Beth Stroul - Academia.edu (original) (raw)
Papers by Beth Stroul
... evaluation best practices. Lourie, Ira S.;Stroul, Beth A.;Friedman, Robert M. Outcomes for ch... more ... evaluation best practices. Lourie, Ira S.;Stroul, Beth A.;Friedman, Robert M. Outcomes for children and youth with emotional and behavioral disorders and their families: Programs and evaluation best practices.(pp. 3-19)Austin ...
The system of care approach was introduced in response to the many systemic problems in serving c... more The system of care approach was introduced in response to the many systemic problems in serving children, youth, and young adults with mental health challenges and their families. Since 1993, the Substance Abuse and Mental Health Services Administration (SAMHSA) has provided resources to states, communities, tribes, and territories to implement systems of care. After extensive evaluation documented the effectiveness of systems of care, SAMHSA determined that the approach was ready for widespread adoption and launched a system of care expansion initiative in 2011. To support expansion efforts, a number of resources and tools have been developed to guide jurisdictions at each stage of the process. All of these are included in this toolkit so that they will be easily accessible together and organized in sequence. A strategic framework for system of care expansion is presented, with an accompanying logic model to depict the process. Detailed guides are included that provide direction fo...
Those who use a telecommunications device for the deaf (TDD) or a teletypewriter (TTY) should cal... more Those who use a telecommunications device for the deaf (TDD) or a teletypewriter (TTY) should call 202-687-5503.
Children's Services, 2002
... Requests for reprints should be sent to Susan Zaro, ORC Macro, 3 Corporate Square, Suite 370,... more ... Requests for reprints should be sent to Susan Zaro, ORC Macro, 3 Corporate Square, Suite 370, At-lanta, GA 30329. ... has taken place primarily in the public sector, for children with the most serious needs (Cole, 1996; Cole & Poe, 1993; Davis, Yelton, & Katz-Leavy, 1993; Lourie ...
Hospital & community psychiatry, 1994
Lack of adequate insurance coverage is one reason that the percentage of children who currently u... more Lack of adequate insurance coverage is one reason that the percentage of children who currently utilize mental health services is significantly lower than the estimated percentage of children with serious mental disorders. Principles of a reformed health care system with particular relevance for children's mental health services include coverage of a broad array of home- and community-based services, provision of organized systems of care for children with serious and persistent mental illness, mechanisms to ensure appropriate utilization of services, and provision of mental health services on the same terms and conditions as other health services. The Clinton Administration's proposed Health Security Act embodied many of these principles. In addition, its call for universal coverage and for elimination of insurance exclusions for preexisting conditions would extend mental health coverage to children who are currently uninsured or underinsured; the plan would also expand the...
The Journal of Mental Health Administration, 1990
This article presents the results of a descriptive study of community-based services for children... more This article presents the results of a descriptive study of community-based services for children and adolescents who are severely emotionally disturbed. The study was funded by the National Institute of Mental Health Child and Adolescent Service System Program (CASSP) and was designed to obtain state-of-the-art information about several promising and innovative treatment approaches emerging in the field--home-based services, crisis services, and therapeutic foster care. The methodology involved literature reviews, a survey to identify programs, detailed questionnaires to learn about identified programs, and site visits to a sample of programs in each category. Two of the service components explored in the study are described in this article. Home-based services include intensive counseling, support, and case management services provided on an outreach basis to troubled children and their families in their own home. Both crisis-oriented and longer-term home-based models are discussed. The crisis services described include a variety of innovative residential crisis services which have been highly successful as alternatives to more restrictive placements in crisis situations. The authors emphasize that these services should not be seen as panaceas but as essential components of a comprehensive, community-based system of care for emotionally disturbed youngsters and their families.
The Journal of Behavioral Health Services & Research, 1997
This article reports on the Health Care Reform Tracking Project, a national study designed to des... more This article reports on the Health Care Reform Tracking Project, a national study designed to describe and analyze state health care reforms and their impact on children and adolescents with emotional disorders and their families. It summarizes the results of the baseline survey of states conducted in 1995, exploring the nature and extent of the reforms in which states are engaged, most of which involve applying managed care technologies to their Medicaid programs. Trends across states are identified with respect to mental health service delivery, particularly with respect to children and adolescents. The article concludes with a discussion of issues and concerns related not only to mental health service delivery for children and adolescents with emotional disorders and their families but also to the systems of care that have been developing over the past decade to serve them. Some of these concerns include the lack of pilots or demonstrations, limited mental health coverage in some reforms, the lack of integration between mental health and substance abuse systems, the lack of special provisions for children, the need for more reliable bases for deriving capitation rates, the limited incorporation of systems of care, the need to incorporate interagency treatment planning and service delivery approaches, the lack of outcome measures specific to and appropriate for children, and the need for greater family involvement in the planning and implementation of these reforms.
