelnorms, some agencies appearto be more heavily involved withthe network than others.

In addressingthis question, we propose that, in mentalhealth service-implementationnetworks,involvement in thenetworkby an agency's SMIservice component or unit willdepend on the extent to which various service-relatedcharac-teristics of thatunit are consistentwith prevailinginstitutional-





level professionalnorms that favorsuch involvement.We havefocused on four such characteristics nd put forwardfourrelatedhypotheses:comprehensivenessof services, treatmentphilosophy, service emphasis,and intensity of agency-clientcontact.Consistent with service-implementationnetwork

methodology,our hypotheses and data analysis focus only onthe relevant componentof an organizationthat serves a par-ticularclient group, in this case, SMI adults. Therefore,weoften distinguish the SMIservice or program"unit" f anagency from thatagency as a whole. In addition,althoughagencies and their units may be involved in multiple networkshaving differentprofessionalnorms (see Exhibit 1), our con-cern here is only with their involvement in a single imple-mentation networkwith a single set of professionalnorms.

HYPOTHESES

Comprehensiveness of Services

Becausecomprehensive-serviceunits of agenciesobviously can serve more of the multiple needs of a particularclient group than can agency units offering few services, theywould seem to have less need to develop service links withother organizations.However, because of the many servicesthey offer, such agency units become valuable and centralmembers of any service network (Whettenand Aldrich 1979;Whettenand Leung 1979). By developing links to a relatively

small numberof comprehensive-serviceagencies, agency unitsoffering few such services themselves can greatlyexpand thenumberof services their clients receive without adding a greatdeal of additionalcomplexityto theirown operations.Con-versely, while agencies having comprehensive-serviceunitswill add to the complexityof theiroperationsby having tomanagethe links to these many other organizations,their posi-tion of centrality n the network is likely to enhance theirpower and legitimacy(Bojeand Whetten1981;Cook 1977;Oliver 1990).

Becauseof the importanceof comprehensive-serviceunitsto the overall effectivenessof the entire service-implementationnetwork and because the largenumber of services offered arelikely to make them highly visible among clients and profes-sionals in a community,the local, state,and federal institu-tional-levelpressureson these service units to become heavilyinvolved in service-implementationnetworksare likely to bequite strong. In addition,by offeringmany services to a par-ticularclient group such as SMIadults, agency professionalsbecome broadlyexposed to the problemsof theirclients, thusbecoming more acceptingand supportiveof institutional-level





professionalnorms thatconcern the full range of client needs.This leads to:

Hypothesis 1:Becauseinstitutional-levelpressures to be partofa service-implementationnetworkare likely to be greatest for

service units providingcomprehensiveservices, the morecomprehensivethe servicesprovided by a particularclient-based service unit of an organization,the greaterwill be theunit's involvement in that service-implementationnetwork.

TreatmentPhilosophy

An implicitassumption up to this point has been that theprofessionalnorms and views of institutional-levelplannersand policy makers will be generallyconsistent with the viewsof the professionalswho actually implementservices. How-

ever, since a service-implementationnetwork is a collection oforganizations thatprovide many differenttypes of services to acommon set of clients, it is likely that not all organizationswillshare the same professionalnorms or ideologies. It is alsolikely thatat least some professionalgroups in the networkwill not have the same views as those of institutional-levelplanners and policy makers.In particular, ome professionalsmay have adopted a treatmentphilosophy that limits the needfor the complexitiesof a highly integratedsystem of services.

A situation of competing treatmentphilosophies will be

especially prevalent when the effectivenessof services andservice outcomes in general are difficult to measureaccurately.In the mental health field, thereare two predominanttreat-ment philosophies:a traditionalmedical/psychiatricapproachemphasizingdrug therapy, and a broader,psychosocial/community-supportapproach thatemphasizes rehabilitationand integration nto society in addition to psychiatrictreatment(Mosherand Keith1980). Whileboth approaches arevalid, theemphasis of institutional-levelpolicy makersand plannershasgraduallyshiftedaway fromthe medical/psychiatricmodeland toward the broaderapproach(Bakerand Schulberg 1967;Bloomand Parad1977;Wagenfeldand Robin1976).

Becausethe medical/psychiatric view emphasizes patientstabilizationand maintenancethroughdrug therapy,multipleservices (and, thus, multiple agencies)are not criticaltotreatment.As a result, it is likely thatinstitutional-levelpressures to become involved in the service-implementationnetworkand to adopt a generalnetworkphilosophy will notbe enthusiasticallyembracedby those holding a medical/psychiatricview. In contrast,an agency whose SMI-serving




Institutional Norns and Service-ImplementationNetworks

professionalshave a psychosocial/community-supportperspec-tive will become stronglyinvolved in the service-implementa-tion network,relying on many other agencies in the commun-ity to provide the multiple services requiredfor patientrehabilitation. t is the SMI-servingprofessionalsof these

agencies who hold views most closely relatedto ideologies ofinstitutional-levelplannersand policy makers.This suggests:

Hypothesis 2: The more a serviceunit of an organizationhas ageneral treatmentphilosophy towards a particularclient groupthat is consistentwith dominant institutional-levelprofessionalnorms regardinginvolvement in a service-implementationnetwork, the greater will be the service unit's involvement inthat network.

