national evaluation of the comprehensive community mental ... · national evaluation of the...

National Evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program

Data Profile Report

Sarasota County Early Childhood Mental Health PartnershipSarasota County, Florida

Prepared by the National Evaluation Team, December 2009

Sarasota County, FLData Profile Report December 2009

Data are from the CMHS National Evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program. This report is based on data downloaded December 11, 2009.

2

This report is based on data provided by caregivers and youth on the instruments listed below:

Caregiver

• Enrollment and Demographic Information Form (EDIF)

• Caregiver Information Questionnaire (CIQ)

• Living Situations Questionnaire (LSQ)

• Child Behavior Checklist 1½ to 5 (CBCL 1½–5)

• Child Behavior Checklist 6 to 18 (CBCL 6–18)

• Columbia Impairment Scale (CIS)

• Education Questionnaire–Revised (EQ–R)

• Behavioral and Emotional Rating Scale (BERS–2)

• Family Life Questionnaire (FLQ)

• Caregiver Strain Questionnaire (CGSQ)

• Multi-Sector Service Contacts (MSSC–R)

• Cultural Competence and Service Provision Questionnaire (CCSP)

• Youth Services Survey for Families (YSS–F)

• Vineland Screener (VS1, VS2 or VS3)



3

Number Table

BERS–2C BERS–2Y CBCL–O CBCL–Y CCSP CGSQ CIQ CIS DS–R EDIF[a] EQ–R FLQ GAIN LSQ MSSC–R RADS–2 RCMAS SUS–R VS1 VS2 VS3 YIQ YSS–F YSS–Y

intake 108 0 70 114 188 186 164 0 387 187 187 0 188 0 0 0 24 93 0 0

6 Month 84 0 57 63 121 121 121 111 0 121 121 119 0 121 121 0 0 0 9 55 13 0 121 0

12 Month 59 0 46 28 74 74 74 71 0 74 74 74 0 74 73 0 0 0 3 25 18 0 74 0

18 Month 37 0 31 13 44 44 44 43 0 42 44 43 0 44 44 0 0 0 1 12 16 0 44 0

24 Month 27 0 22 7 29 29 28 29 0 29 29 27 0 29 29 0 0 0 0 7 14 0 28 0

30 Month 11 0 9 3 12 12 12 12 0 11 12 12 0 12 12 0 0 0 0 3 3 0 11 0

36 Month 1 0 1 0 1 0 1 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 1 0

BERS–2C BERS–2Y CBCL–O CBCL–Y CCSP CGSQ CIQ CIS DS–R EDIF[a] EQ–R FLQ GAIN LSQ MSSC–R RADS–2 RCMAS SUS–R VS1 VS2 VS3 YIQ YSS–F YSS–Y

int + 6 Month 72 0 45 61 121 121 107 0 121 121 119 0 121 0 0 0 9 51 0 0

int + 12 Month 46 0 28 26 74 74 67 0 74 74 74 0 74 0 0 0 3 21 0 0

int + 18 Month 25 0 14 12 44 44 39 0 42 44 43 0 44 0 0 0 1 8 0 0

int + 24 Month 18 0 8 7 29 28 27 0 29 29 27 0 29 0 0 0 0 5 0 0

int + 30 Month 9 0 6 3 12 12 10 0 11 12 12 0 12 0 0 0 0 1 0 0

int + 36 Month 1 0 1 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 0

int+6m+12m 44 0 27 26 73 73 73 66 0 73 73 73 0 73 72 0 0 0 3 21 0 0 73 0

int+6m+12m+18m 23 0 13 12 42 42 42 37 0 40 42 41 0 42 42 0 0 0 1 8 0 0 42 0

int+6m+12m+18m+24m 16 0 8 6 26 26 26 24 0 26 26 25 0 26 26 0 0 0 0 4 0 0 26 0

int+6m+12m+18m+24m+30m 9 0 6 3 12 12 12 10 0 11 12 12 0 12 12 0 0 0 0 1 0 0 11 0

int+6m+12m+18m+24m+30m+36m 1 0 1 0 1 0 1 1 0 1 1 1 0 1 1 0 0 0 0 0 0 0 1 0

[a] The CIUF is considered to be the follow-up instrument to the EDIF, so they are presented together.



4

Data Explanations

● The number of cases reported in each slide varies, depending on the data available.

● Summary statistics based on fewer than 10 cases are not reported. When all summary statistics on a slide are based on fewer than 10 cases, the entire slide is not included.

● When data for follow-up timeframes are reported, the number of cases reported include only cases with complete follow-up data for all timeframes.

