The outcomes of a reform of the Denver mental health system, cosponsored by the state and the RWJF, are contrasted with changes in a comparison area of the state. The study examines the structural characteristics of the mental health system, staff attitudes and satisfaction, and client-reported services and outcome. Results indicate that, in Denver, structural changes, the introduction of new services, and an intervening financial crisis increased worker dissatisfaction. Client reports documented parallel changes in the following variables: continuity of care, unmet need for case management services, frequency of symptoms, and satisfaction with services. The reform had no impact, however, on most quality-of-life indicators. The possibly adverse consequences of centralizing the system and the indirect influences of system integration on quality of life are discussed.

No abstract

Residential Treatment Centres (RTCs) provide 24‐hour care and mental health services to young people, many of whom are referred from county departments that oversee services to young people involved with child welfare services, mental health services and corrections. While RTCs are required to provide mental health services to young people, the regulations governing these programmes have few specific requirements about the process, content or duration of treatment. Therefore, many questions have arisen about what a typical RTC day looks like and whether it differs among providers or differs based on the severity or type of the young person's mental‐health related behaviours and symptoms. This study conducted interviews with RTC providers in the State of Colorado on this topic. Most RTC services were relatively uniform across case types within each RTC. It appears that with a few exceptions, a similar set of services is provided to all young people, regardless of their problems.

No abstract