Service Emphasis

Organizationsoften provide multiple services to clientswho fit a variety of need categories.Therefore,many of theorganizationsparticipating n a service-implementationnet-work often provide some services that have nothing to do withthe purpose of the network. The networkis designed specif-ically to tap only those componentsof organizationsneeded toserve a particularclient group.

Some organizationswill, however, be highly committedtoserving the network'sspecificclient group. When strong insti-

tutional-level pressuresexist, these organizationswill be mostresponsive.They have a high level of commitmentto provideservices to those clients whose needs are the foundationof therationalefor forming the network.In the mentalhealth area,an agency, even a small one, that is devoted exclusively orheavily to serving SMI adults would likely be affectedbyinstitutional-levelnorms favoringstrong involvement in theservice-implementationnetwork. Conversely, organizationsthat mostly provide services to non-SMIclient groups arelikely to be only marginallyinvolved in the SMIservice-implementationnetwork,regardlessof treatmentphilosophy orof the importanceof thatorganization'sservices to the networkas a whole. In these latterorganizations, nstitutional-levelpressureswill be felt only marginallyby their professionalsand administrators.Many of these individuals will respondmore strongly to the normsof other professionalgroups thatspecificallyaddress the needs of the majorityof the particularorganization'sclients.Thus:

Hypothesis 3: The greateran organization'srelativeemphasison and resource commitmentto serving a client group that,accordingto prevailinginstitutional-levelprofessionalnorms,

400/1-PART, October 1991




is best served through a service-implementationnetwork,thegreaterwill be the involvement in that networkby the relevantservice unit of the organization.

Intensiveness of Agency-Client Contact

While the professionalsof many agencies and serviceunits may adopt and institutionalizeprofessionalnorms thatfavor delivering services throughan implementationnetwork,nonintensive-serviceagencies and units are more likely thanothers to adopt such normsbecause these will be most consist-ent with the service needs of their clients. In view of thelimitationsof the servicesprovided by these nonintensive-service units, theirprofessionals are most likely to accept theidea that multiple agencies should be involved in serving themultiple needs of clients. Forinstance,an agency thatprovides

only meals or informationor brief counseling will need to seekthe services of other agencies to address theirclients' full rangeof problems.

In a well-integratedimplementationnetwork,services aresupposed to build on one anotheras clients go from oneagency to another so that each agency need not engage infullscaleneeds assessments or provide in-depth services formost of theirclients.Thus, it is not required to spend manyhours with each client at any given client visit to serve thatclient's needs adequately.Forthis reason,professionalsin

nonintensive-serviceunits are likely to find that institutional-level norms regardingdelivery of services througha service-implementationnetworkare highly congruentwith theservices they provide. In contrast, ntensive-serviceunits-likeshelteredworkshopsor drug detoxificationcenters-will seeinvolvement in the service-implementationnetworkto be lesscriticalfor the needs of theirclients, and given the complexitiesand potentialloss of autonomyassociated with attempts tocoordinateand deliver services interorganizationally, ess likelyto participate n the network.Therefore:

Hypothesis 4: Because the service units of organizationsproviding nonintensiveagency-clientcontact are most likely toaccept institutional-levelprofessionalnorms regardinginvolvement in a service-implementationnetwork,the lessintensive the agency-clientcontactfor a particularclient-basedservice unit of an organization,the greaterwill be itsinvolvement in that service-implementationnetwork.





METHODSAND MEASURES

Sample

The city selected for the study researchsite was located in

the north-centralUnited Statesand had a metropolitanareapopulationof slightly over 800,000.In a survey by Torrey,Wolfe, and Flynn (1988)of the PublicCitizen Health ResearchGroup, the state in which the city was located rankedin thetop third in terms of the qualityof existing inpatientandoutpatientSMIprograms,adjustingfor per-capitastate income,althoughnear-term mprovementswere thought to be slow incoming owing to little state-levelcommitmentto innovation orcoordinationof SMI services.The communitymental healthcenter (CMHC)studied was singled out in the survey as beinga particularlygood one, and the directorof adult services was

seen as strongly committedto encouragingan integratedsystem of servicedelivery. Overall,with strong norms favoringa service networkby local- and federal-levelprofessionalsbutnot by those at the state level, the source of most funding, thegeneral institutional-levelclimate for a mental health service-implementationnetworkappearedto be favorablebut notexceptionallystrong.