The Journal of Behavioral Health Services & Research, 2007
The federal Comprehensive Community Mental Health Services for Children and Their Families Progra... more The federal Comprehensive Community Mental Health Services for Children and Their Families Program was initiated in 1992 to provide grants to states, communities, territories, and Indian tribes to develop systems of care to serve children and adolescents with or at risk for emotional disorders and their families. As part of the national evaluation of this program, a study was undertaken to assess the ability of funded sites to sustain their systems of care beyond the federal grant period. The study involved a web survey and telephone interviews with local and state respondents to examine the extent to which key components of systems of care were maintained during the period in which federal funds were phasing out and during the postgrant period. Study results demonstrate positive and negative changes that occurred in the communities which are included in the sample, with respect to maintaining the availability of each service included in the broad service array, the implementation of system of care principles, the system of care infrastructure, and the achievement of system of care goals. In addition, results identify factors that contribute to or impede the ability to sustain systems of care, and the effectiveness of various strategies for sustainability. Study findings offer guidance not only to federally funded system of care communities but also to nonfunded communities engaged in system of care development to enhance their ability to sustain systems of care for this population over time. Findings will also assist federal, state, and local policymakers, technical assistance providers, family members, advocates, and other key stakeholders to more effectively support the development of viable, sustainable systems of care.
Journal of Behavioral Health Services & Research, 1990
The Future of Children, 1998
For more than a decade, the philosophy of community-based systems of care has guided the delivery... more For more than a decade, the philosophy of community-based systems of care has guided the delivery of mental health services for children and adolescents served by publicly funded agencies. This philosophy supports system attributes that include a broad array of services; interagency collaboration; treatment in the least-restrictive setting; individualized services; family involvement; and services responsive to the needs of diverse ethnic and racial populations. The notion of systems of care emerged in an era when managed health care also was gaining popularity. However, the effect of managed care on the delivery of mental health and substance-abuse services-also known as behavioral health services-has not been widely studied.
Evaluation and Program Planning, 2010
Administration and Policy in Mental Health and Mental Health Services Research, 2010
Solutions, a work group discussed the status of linkages between the research and system change c... more Solutions, a work group discussed the status of linkages between the research and system change communities in the children's mental health field. The "system change" community was defined as policy and service system leaders, service providers, service system and applied researchers, families, youth, and advocates. The group's deliberations were based on the premise that the relationship between research and system change has been tenuous at best, and that significant improvements in this relationship are essential to ensure that research will better inform policy and practice in the future. The work group was comprised of researchers, policy makers, system change leaders, and family advocates who all agreed on the vital importance of this endeavor.
American Psychologist, 1990
... evaluation best practices. Lourie, Ira S.;Stroul, Beth A.;Friedman, Robert M. Outcomes for ch... more ... evaluation best practices. Lourie, Ira S.;Stroul, Beth A.;Friedman, Robert M. Outcomes for children and youth with emotional and behavioral disorders and their families: Programs and evaluation best practices.(pp. 3-19)Austin ...
The system of care approach was introduced in response to the many systemic problems in serving c... more The system of care approach was introduced in response to the many systemic problems in serving children, youth, and young adults with mental health challenges and their families. Since 1993, the Substance Abuse and Mental Health Services Administration (SAMHSA) has provided resources to states, communities, tribes, and territories to implement systems of care. After extensive evaluation documented the effectiveness of systems of care, SAMHSA determined that the approach was ready for widespread adoption and launched a system of care expansion initiative in 2011. To support expansion efforts, a number of resources and tools have been developed to guide jurisdictions at each stage of the process. All of these are included in this toolkit so that they will be easily accessible together and organized in sequence. A strategic framework for system of care expansion is presented, with an accompanying logic model to depict the process. Detailed guides are included that provide direction fo...
Those who use a telecommunications device for the deaf (TDD) or a teletypewriter (TTY) should cal... more Those who use a telecommunications device for the deaf (TDD) or a teletypewriter (TTY) should call 202-687-5503.
Children's Services, 2002
... Requests for reprints should be sent to Susan Zaro, ORC Macro, 3 Corporate Square, Suite 370,... more ... Requests for reprints should be sent to Susan Zaro, ORC Macro, 3 Corporate Square, Suite 370, At-lanta, GA 30329. ... has taken place primarily in the public sector, for children with the most serious needs (Cole, 1996; Cole & Poe, 1993; Davis, Yelton, & Katz-Leavy, 1993; Lourie ...
Hospital & community psychiatry, 1994
Lack of adequate insurance coverage is one reason that the percentage of children who currently u... more Lack of adequate insurance coverage is one reason that the percentage of children who currently utilize mental health services is significantly lower than the estimated percentage of children with serious mental disorders. Principles of a reformed health care system with particular relevance for children's mental health services include coverage of a broad array of home- and community-based services, provision of organized systems of care for children with serious and persistent mental illness, mechanisms to ensure appropriate utilization of services, and provision of mental health services on the same terms and conditions as other health services. The Clinton Administration's proposed Health Security Act embodied many of these principles. In addition, its call for universal coverage and for elimination of insurance exclusions for preexisting conditions would extend mental health coverage to children who are currently uninsured or underinsured; the plan would also expand the...