● When the number of cases reporting data for a timeframe is less than 30, that timeframe is not included.



5

Section I: Child and Family Status at Intake

This section provides a detailed description of the children and families being served by CMHS-funded systems of care. Information in this section was gathered at intake using the following instruments:

Enrollment and Demographic Information Form (EDIF): The EDIF gathers demographic, diagnostic, and system of care enrollment information on all children receiving CMHS-funded system of care services. Information for the EDIF is gathered from record review and caregiver report.

Caregiver Information Questionnaire–Intake (CIQ–I): The CIQ–I is administered to caregivers and gathers additional demographic information, as well as information on risk factors, family composition, custody status, service use history, and presenting problem(s) for children enrolled in the Longitudinal Child and Family Outcome Study.



6

Demographic Characteristics of Children Served[a]

Demographics

Gender (n = 387)

Male 70.8%

Female 29.2%

Average Age at Intake (n = 384)

Average Age 4.5 years

Age Group (n = 384)

Birth to 3 years 31.3%

4 to 6 years 49.0%

7 to 11 years 19.8%

12 to 14 years 0.0%

15 to 18 years 0.0%

19 to 21 years 0.0%

Race/Ethnicity (n = 383)

American Indian or Alaska Native 0.0%

Asian 0.3%

Black or African American 24.8%

Native Hawaiian or Other Pacific Islander 0.0%

White 53.3%

Hispanic/Latino 15.1%

Multi-Racial 6.0%

Other 0.5%

[a] Data reported were collected using the Enrollment and Demographic Information Form (EDIF).



7

Intake Referral Information and Agency Involvement[a]

Referral Agency[b]

0.0%

0.0%

0.0%

8.3%

24.6%

9.6%

13.7%

1.6%

0.0%

21.2%

0.0%

0.0%

1.3%

1.0%

0.0%

1.0%

0.5%

17.1%

0% 20% 40% 60% 80% 100%

Corrections

Juvenile Court

Probation

School

Mental Health

Physical Health

Child Welfare

Substance Abuse Clinic

Family Court

Caregiver

Self

Early Head Start

Head Start

Early Intervention (Part C)

Preschl Spec Ed (Part B)

Other Care Programs

Early Care: Other

Other

n = 386

Agency Involvement[b,c]

0.0%

0.0%

0.0%

43.4%

33.3%

70.0%

26.9%

0.0%

0.0%

1.3%

5.2%

0.3%

0.3%

30.7%

1.0%

12.1%

0% 20% 40% 60% 80% 100%

Corrections

Juvenile Court

Probation

School

Mental Health

Physical Health

Child Welfare

Substance Abuse Clinic

Family Court

Early Head Start

Head Start

Early Intervention (Part C)

Preschl Spec Ed (Part B)

Other Care Programs

Early Care: Other

Other

n = 387

[a] Data reported were collected using the Enrollment and Demographic Information Form (EDIF).[b] Mental health = Mental health agency, clinic or provider; Physical health = Physical health care agency, clinic, or provider;

Child welfare = Child welfare agency or child protective services.

[c] Because individuals may report involvement in more than one agency, percentages may sum to more than 100%.



8

DSM–IV Axis I and Axis II Diagnoses[a]

Diagnosis[b] (n = 163) %

Attention-Deficit/Hyperactivity Disorders 41.1%

Disruptive Behavior Disorder 24.5%

Adjustment Disorders 17.8%

Other 15.3%

PTSD and Acute Stress Disorder 8.6%

Anxiety Disorders 8.6%

Oppositional Defiant Disorder 6.7%

Mood Disorders 6.7%

Pervasive Developmental Disorders 4.3%

V code[c] 2.5%

Mental Retardation 1.2%

Learning, Motor Skills, and Communication Disorders 1.2%

Conduct Disorders 1.2%

Impulse Control Disorders 1.2%

Substance Use Disorders[d] 0.0%

Schizophrenia and Other Psychotic Disorders 0.0%

Personality Disorders 0.0%

Substance Induced Disorders 0.0%


[b] Because youth may have more than one diagnosis, percentages for diagnoses may sum to more than 100%.[c] V Code refers to Relational Problems, Problems Related to Abuse or Neglect, and additional conditions. Percentage excludes V71.09 (No Axis I or II diagnosis).[d] Substance Use Disorders include caffeine intoxication.