The size of the city studied (the SMInetworkencom-passed the county as well) was also importantin site selection.A city of approximately500,000to one million people was

deemed sufficientlylarge that a networkof diverse organiza-tions would be likely. Substantially argercities were seen aslikely to produce several subnetworks,therebycomplicatinganalysis and interpretationof results.Finally,SMI services inthe city studied were ostensiblycoordinatedand facilitatedbya private,not-for-profitcore agency. This CMHCreceivedfunding, mostly throughstate sources, to ensure that the city'smentally ill were adequatelyserved.

Data Collection

Data were collected in 1987using the following pro-cedures. First,the head of adult SMIservices at the city'sCMHCwas identified and persuaded to cooperate.He and hisstaff generateda list of twenty-sixorganizationsinvolved withSMIservices in the community.Next, at a group meeting setup by the CMHC contactperson,we met with the directorsorprogramneads of eight agencies thought to be criticalto theSMInetwork. From their suggestions, the SMInetwork wasexpanded to forty-six organizations,'thirty-oneof which wereidentified as having specificprogramsto serve the adult SMIpopulation.These thirty-oneservice providersbecame the

'Respondents were given the oppor-

tunity to identify additional agencies

in the network. Although some were

added, none were mentioned by at

least two respondents, our criterion

for inclusion in the network.




Institutional Nornmsnd Service-ImplementationNetworks

focus of our investigation; however, their links to the fifteennonproviders were also examined.2We identified the person ateach agency who knew the most about its adult SMIprograms(usually either the program head or the executive director).Key CMHC people sent lettersof introduction,and question-naires were mailed with a letterof explanationfrom theresearchers.Nearly all of the thirty-one service providershadto be contactedon follow-up, so that all or partof eachquestionnaire was completed through telephoneor personalinterview. Respondentswere strongly encouragedto seekinformation from membersof their staffs to maximizeaccuracy.Unusual responses were checked out using addi-tional follow-up calls and were corrected when necessary.As aresult of these data-collectionprocedures, responses wereeventually received from twenty-eightof the thirty-oneagencies surveyed, with almost no missing data. (Dataon

linkages with the other three agencies were obtained fromthetwenty-eight respondents;therefore,only data about them-not from them-is included in the research.)Thus, almost theentire adult mental health service-implementationnetwork inthe city was studied.

Dependent Variable: Network Involvement

Consistentwith the service-implementationnetwork focusof this research,network involvement was measuredby askingrespondents to indicatetheir SMI unit's involvement with each

of the other forty-fiveidentifiedorganizations-providers andnonproviders-regarding five types of service-relatedactivities(but focusing only on services to SMI adults): referral nflows,referraloutflows, case coordination,jointprograms, andservice contracts.Only those referral inks designated as"significant" y respondents were counted; no other attemptwas made to measure relativedegrees of interorganizationalinvolvement. (Responses for each type of activity weredichotomously coded). From these data, three conceptuallydistinct measures of network involvement were developed:

Service links: This measure was computed by summing thenumber of different types of SMI linkages an agency had withall other organizationsin the network.

The mean score for the network of thirty-one service providerswas 16.63(s.d. = 12.94), the maximum possible score being 150.Overall,this measure indicates the extent to which an agency'sadult SMIservices were delivered interorganizationallythroughthe service-implementationnetwork.

Organizational links: This measure was computed by sum-ming the number of organizations n the adult SMI network to

2The fifteen network participants not

actually surveyed-the nonprovid-

ers-included such organizations asUnited Way, the police department,

the courts, and the housing authority.A pretest in another community indi-

cated that organizations like these had

great difficulty answering our ques-

tions-they kept no records on their

SMI dients and made no program-

matic distinction between this par-

ticular client group and others they

served. On average, SMI service pro-

vider agencies in the community we

studied had 16.63 service links and

9.41 organizational links (see dis-

cussion of measures below) to theother thirty provider agencies. In

contrast, provider agency service andorganizational links to the fifteen

nonproviders was only 4.85 and 3.33,respectively, suggesting more of a

peripheral role in the network.





which the unit was linked, regardlessof the type or number ofservices involved.

The mean scorefor the thirty-oneagencies thatmade up theprovidernetwork was 9.41 (s.d. = 6.64, maximumscore =

31-1).Since service links and organizational links were highlycorrelated(r = .90), and since service links was a far richermeasureof networkinvolvement,it was used only in the maindata analysis.

Multiplexity:This measurewas computed by dividing organi-zational links into service links.

A high score means that a unit's service links to other organi-zations typicallyinvolved multiple types of linkages.The meanmultiplexityscore was 1.72 (s.d. = .59)for the network of

thirty-one provideragencies.The term "multiplexity"sborrowed fromnetworkresearchers Aldrichand Whetten1981;Paulson 1985).It is a measureof the average strengthofan organization'sties to its linkagepartners.The idea is thatmultiple service links to any one network partnerwill be morestable and enduring than a single service link which, oncebroken,means the end of the relationship.Exhibit2 lists thetwenty-eight agencies studied and gives each agency's scorefor each dependent variable.