The Journal of Mental Health Administration, 1990
This article presents the results of a descriptive study of community-based services for children... more This article presents the results of a descriptive study of community-based services for children and adolescents who are severely emotionally disturbed. The study was funded by the National Institute of Mental Health Child and Adolescent Service System Program (CASSP) and was designed to obtain state-of-the-art information about several promising and innovative treatment approaches emerging in the field--home-based services, crisis services, and therapeutic foster care. The methodology involved literature reviews, a survey to identify programs, detailed questionnaires to learn about identified programs, and site visits to a sample of programs in each category. Two of the service components explored in the study are described in this article. Home-based services include intensive counseling, support, and case management services provided on an outreach basis to troubled children and their families in their own home. Both crisis-oriented and longer-term home-based models are discussed. The crisis services described include a variety of innovative residential crisis services which have been highly successful as alternatives to more restrictive placements in crisis situations. The authors emphasize that these services should not be seen as panaceas but as essential components of a comprehensive, community-based system of care for emotionally disturbed youngsters and their families.
The Journal of Behavioral Health Services & Research, 1997
This article reports on the Health Care Reform Tracking Project, a national study designed to des... more This article reports on the Health Care Reform Tracking Project, a national study designed to describe and analyze state health care reforms and their impact on children and adolescents with emotional disorders and their families. It summarizes the results of the baseline survey of states conducted in 1995, exploring the nature and extent of the reforms in which states are engaged, most of which involve applying managed care technologies to their Medicaid programs. Trends across states are identified with respect to mental health service delivery, particularly with respect to children and adolescents. The article concludes with a discussion of issues and concerns related not only to mental health service delivery for children and adolescents with emotional disorders and their families but also to the systems of care that have been developing over the past decade to serve them. Some of these concerns include the lack of pilots or demonstrations, limited mental health coverage in some reforms, the lack of integration between mental health and substance abuse systems, the lack of special provisions for children, the need for more reliable bases for deriving capitation rates, the limited incorporation of systems of care, the need to incorporate interagency treatment planning and service delivery approaches, the lack of outcome measures specific to and appropriate for children, and the need for greater family involvement in the planning and implementation of these reforms.
The Journal of Behavioral Health Services & Research, 2007
The federal Comprehensive Community Mental Health Services for Children and Their Families Progra... more The federal Comprehensive Community Mental Health Services for Children and Their Families Program was initiated in 1992 to provide grants to states, communities, territories, and Indian tribes to develop systems of care to serve children and adolescents with or at risk for emotional disorders and their families. As part of the national evaluation of this program, a study was undertaken to assess the ability of funded sites to sustain their systems of care beyond the federal grant period. The study involved a web survey and telephone interviews with local and state respondents to examine the extent to which key components of systems of care were maintained during the period in which federal funds were phasing out and during the postgrant period. Study results demonstrate positive and negative changes that occurred in the communities which are included in the sample, with respect to maintaining the availability of each service included in the broad service array, the implementation of system of care principles, the system of care infrastructure, and the achievement of system of care goals. In addition, results identify factors that contribute to or impede the ability to sustain systems of care, and the effectiveness of various strategies for sustainability. Study findings offer guidance not only to federally funded system of care communities but also to nonfunded communities engaged in system of care development to enhance their ability to sustain systems of care for this population over time. Findings will also assist federal, state, and local policymakers, technical assistance providers, family members, advocates, and other key stakeholders to more effectively support the development of viable, sustainable systems of care.
Journal of Behavioral Health Services & Research, 1990
The Future of Children, 1998
For more than a decade, the philosophy of community-based systems of care has guided the delivery... more For more than a decade, the philosophy of community-based systems of care has guided the delivery of mental health services for children and adolescents served by publicly funded agencies. This philosophy supports system attributes that include a broad array of services; interagency collaboration; treatment in the least-restrictive setting; individualized services; family involvement; and services responsive to the needs of diverse ethnic and racial populations. The notion of systems of care emerged in an era when managed health care also was gaining popularity. However, the effect of managed care on the delivery of mental health and substance-abuse services-also known as behavioral health services-has not been widely studied.
Evaluation and Program Planning, 2010
Administration and Policy in Mental Health and Mental Health Services Research, 2010
Solutions, a work group discussed the status of linkages between the research and system change c... more Solutions, a work group discussed the status of linkages between the research and system change communities in the children's mental health field. The "system change" community was defined as policy and service system leaders, service providers, service system and applied researchers, families, youth, and advocates. The group's deliberations were based on the premise that the relationship between research and system change has been tenuous at best, and that significant improvements in this relationship are essential to ensure that research will better inform policy and practice in the future. The work group was comprised of researchers, policy makers, system change leaders, and family advocates who all agreed on the vital importance of this endeavor.
American Psychologist, 1990