9

DC:0-3R Axis I Diagnoses[a]

DC: 0-3R Axis I[b] (n = 59) %

Adjustment Disorder 16.9%

Sensory Stimulation-Seeking/Impulsive 16.9%

Hypersensitive[c] 16.9%

Anxiety Disorders[d] 16.9%

Regulation Disorders of Sensory Processing 10.2%

Mixed Disorders of Emotional Expressiveness 6.8%

Sleep Disorders[e] 6.8%

Other Disorders 5.1%

PTSD 1.7%

Disorders of Relating and Communicating 1.7%

Deprivation/Maltreatment Disorder 0.0%

Specific Phobia 0.0%

Depression[f] 0.0%

Feeding Disorders[g] 0.0%

Disorders of Affect 0.0%

Prolonged Bereavement/Grief Reaction 0.0%

Hyposensitive/Underresponsive 0.0%

Multi-System Developmental Disorder 0.0%

[a] Data reported were collected using the Enrollment and Demographic Information Form (EDIF).[b] Because children may have more than one diagnosis, percentages may sum to more than 100%.[c] Includes hypersensitive-type A: fearful/cautious and type B: negative/defiant.[d] Includes anxiety disorders of infancy and early childhood, separation anxiety disorder, social anxiety (social phobia), generalized anxiety disorder, and anxiety disorders not otherwise specified.[e] Includes sleep behavior disorder, sleep-onset disorder (sleep-onset protodyssomnia), and night-waking disorder (night-waking protodyssomnia).[f] Includes depression of infancy and early childhood, type I major depression, and type II major depression.[g] Includes feeding behavior disorder, feeding disorder of state regulation, feeding disorder of caregiver-infant reciprocity, infantile anorexia, sensory food aversions, feeding disorder associated with concurrent medical condition, and feeding disorder associated with insults to the gastrointestinal tract.



10

DC:0-3R Axis II Diagnoses[a]

86.0%

62.8%

75.0%

88.9%

100.0%95.3%

100.0%

9.3%

27.9%

22.7%

8.9%

0.0%4.7%

0.0%4.7%

9.3%2.3% 2.2% 0.0% 0.0% 0.0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Overinvolved

(n = 43)

Underinvolved

(n = 43)

Anxious/Tense

(n = 44)

Angry/Hostile

(n = 45)

Verbally Abusive

(n = 43)

Physically Abusive

(n = 43)

Sexually Abusive

(n = 43)

Relationship Problems Checklist

No Evidence Some Evidence, Needs Further Investigation Substantive Evidence




11

Participation in Development of Service Plan[a]

100.0%

32.9%

48.1%

98.7%

39.9%

21.5%

36.1%

5.7%

0.6%

8.9%

55.7%

51.3%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Child's Caregiver/Guardian

Child

Other Family Member

Case Mgr/Service Coordinator

Therapist

Other Mental Health Staff

Education Staff

Child Welfare Staff

Juvenile Justice

Health Staff

Family Advocate

Other

Part

icip

an

t[b

,c]

n = 158


[b] Because more than one participant may be involved in the development of the service plan, participants may sum to more than 100%.[c] Other includes School Resource Officer, Teacher, Psychiatrist, Youth Advocate, Foster Home Staff, AmeriCorp Worker, School Principal, and Big Brother.



12

Presenting Problems[a] Reported

3.9%

2.4%

8.8%

23.0%

42.3%

0.0%

9.4%

0.3%

2.4%

9.4%

5.1%

47.4%

0.0%

30.2%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Suicidal Ideation/Self-Injury

Depression

Anxiety

Hyperactivity and Attention

Conduct/Delinquency

Substance Use

Adjustment

Psychotic Behaviors

Pervasive Developmental Disability

Specific Developmental Disability

Learning Disability

School Performance

Eating Disorder

Other

Pre

sen

tin

g P

rob

lem

s[b

]

Record Review

n (records reviewed) = 331

[a] Data reported were collected using the Enrollment and Demographic Information Form (EDIF) and the Youth Information Questionnaire (YIQ).

[b] Because youth may present with more than one problem, percentages may sum to more than 100%.



13

Presenting Problems Reported for Young Children[a]

1.7%

42.0%

10.0%

23.3%

9.7%

2.0%

7.0%

12.7%

3.0%

7.7%

6.7%

7.7%

11.0%

3.3%

1.0%

13.3%

8.0%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Feeding Problems in Young Children

Disruptive Behaviors in Young Children

Persistent Non-Compliance

Excessive Crying/Tantrums

Separation Problems

Non-Engagement with People

Sleeping Problems

Excluded from Preschl/Childcare Prgm Due to Behavior

At Risk For/Has Failed Family Home Placement

Maltreatment

Other Problems of Child's Health

Parental/Caregiver Mental Health

Parental/Caregiver Substance Abuse/Use

Family Health Problems

Other Parent/Caregiver/Family Problems

Housing Problems

Other Early Child Problems

Pre

sen

tin

g P

rob

lem

s[b

]

n = 300


[b] Because children may present with more than one problem, percentages may sum to more than 100%.