Independent Variables

Comprehensiveness f services:A main componentof theCommunitySupport Program s its specificationof three mainorganizationalfeatures for the local community-supportsystem, one of which is a list of ten essential "keyservicecomponents" Turnerand TenHoor1978).Our measure is adetailed checklistof sixty-eightspecific services listed withinthese ten broad service areas.3Eachagency's responses weresummed to determine the total number of types of servicesofferedby thatagency.

Treatmentphilosophy:Buildingon measuresdevelopedby Bakerand Schulberg (1967),two questions were used tomeasurethe extent to which the agency's adult SMItreatmentphilosophy had a community-supportorientationas opposedto a medical/psychiatricperspective.A five-point Likertscalewas used for responses to each question.The two questionswere similarconceptuallyand were sufficientlycorrelated(r = .46; p < .01) to warranttheir being combined into a singlemeasure.High scores reflecta strong community-supportorientation.

3One shortcoming of this measure is

that all the services an agency pro-

vides are weighted equally. Thus,

resources for one agency may be

spread relatively equally across all

the SMI services it offers, while

another multiple service agency may

concentrate most of its resources on

only one service.





Exhibit 2Scores for Agencies' Involvement in the Mental Health Service-ImplementationNetwork

Organizational

Agency ServiceLinks* Links Multiplexity1. CMHC (core agency) 101 (78) 41 (30) 2.46 (2.60)2. General hospital (forprofit) 62 (49) 28 (20) 2.21 (2.45)3. Christian Mission 47 (38) 24 (18) 1.96 (2.11)4. Adult Protective Services(state) 41 (32) 28 (22) 1.46 (1.45)5. Mental health agency 41 (35) 18 (16) 2.28 (2.19)6. Familyand Children'sAgency 40 (23) 28 (18) 1.43 (1.28)7. Center for homeless 35 (24) 18 (12) 1.94 (2.00)8. Generalhospital (Catholic) 34 (21) 31 (19) 1.10 (1.11)9. Community-supportservice agency 33 (31) 16 (14) 2.06 (2.21)

10. Crisis and InformationCenter 31 (23) 24 (16) 1.29 (1.44)11. Psychiatric clinic 30 (25) 16 (13) 1.88 (1.92)12. State mental hospital 29 (23) 16 (11) 1.81 (2.09)13.Neighborhood center 26 (16) 14 (8) 1.86 (2.00)14. Office of VocationalRehabilitation 23 (23) 8 (8) 2.88 (2.88)15. Salvation Army 17 (11) 10 (7) 1.70 (1.57)16.Jewish Family and Vocational Services 13(12) 13 (12) 1.00 (1.00)17. MentalHealth Association 13 (7) 6 (3) 2.17 (2.33)18. Visiting Nurses 13 (13) 8 (8) 1.63 (1.63)19. Alcohol and drug abuse center 12 (10) 7 (5) 1.71 (2.00)20. Personal care home 8 (8) 4 (4) 2.00 (2.00)21. Senior citizen center 8 (6) 7 (5) 1.14 (1.20)

22. Psychiatric hospital (private) 7 (4) 7 (4) 1.00 (1.00)23. Goodwill Industries 5 (5) 3 (3) 1.67 (1.67)24. Halfway house 4 (3) 4 (3) 1.00 (1.00)25. Neighborhood center 3 (3) 1 (1) 3.00 (3.00)26. CorrectionalPsychiatricCenter (state) 2 (1) 2 (1) 1.00 (1.00)27. Veteran's AdministrationHospital 2 (2) 2 (2) 1.00(1.00)28. Neighborhood center 1 (1) 1 (1) 1.00 (1.00)

*Figures n parenthesesare linkages to the thirty-oneSMIserviceprovider agencies only.

Serviceemphasis:Two measureswere developed-thepercentageof an agency's total budget devoted to adult SMIservices and administration,and the number of adult SMIclients an agency serves on a "typical" ay as a percentage ofthe totalnumber of clients of all types it serves. Becausethesetwo measureswere highly correlated(r = .93), only the secondmeasure was used.

Intensivenessof agency-clientcontact: Respondentswereasked to indicatethe percentagesof adult SMIclients servedby their agency in each of seven categoriesof intensity of




Institutional Norns and Service-ImplementationNetworks

agency-client contact (i.e., time spent on a client in any given

day). A mean score then was computed for each agency, with

a high score reflecting an average agency-client contact of long

duration. This specific measure was originally developed byProvan (1984) for a sample of human service agencies.

Means, standard deviations, and correlations for all vari-

ables used in the study are reported in Exhibit 3.

