A System of Care for Children's Mental Health: Expanding the Research Base. Proceedings of the Annual Research Conference (8th, Tampa, Florida, March 6-8, 1995) (original) (raw)

The Impact of Managed Care on Mental Health Services for Children and Their Families

The Future of Children, 1998

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.

Evaluating systems of care: Missing links in children's mental health research

Journal of Community Psychology, 2004

Systems of care (SOCs) have been developed throughout the country to meet the needs of children with severe emotional disturbances (SED) and their families. In these SOCs, multiple agencies and disciplines are expected to work together with informal community supports to address families' needs . A review of the literature on the impact of SOCs suggests: (a) communities' service delivery systems change; and (b) children experience modest improvements in symptomatology and functioning. At the same time, little is known about (a) which components of the SOC approach, at what levels, are necessary to impact child and family outcomes; (b) the degree to which SOCs affect other family members, beyond the target child; and (c) the impact of community contexts and supports in SOCs. Future research should improve measurement of key SOC constructs, examine the relation between specific levels of implementation and outcomes for the entire family, and investigate the impact of broader community systems and supports on families within SOCs.

The Impact of Managed Care on Systems of Care That Serve Children With Serious Emotional Disturbances and Their Families

Children's services, 2002

A qualitative case study approach was used to evaluate the impact of managed care reforms on a select sample of systems of care funded by the Comprehensive Community Mental Health Services for Children and Their Families Program. Analyses indicated that the system-of-care philosophy and approach could be maintained in a managed care environment under the right circumstances. These circumstances include (a) the preexistence of a system-of-care philosophy prior to the integration of managed care, (b) stakeholder involvement in managed care planning and implementation, (c) use of a broad array of providers and sufficient support for case manage

Distribution and costs of mental health service within a system of care for children and adolescents

Administration and Policy in Mental Health, 1993

As the concept of the system of care is implemented in states and localities across the country, it is important to define the kinds, the volume, and the cost of services necessary to address the needs of children and adolescents with mental health problems. This article focuses on the services that are usually the responsibility of the mental health system and provides a model for planning based on experiences in one state.

Public-Sector Managed Care for Children's Mental Health Services: Stakeholders' Perspectives. Symposium

1996

This paper presents contributions at a symposium about Carolina Alternatives (CA), a North Carolina program that blends capitated financing with public sector managed care for mental health and substance abuse services for children and youth eligible for Medicaid. The symposium focused on stakeholders' perspectives and on expenditure patterns of inpatient and outpatient services. First, Dan Tweed presented "Stakeholders' Perspectives: Overview of Carolina Alternatives." Next, Dalene Stangl presented "Stakeholders' Perspectives: Area Programs, Hospitals, and Departments of Social Services." The perspectives of three groups (the 10 area programs responsible for care management, the hospitals that provide mental health and substance abuse services, and the county directors of departments of social services) regarding how CA restructured service delivery, implemented care management, and redefined interagency relations are defined. Elizabeth Farmer and Julia Gagliardi presented "Stakeholder's Perspectives: Client Satisfaction and Outcomes." Preliminary results indicated overall client satisfaction and acceptability of the outcome measures to clients and staff. The final contribution, by David Langmeyer, "Stakeholders' Perspectives: Preliminary Cost Findings," compared service costs between area programs that participated in CA and those that did not. It found CA was successful in reducing costs associated with inpatient services but this decrease was offset by a dramatic increase in non-inpatient services for participating area programs. (DB)

Accountability Factors Associated with the Delivery of Mental Health Services to Children

Tradition-a Journal of Orthodox Jewish Thought, 1998

This study describes a sample of children served in a community mental health center and identifies factors associated with the delivery of services to them. The data are from a 1993 sample. Results of the analysis indicate the number of sessions, total services and referrals are associated with the presence of treatment plans for children.

Trends in Characteristics of Children Served by the Children’s Mental Health Initiative: 1994–2007

Administration and Policy in Mental Health and Mental Health Services Research, 2009

Data from 14 years of the national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program were used to understand the trends of the emotional and behavioral problems and demographic characteristics of children entering services. The data for this study were derived from information collected at intake into service in 90 sites who received their initial federal funding between 1993 and 2004. The findings from this study suggest children entering services later in a site's funding cycle had lower levels of behavioral problems and children served in sites funded later in the 14 year period had higher levels of behavioral problems. Females have consistently entered services with more severe problems and children referred from non-mental health sources, younger children, and those from non-white racial/ethnic backgrounds have entered system of care services with less severe problems. The policy and programming implications, as well as implications for local system of care program development and implementation are discussed. Keywords children's mental health; CMHI; serious emotional disturbance; service trajectories; systems of care The prevention and treatment of children's mental health problems remains a national priority. In the United States an estimated 5% of children experience severe emotional or behavioral difficulties in any 6-month time period (CMHS, 2006), yet many do not receive treatment