14

DSM-IV Axis IV: Psychosocial and Environmental Problems[a] at Intake

78.1%

25.2%

30.3%

1.3%

14.8%

29.0%

1.3%

18.7%

21.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Primary Support[b] Social

Environment[c]

Educational Occupational Housing Economic Access to

Healthcare

Legal Other[d]

Problem[e]

n = 155

[a] Data reported were collected using the Enrollment and Demographic Information (EDIF).[b] Primary support problems include health problems in family, removal from the home, remarriage or divorce of parent, and child abuse or neglect.[c] Social environment problems include inadequate social support, death or loss of a friend, and adjustments to life-cycle transitions.[d] Other problems include discord with non-family caregivers, unavailability of social service agencies, and exposure to disasters.

[e] Because youth may experience more than one psychosocial or environmental problem, problems may sum to more than 100%.



15

Family and Child History[a]

Has the child ever . . .

Witnessed domestic violence? (n = 183) 41.5%

Lived with someone who was depressed? (n = 179) 60.9%

Lived with someone who had a mental illness, other than depression? (n = 177) 35.6%

Lived with someone who was convicted of a crime? (n = 182) 39.0%

Lived with someone who had a substance abuse problem? (n = 182) 47.8%

Been physically abused? (n = 182) 12.1%

Been sexually abused? (n = 181) 6.6%

Run away? (n = 185) 8.1%

Had substance abuse problems? (n = 186) 0.0%

Attempted suicide? (n = 185) 2.2%

[a] Data reported were collected using the Caregiver Information Questionnaire–Intake (CIQ–I).

• 64% of caregivers reported a family history of depression (n = 177).

• 45% of caregivers reported a family history of mental illness, other than depression (n = 176).

• 55% of caregivers reported a family history of substance abuse (n = 182).



16

Custody Status[a,b] at Intake

28.5%

50.5%

3.8%

6.5%

0.0%

0.5%

5.9%

0.0%

3.2%

1.1%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Two Parents[c]

Biological Mother Only

Biological Father Only

Adoptive Parent(s)

Sibling(s)

Aunt and/or Uncle

Grandparent(s)

Adult Friend

Ward of the State

Other

n = 186

[a] Data reported were collected using the Caregiver Information Questionnaire–Intake (CIQ–I).[b] Custody Status is collected on the CIQ and refers to legal custody. This may not reflect living arrangement, which is collected on the LSQ.

[c] Includes two biological parents, or one biological parent and a step or adoptive parent.



17

Economic and Employment Status[a] at Intake

Family/Household Annual Income

Family Income[b] (n = 179)

Less Than $5,000 14.0%

$5,000–$9,999 11.2%

$10,000–$14,999 10.6%

$15,000–$19,999 9.5%

$20,000–$24,999 13.4%

$25,000–$34,999 20.7%

$35,000–$49,999 9.5%

$50,000–$74,999 6.1%

$75,000–$99,999 3.4%

$100,000 and Over 1.7%

Poverty Level

Poverty categories are based on the U.S. Department of Health and Human Services poverty guidelines, which are available for the 50 States. The categories take into account calendar year, State, family income, and household size. Specifically, if family income is less than the relevant poverty threshold, they are "below poverty", if income is 1 to 1.5 times the threshold, they are "at/near poverty", and if income is more than 1.5 times the threshold, they are "above poverty". In 2009, the poverty threshold for a family of four residing in the 48 contiguous States was $22,050.

52.0%

19.8%

28.2%

Below Poverty

At/near Poverty

Above Poverty

n = 177

Employment History

Caregiver Employed in the Past 6 Months[c] 62.2% (n = 185)

Average Months of Employment in the Past 6 Months 4.9 (n = 115)

Average Hours Worked Per Week in the Past 6 Months 34.3 (n = 115)

[a] Data reported were collected using the Caregiver Information Questionnaire–Intake (CIQ–I).

[b] Family income is reported from the family with whom the child has lived with the most in the 6 months prior to data collection.[c] Only caregivers who reported being employed in the past 6 months were asked the average number of months and hours per week worked.



18

Section II: Living Situation

This section provides information on children’s living situations. Information in this section was taken from the Living Situations Questionnaire (LSQ).