Exhibit 3Means, Standard Deviations, and Correlation Matrix

for All Independent and Dependent Variables (N = 27)

Independent Variables Mean S.D. 1 2 3 4 5

1. Comprehensivenessof Services 17.26 10.52

2. Treatment Philosophy 3.82 .79 .0213. SMI Service Emphasis .43 .39 -.01 .244. Intensiveness of Agency-

Client Contract 3.52 2.05 .28 -.17 .07

Dependent Variables

5. Service Links2 16.63 12.94 .44 .50 .21 -.326. Multiplexity2 1.72 .59 -.11 .05 .41 -.49 .42

'For r 2 .32, p < .05; for r > .41, p < .01; for r > .55, p < .001.

2Provider-providerlinks only.

DATA ANALYSIS

The findings reportedin Exhibits3 and 5 are based onresults from twenty-sevenof the twenty-eightagencies sur-veyed. After reviewing results from all twenty-eight organi-zations, it became apparentthat service-implementationnetwork involvement scores for the CMHC,the core agency,were so high that interpretation and conclusions drawn from

the full data set would be misleading.Becausea major purposeof the CMHCwas to coordinate and plan the interorganiza-

tional delivery of mentalhealth services, it is not at allsurprisingthat this agency's linkage scores to other organi-zations in the network were extremelyhigh. In view of theirsomewhat different role in the community,it did not seemunreasonableto focus on the other organizationsin thenetwork.Thus, we decided to drop the CMHCfrom the finaldata analysis,yielding a networkof twenty-seven organiza-tions. The links that these twenty-sevenagencies maintainedwith the CMHCwere, however, included as partof eachagency's linkage score since the CMHC was itself an importantmemberof the providernetwork.





Exhibit 4Agencies in Community Mental Health Center'sService Implementation Network for Seriously Mentally Ill Adults

0 Providers

) Non-providers

1 Community Mental Health Center 36 Department for Social InsuranceService Providers 37 Department for Social Services2 to 28: See list on Exhibit 2 38 Community Ministries29 Drop-In Center 39 Housing Authority30 Schizophrenia Foundation 40 County courts31 University Psychology Department Clinic 41 County policeNon-Providers 42 Family support group32 American Red Cross 43 Homeless advocacy group33 Board of Health 44 City police34 Catholic Charities 45 Advocacy group35 Department for Human Services 46 United Way

Note: The closer an agency is to the center,the greaterthe number of servicelinks it maintains with the CMHC(range= 0-5 links).





Unfortunately,excluding the CMHCfrom the main dataanalysis limits knowledge of this key member'srole in theservice-implementationnetwork.To resolve this problem,amap of service links to the CMHCwas developed (Exhibit4).Besides indicatingthe importanceand centrality of the CMHCin the community'sadult SMIservice-implementationnetwork,Exhibit4 readily shows the existenceof a primarynetwork ofall thirty-oneservice providersanda secondarynetwork offifteen nonproviders.Although some of the nonservice-providingagencies (representedby pentagons)are linked tothe CMHCthroughat least one type of service tie, six of theseagencies have only one such tie and four have none at all. Incontrast,the CMHCmaintainsservice ties to all the otherthirty service providers(representedby circles),half of whichhave at least three service links with the CMHC.

These findings give additionalsupport to the contentionthat the fifteen nonproviderswere only peripheralmembersofthe adult SMIservice-implementationnetworkand reinforceour decision to exclude them from the data-collectionprocess.In addition,maintainingat least some service links to theCMHCis criticalto the theoreticalunderpinningsof the study,given the importanceof this core agency for advocacy of pro-fessional norms regardingdelivery of services throughanimplementationnetwork.Agencies with no service ties to theCMHCare unlikely to be concemed with or affectedby thesame institutional-levelprofessionalnorms as those that do

have such ties. Since the thirty-oneprovidersrepresentthecore of the SMIservice-implementationnetwork,the hypoth-eses should be most relevantfor these particularorganizations.Thus, hypothesis testing focuses on service links among theservice providers,althoughproviderlinks to nonprovidersarealso examined for comparison.

The statisticaltechniquesused for hypothesis testing arePearsoncorrelations,reportedin Exhibit 3, and multiple re-gression analysis,reportedin Exhibit 5. Despite the smallnumber of agencies from which data were collected,we

wanted to use a multivariatestatistical techniquein order tosee the unique contributionof each independent variablein

explaining the dependent variables.The use of only fourvariablesin the predictorset allowed for a meaningful test ofthe overall model while it minimized some of the problemsthat would certainlyresult if large numbersof independentvariables were used with such a small sample. Even so, resultsmust be interpretedwith some caution. In particular, he totalvarianceexplainedby the entire predictorset for each equationmust focus on the adjustedR2statistic,which is a conservativeadjustmentfor sample size. A small sample also means that




Institutional Norms and Service-Implementation Networks

Exhibit 5Standardized Multiple Regression Results for Predictors of Involvementin the Service-ImplementationNetwork (N = 27)

