This study explored whether youth involved in joint service systems differed from single-agency users in terms of types of crimes committed and clinical functioning. Data from 4,924 youth involved in one county's public mental health and juvenile justice service systems were examined. Twenty percent of those youth receiving mental health services had recent arrest records, and 30% of youth arrested received mental health services. Of all youth arrested in the county, mental health service users had more arrests than non-mental health service users. A subsample of 94 mental health service users with arrests was matched on demographics with 94 mental health service users without arrests. Youth with arrests had a higher frequency of conduct disorder, higher Child Behavior Checklist Externalizing and Total Problem Scale scores, and more functional impairment on the Child and Adolescent Functional Assessment Scale as compared to youth without arrests. Implications for behavioral health service delivery were discussed.
Limited information exists regarding how some popular measures for assessing the effectiveness of services to children with severe emotional disturbance interrelate when used as part of ongoing outcome accountability systems. This article examines the interrelationships--at intake and over time--between the Child Behavior Checklist (CBCL), the Youth Self Report (YSR), the Child and Adolescent Functional Assessment Scale (CAFAS), and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) clinical diagnoses across six California care systems. At intake, there were mild to moderate relationships between the clinical diagnosis, the CAFAS, the CBCL, and the YSR. These relationships were not as strong as those found in other studies conducted in more controlled research environments. There was limited agreement among the CAFAS, the CBCL, and the YSR regarding the outcomes of the youths served. These findings raise questions regarding translating measures from research settings to clinical environments and reconciling differences between outcome measures.
The characteristics of 128 youth with emotional and behavioral disorders referred to a system of care were investigated according to agency referral, behavioral and emotional issues, and risk factors. The referral process in this system of care was unique, with each agency referring youth deemed to need multiagency services. The primary analysis used a two-step clustering procedure to examine characteristic profiles, and results produced evidence of four types of referral profiles: Troubled, Troubling. Troubled and Troubling, and At Risk. It was found that youth with various impairments and corresponding needs were referred by different agencies (e.g., troubling youth were most likely to be referred by juvenile probation), but all agencies referred youth across the four clusters. The results of this study are examined with respect to the long-standing policy debate regarding which youth with emotional and behavioral disorders should be given priority to receive services. Implications about evaluating outcomes in systems of care are also discussed.
This article describes the educational and functional status of youth served in joint education and mental health programs nested within two counties implementing the California System of Care Model for youth with severe emotional disturbance. The goals of the study were to (a) describe the demographic, educational, and clinical characteristics of youth served in education/mental health programs; (b) understand the relationship between functional status and academic achievement of these youth; and (c) compare these youth with matched peers involved in the broader system of care. Children and adolescents in the education/mental health programs were primarily AngloAmerican boys with low academic achievement and high levels of functional impairment. Functional status and academic achievement were not related. Youth served in the specialized programs were more functionally impaired than youth served in the broader care system. This study provides evidence that youth served in education/mental health programs have the types of multisystem needs that may warrant multiagency collaboration and services.
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