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Family involvement in the planning and execution of mental health treatment has been shown to positively influence child outcomes; however, there is wide variability in the levels of involvement by families. The current study investigated the influence of child, family caregiver, service system, and community factors on the level of family involvement in the mental health treatment of children with severe emotional disturbances (SED). Although prior work in this area has primarily focused on family and child characteristics, the current study adds to the knowledge base by also exploring factors associated with the quality of service delivery that may influence levels of family involvement. The current study is a secondary analysis of existing data from the Impact Study of Medicaid in Mississippi and Tennessee that used in-depth interviews with parents and case review ratings. A total of 136 children and adolescents who received Medicaid coverage for mental health treatment in Mississippi and Tennessee were the focus of this study that assessed child and caregiver characteristics at the beginning of the study and rated service system factors 6 months after the study began. Results of the multiple regression analysis revealed the quality of the service delivery system had the most influence on the level of family involvement. Results suggest that levels of family involvement may have less to do with caregiver health, or other family characteristics, and more to do with the quality of the service delivery system. [ABSTRACT FROM AUTHOR]

The combined effect of race and place of residence on caregivers’ perceptions of children’s mental health services is underresearched. Differences in caregiver strain, barriers-to-care endorsement, and provider satisfaction are examined among 175 rural and urban African American caregivers from one Southern state whose children received Medicaid sponsored mental health services. Children exhibited clinical levels of externalizing and internalizing mental health symptoms and high levels of co-occurring physical health problems. Almost one quarter were cared for by someone other than biological parents. Almost all caregivers reported strain associated with children’s mental health problems, compromised personal health status, and high levels of depression. Family perception barriers (such as concern about potential negative reactions of significant others) were most endorsed. Most caregivers were satisfied with their children’s mental health services, with lowest levels on the provider sensitivity subscale. Initial rural—urban differences in caregiver strain did not remain significant in multiple regression analyses after other covariates were included. [ABSTRACT FROM AUTHOR]

Persons who care for children and adolescents who are experiencing mental illness often incur a considerable burden as a result of their care work. Furthermore, caregivers living in rural areas often have increased difficulties as a result of longer travel times, lack of specialty services, and fewer community resources. While there is ample evidence documenting caregiver burden, it continues to go largely unaddressed by mental health care systems and economic and legal structures that might instead be altered to better support primary caregivers. In this article, we report the experiences of 42 rural primary caregivers for children and adolescents with mental health issues and apply a justice framework, informed by feminist care theory, to suggest possible alternatives for building mechanisms for caregiver support. [ABSTRACT FROM AUTHOR]

The correlation between the Recovery Assessment Scale (RAS) and the Rosenberg Self-Esteem Scale (RES) was examined among adult participants in consumer-directed services. Hierarchical regression analysis was conducted with RES subscales as dependent variables predicted by RAS variables. Controls were race, age, gender, diagnosis and involvement in peer-directed activities. Regression models for global and positive self-esteem demonstrated moderate fit (explaining 48 to 51% variance, p<.001). As expected negative self-esteem models demonstrated poor fit. 'Personal confidence and hope' RAS subscale scores were significantly associated with positive self-esteem. Non-dominance by symptoms was associated with positive and global self-esteem in unadjusted analysis, but attenuated in regression analyses. The RAS demonstrated concurrent validity with the RES in this sample. RAS domains reflective of self-concept correlated with global and positive self-esteem. Reliance on others, non-dominance by symptoms and goal and success orientation might not to be related to self-esteem among participants in consumer-directed mental health services. [ABSTRACT FROM AUTHOR]

The aim of this study was to examine differences in responses to the Caregiver Strain Questionnaire (CGSQ) between African American and White caregivers of children with emotional and behavioral challenges. Significant item- and scale-level differences were detected across groups with African Americans consistently reporting less strain. We examined whether these differences were more likely due to nonequivalent measurement than to real differences in the experience of caregiver strain. Confirmatory factor analysis showed that the model fit the data well for both racial groups, but there were some differences in structural components. Internal consistency was equivalent across the groups. In an examination of criterion validity, regression analyses showed that African American caregivers experienced a slower rate of increase in objective caregiver strain at a given increase in child internalizing problems. No other race differences were found in the regression analyses. In general, we conclude that the CGSQ can be useful for detecting caregiver strain and identifying family support needs for both White and African American caregivers. Differences across groups in reports of caregiver strain, however, call for more research on racial differences in the impact on the family of caring for a child with emotional and behavioral disorders. [ABSTRACT FROM AUTHOR]

This article aims to inform evaluators about issues involved in using and integrating administrative databases from public agencies. With the growing focus on monitoring and oversight of public programs for health, mental health and substance abuse problems, existing data sets in public agencies became an important source of evaluation and planning information. The focus of this article is on the methods used to find, integrate and analyze multiple existing databases. Primary challenges that confront the evaluator in identifying and accessing data sources and in addressing the technical issues involved are discussed. [ABSTRACT FROM AUTHOR]

Presents a study which evaluates the implementation of the Fort Bragg Demonstration. Background information on origins of program evaluations; Use of case study approach; Parties participating in Demonstration; What is meant by program fidelity; How the implementation of Demonstration has deviated from initial plan.

A model is presented for assessing social service needs on the local community level. The model expands existing definitions of community needs assessment to include six phases: (a) defining the parameters and constituents, (b) identifying the information needs and common values among these constituencies, (c) integrating and translating research knowledge from the social sciences, (d) developing procedures for gathering specific information for decision making, (e) gathering and organizing community-level information (e.g., secondary data), and (f) presenting information to the constituent groups. This model is designed to improve the quality of social service decisions by promoting the effective use of social science research knowledge in community decision making and promoting consensus and cooperation among local stakeholder groups through a direct focus on values. A case study is presented that illustrates the implementation of the model in an assessment of the need for day care services for young children. [ABSTRACT FROM AUTHOR]

Psychologists are becoming more and more sensitized to the influence of mental health policy on the delivery of psychological services and simultaneously, to the role they can or ought to play in the mental health policy-making process. Traditional and potential roles lot- psychologists in this process arc identified and classified by means of a community psychology framework. The Centrality of values in these roles is identified, and conceptual tools are presented for understanding the relationship between psychologists and policy makers. Implications for research, training, and practice are drawn. [ABSTRACT FROM AUTHOR]

This study uses existing data from Hawaii's public mental health system for children and youth as an example of a state-level examination of service use patterns and health care disparities. The purpose of this study was to compare differences in mental health service utilization between rural and non-rural children, especially use of residential services. This study used a performance measure approach to conduct multi-level modeling on existing administrative data to examine the impact of community factors on service utilization. Rural children were found to have the most serious levels of mental health problems at intake, more likely to be placed in out-of-home care, more likely to receive only out-of-home care, more likely to in stay out-of-home longer, and less likely to receive follow-up care than their non-rural counterparts. Practice, policy, and research implications are discussed.