Provider-Provider Provider-NonproviderNetwork Network

SMI Service Service Multi- Service Multi- HypothesizedOrientation Links plexitya Links plexitya Relationship

Comprehensiveness .33 .06 .14 .19 +of Services (.06)b (NS) (NS) (NS)

Treatment .40 -.16 .29 .36 +

Philosophy (.03) (NS) (NS) (.09)

SMI Service .14 .49 -.24 -.14 +

Emphasis (NS) (.01) (NS) (NS)

Intensiveness of -.36 -.57 -.09 -.05Agency-Client Contact (.05) (.001) (NS) (NS)

Multiple R .65 .68 .38 .41Adjusted R2 .32 .37 .00 .02Significance .01 .01 NS NS

aMultiplexity= Service Links divided by Organizational LinksbLevelof significance (NS = not significant)

individual beta weights must be quite strong to attain statis-tical significance. Thus, when significant results are found,they can be interpreted with reasonable confidence.

RESULTS

Exhibit 3 reports correlations for the provider-provider

network.Three of the four measures of SMI service orientationwere significantly correlatedwith service links and all were inthe directionhypothesized. Results for multiplexity were sup-portive of the hypotheses on service emphasis and intensive-

ness of agency-client contact,but no relationship was foundwhen the focus was on comprehensiveness of services ortreatmentphilosophy. Multiple regression analysisof theprovider-provider network reaffirmed these correlations. Thehypotheses for comprehensiveness of services, treatmentphilosophy, and intensiveness of agency-client contact allreceived reasonably strong supportin the service linksequation, particularly in view of the small sample size. Onlyservice emphasis received no support.Formultiplexity,regression results also reaffirmed the strength of the corre-lation findings. Specifically,hypotheses for service emphasisand intensiveness of

agency-clientcontact were strongly





supported,while those for comprehensiveness of services andtreatmentphilosophy received no support.Collectively,thefour service-orientationmeasuresexplained32 percentof thevariancein service links and 37 percentof the varianceinmultiplexity (adjustedR2used for both;p < .01 for both).

These results stand in starkcontrastto regressionfindingsthat consideredonly providerlinks to the fifteen nonproviders.As shown in Exhibit5, almost no variancein either servicelinks or multiplexity was explainedby the four measuresof

service orientation.

DISCUSSION

Examinationof the findings for each measureof serviceorientationprovides furtherinsights about agency involvement

in an adult SMI service-implementationnetwork,and con-tributesto both the theoryand methods of studying inter-organizationalactivity.One of the more interestingfindings isthe contrastingresults for service link and multiplexity whenusing comprehensiveness of services and treatmentphilos-

ophy as predictorsin the regressionequations.As hypoth-esized, and consistentwith argumentsbased on institutional-level norms,SMIservice units thatoffer comprehensiveservices and psychosocialtreatmentphilosophy had relativelymany service links to other agencies. In contrast,norelationshipwas found for either of these two independent

variableswhen predictingmultiplexity. The weak finding forcomprehensiveness of services may be explained at leastpartiallyby referring o the finding for service link.Specifically, f many limited-serviceSMIprogramunits arelinked interorganizationallyo a small number ofcomprehensive-serviceunits, then both types of service unitswould have similarlevels of multiplexitywith each other. Forinstance,if a neighborhoodcenterand a senior citizen center,each having an SMIprogramunit offeringa single programfor SMIadults, send and receive clients throughreferralstoand from a multiple-servicemental health center,then the

strengthof the linkage would be the same for all threeagencies (i.e., multiplexity= 2), while the total number of

service links would be highest for the mental health centerhaving comprehensiveservices.Tying back to the theory,while institutional-levelpressuresmay be strongestfor the

comprehensive-serviceunits of agencies because of theirmore

centralroles in maintainingviable networks (thus resultingin

high service-link scores),multiplexity scores for both types of

agencies will be about the same.





As hypothesized, a positive relationshipwas foundbetween treatmentphilosophy and service links. This findingis consistentwith the institutionaltheory-basedview thatstrong professionalnorms favoringnetworkinvolvementwould be most stronglyassociatedwith the service units ofagencies thatadvocateda community-basedpsychosocialtreat-ment philosophy.However, it appearsthat having comprehen-sive servicesand a psychosocialtreatmentphilosophy arerelevantonly for explainingwhy SMIunits develop few versusmany links to the other agencies that make up the service-implementationnetworkand not for explaining the averagenumber of ties maintainedwith individual linkage partners(i.e., multiplexity). Foryears, institutional-levelmental healthplannersand policy makers have stronglyencouragedagenciesto develop integratedsystems of service delivery but the typeof network ties has seldom been specified. As long as clients

can move readily from one agency to another so that a fullrangeof services is provided, the network is thought to beeffective. It appearsthat for at least some types of SMIprogramunits, network involvement,while high, is spreadover many agencies, therebyenablingsuch units to respond toinstitutional normsyet to avoid becomingdependent on a fewnetworkmembers.

In contrast,but consistentwith predictionsbased oninstitutional-levelnorms, intensiveness of the agency-clientcontact was a strongnegative predictorof both service links

and multiplexity, the only variable to do this. The staffsofmany SMIprogramunits that serve theirclients intensively onany given visit areapparently not highly responsive toprofessionalnorms favoringnetworkinvolvement,believinginstead that the services they provide are generally sufficientto allow clients to maintain a reasonablynormallife (at leastuntil theirnext visit) with little need to develop many links tothe service-implementationnetwork.If contact with otheragencies is deemed necessary, the linkagesdeveloped arerarelymultiplex,implying a low level of commitmentto anyservice links thatmight be established.

Finally, the results indicate that strong (i.e., multiplex)linkages,althoughnot necessarilylarge numbersof linkages,are most likely not only for intensive-service units but also forthose having a strongemphasis on SMIservices in general.Those agencies heavily committedto serving the needs of SMIadults are most likely to be aware of and responsive to institu-tional-levelnorms that focus on the SMIclient group. Theythus recognize the importanceof establishingstrong servicelinks to other agencies providing SMIservices as a way ofresponding to the multiple needs of their clients.Agencies for





which adult SMIservicesare only a minorpart of their totalactivitiesare not likely to be too concernedwith institutional-level norms regardingservices for this particulargroup. Thus,these agencies appearto devote little time or energy to devel-oping and maintainingstrong (i.e., multiplex)links to otheragencies in the SMInetwork,perhapsconcentrating nstead onlinkages that involve theirmajorservice emphasis.

One additionalfinding that warrantssome discussion isthe sharpcontrastin results when networks of service pro-viders are comparedonly with those that include nonprovideragencies. Most studies of interorganizational ctivity focus onbroadlydefined networks.Even when the focus is narrowedconsiderably, as with the study by Hall et al. (1977)on problemyouth or the mentalhealth studies of Gruskyet al. (1985)andMorrissey et al. (1985),entireorganizationsare studied without

regardto the extent of their commitment to the particularservice that is central to the network.The results in Exhibit 5quite stronglydemonstratethat the institutionallybasedservice orientationmeasures that have been the focus of thisstudy are more likely to be salient for explaining service linksto other agencies when only the service providersthemselvesare considered.Service links to nonproviders such as UnitedWay, the police and courts, the Red Cross,and the boardofhealth are not unimportant to SMIservice providers.However,the nonprovidersare not at the core of the SMIservice-delivery system and tend not to be concerned with differences

in the SMIadults they encounter.Most important,the non-providersare unlikely to be responsive to the institutional-level norms thatguide the delivery of mental health servicesfor most providerunits. As a result, the commitment of thesenonproviders to a broad rangeof adult SMI needs and to anetwork-basedservice delivery system is likely to be weak.The importanceof makingsuch a core-peripherydistinctionwhen studying organizationalnetworkshas been recognizedby others (Bojeand Whetten1981;Galaskiewicz1979;Perruciand Pilisuk 1970),particularlyregardingan understandingofnetwork power. The conclusionshere both reinforce the need

to make this distinctionand contribute to a broaderunder-standing of service-relateddifferencesamong core andperipherymembers of a network.

CONCLUSION

Overall,despite the fact thatall four hypotheses were notfully supportedusing both measuresof service network in-volvement, the results were sufficientlystrong to warrantsupportof the study's main thesis:involvementn a service-implementationetwork anbeexplained easonably ell by those





key aspectsof theserviceorientationf organizationshatreflecttheir ikelycommitmento andacceptancef institutional-levelprofessionalorms.

The test of hypotheses focused on a network of agenciesproviding services to SMIadults because the institutional-levelprofessionalnorms favoringagency involvement in a service-implementation network are particularlystrong in the com-munity mental health field. However, given the strengthof thetheoreticalargumentsunderlying the study, it seems reason-able to conclude that the general thesis proposed here wouldbe applicablein explaininginterorganizationalervice linksamong organizationsin other areas of health, social service,and public welfare.Such a conclusion is most likely whenclient outcomes are importantbut vaguely specified and diffi-cult to assess, thus leading to a situationin which resource-

allocation decisions are linked only loosely to measuresofclient effectiveness.

This study advancesan understanding of institutionaltheoryby demonstratingthe importanceof service-relatedcharacteristics or explainingwhether or not institutional-levelprofessionalnorms favoringnetworkinvolvement will beadopted and implemented.Much of the earlier work using aninstitutional-theoryperspectivehas focused on the extent towhich institutional-levelfactors,such as professionalnorms,have contributed not to interorganizationalnvolvement,but to

internalstructuralsimilarities,or structural somorphism,among members of an organizationalfield (cf.Dimaggio andPowell 1982;Oliver 1988).Otherwork has focused on inter-organizational nvolvementnot as an outcome, but as an insti-tutional-level factorin its own right that is the basis ofmimicryand subsequentisomorphism(GalaskiewiczandWasserman1989).By examiningthe tie between an organiza-tion's service orientationand institutional-levelprofessionalnorms and the extent to which this tie can explain inter-organizational nvolvement,this study broadensboth the wayin which institutionaltheoryhas been conceptualizedand the

way in which interorganizationalactivity has traditionallybeenstudied.

Perhapsthe majorcontributionthis study makes to thegrowing body of researchbased on institutionaltheory is itsfocus on organizationalneeds and interests as the basis fordifferencesin levels of adoptionand implementationof insti-tutional-levelprofessionalnorms.By focusing on the differentservice orientationsof organizationalunits as indicators of theextent to which norms might be acceptedand implemented,this study has explicitlyrecognized the importance of con-





sidering differencesin the ways organizationsdo things whileremainingwithin the basic frameworkof institutionaltheory.

As noted by Dimaggio (1988,4), most of the institutional

theory literaturefocuses "onthe taken-for-grantednatureof

organizationalforms and practices"and thus "defocalizes,ordistractsattention from,the ways in which variationin thestrategiesand practicesof goal-directedactorsmay be relatedto variationin organizationalstructures,practices,and forms."A basic assumptionof institutionaltheory has been that thepresenceof strong institutional-levelnorms will affect allactorsin the organizationalfield relativelyequally. Theperspective thus does not address "whyinnovationsvary intheir rateand ultimateextent of diffusion"(1988,12).Dimaggioargues furtherthat institutionaltheorycan and should incorpo-ratedifferentorganizationalneeds and interestswhile still

remainingtrue to the basic belief thatorganizationaloutcomesare not necessarilytied to the conscious strategicchoices ofindividual managers.

Futureresearchneeds to consider more explicitly theconsistencybetween broad institutionalpressuresand specificorganizationalor subunit characteristics uch as goals, taskspecialization,or agendas as ways of understandingvariationin compliancewith or adoption of institutional-levelnorms.The findings of this study, while not conclusive, support sucha broader interpretationof institutional-theory hinking.

This researchalso has several importantmethodologicalcontributionsto make for the study of interorganizationalrelations.Forone thing, researchersof service networksshouldconsiderfocusing only on those organizationsthat actuallyprovide specificprogramsand services to a particularandidentifiableclient group, whether in mentalhealth,geriatricservices, drug rehabilitation, obtraining,or in other areas.Those organizationsthathave some involvement with theclient group but offer no specific services are likely to be farremoved from institutional-levelprofessionalnorms that favor

a highly integratedservice-deliverynetwork and are also likely

to presentmajordata-collectionproblemsif specific programand client data are required.

Perhapsthe majormethodologicalcontributionof the

study relates to its focus on a service-implementationnetwork.We have emphasized that even though services are providedby organizations,data collectionand measurementmust focuson the relevant servicecomponentof each organizationandnot on the organizationas a whole, unless the organizationprovides services in a single areaonly. Thus, the service-





implementationnetworkperspectiveprovides a conceptualand methodologicalalternativeto the basic assumptionfoundin much of the mainstreamorganizationtheoryliteraturethatorganizationsact in unified ways when developing inter-organizationalrelations(cf.Oliver 1990, 242). Suchanassumptionis particularlyproblematicwhen linkagesarestudied thatare typicallydeveloped and maintained byprofessionalsat the service-delivery evel. In general, thefindings and conclusionspresented here are only likely to begeneralizableto othercommunitiesor to other types of servicenetworks when similarmeans of conceptualizingandbounding the network are employed.

Finally, several shortcomingsof the study need to beacknowledged.First, by focusing on specific service com-ponents instead of on organizationsas whole units, the

implicationsof involvement in multiple implementationnetworksby an organizationwere not addressed. It is unclear,for instance,whether interactionsamong the multiple servicecomponentsof an organization,particularlywhen affectedbyinternalpower differences,might have impacton the adoptionof institutionalnorms.This is an issue for further research.

Second, the study can be criticizedfor relying on singlerespondentsfrom each agency.We acknowledge the potentialproblemsfrom this methodbut feel that we have minimizedthem by our carefulattemptto collect data from the single

most knowledgeableperson regardingSMI services in eachagency, by our focus only on a single, narrowlydefinedservice componentin each agency, and by our confirmingofsurvey data through personaland telephone interviews.

Third,the small sample size limited the numberofvariables we could examine. While subsequentresearchonpublic-servicedelivery in other domains would benefit fromthe study of largernetworks and additional variables, thenature of the service-implementationnetworkmethodology islikely to keep sample sizes relativelysmall unless data are

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