The LSQ is administered to caregivers and gathers information on where the child was living in the past 6 months, with whom the child was living, and number of days in each living situation.



19

Living Situations[a] at Intake

Child Lives With[b]

Biological Family[c]

Adoptive Family[d]

Non-Parent Relative[e]

Non-Relative[f] Independent Living[g]

(n = 188) 80.3% 6.4% 21.3% 4.3% 0.0%

Type of Living Situation

2.1%

95.2%

0.0%

0.0%

0.5%

1.6%

0.5%

0.0%

0.0%

0.0%

0.0%

0.0%

0.0%

0.0%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Homeless

Home

School Dormitory

Recreational Camp

Emergency Shelter

Foster Home

Therapeutic/Specialized Foster Home

Group Home

Medical Hospital

Residential Treatment/Therapeutic Camp

Psychiatric Hospital or Unit

Youth Justice Related

Adult Justice Related

Other

n = 188

[a] Data reported were collected using the Living Situations Questionnaire (LSQ). The LSQ reflects living situations during the 6 months prior to data collection.

[b] Since a child may have lived with more than one individual at intake, percentages may sum to more than 100%.

[c] Includes both biological parents or one biological parent with or without a partner.

[d] Includes two adoptive parents or one adoptive parent with or without a partner.

[e] Includes two grandparents, one grandparent with or with a partner, or other relative with or without a partner.

[f] Includes one or more foster parents, staff, or other caregiving adult.

[g] Living alone, with a friend, or within a supervised living situation.



20

Stability of Children's Living Arrangements[a] at Intake, 6 Months, 12 Months, and 18 Months

88.1%

95.2% 95.2% 92.9%

11.9%

4.8% 4.8% 7.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Intake 6 Months 12 Months 18 Months

One Living Arrangement Multiple Living Arrangements

n = 42

[a] Data reported were collected using the Living Situations Questionnaire (LSQ). This instrument collects data on the status of the child/family in the 6

months prior to the interview.



21

Section III: Education

This section provides information on children’s education status and experiences in school. Information in this section was taken from the Education Questionnaire Revised (EQ–R).

The EQ–R is administered to caregivers. It gathers information on school attendance, grade level, academic performance, school settings, Individual Education Plans, extracurricular activities, and disciplinary actions for children and youth enrolled in the Longitudinal Outcome Study. The questions cover all levels of schooling from prekindergarten to postsecondary institutions such as colleges and vocational/trade schools.



22

School Attendance and Performance[a] at Intake

• 66% of children aged 1–4 years attended school in the past 6 months (n = 82).

• 99% of children aged 5–18 years attended school in the past 6 months (n = 90).

• 83% of children of all ages attended school in the past 6 months (n = 175).

School Attendance and Performance

Average Number of Excused and Unexcused Absences in the Past 6 Months (n = 133)

Perfect Attendance 23.3%

Less Than 1 Day Per Month 45.1%

About 1 Day a Month 13.5%

About 1 Day Every 2 Weeks 9.8%

About 1 Day a Week 4.5%

2 Days Per Week 3.0%

3 or More Days Per Week 0.8%

School Performance at Intake (n = 133)

Grade Average 'A' 9.0%

Grade Average 'B' 6.8%

Grade Average 'C' 11.3%

Grade Average 'D' 0.8%

Failing About Half or More Classes 3.0%

School Does Not Grade the Children 63.9%

Other 5.3%

[a] Data reported were collected using the Education Questionnaire–Revised (EQ–R). This instrument collects data on the status of the child/family in the 6 months prior to the interview.



23

Change in School Attendance[a] from Intake to 18 Months

School Attendance[b]

(n = 34)

44.1%

29.4%

26.5%

Improved Remained Stable Worsened


[b] Change in school attendance is defined as the following: 1) improved: children attending school more frequently at the second data collection point than at the first data collection point, 2) remained stable: children attending school at the same frequency at both data collection points, 3) worsened: children attending school less frequently at the second data collection point than at the first.



24

Educational Placements and Individualized Educational Plans (IEP)[a] at Intake

Educational Placements in the 6 Months Prior to Intake[b] (n = 147)

Regular Public Day School 78.2%

Regular Private Day/Boarding School 14.3%

Home Schooling[c] 1.4%

Alternative/Special Day School 7.5%

School in 24-Hour Restrictive Setting[d] 0.7%

Postsecondary School 0.0%

Daycare or After-School Care Program 42.5%

Other 6.1%

Percent with IEP (n = 144)

Individualized Education Plan 34.0%

Reasons for IEP[e] (n = 49)

Behavioral/Emotional Problems 73.5%

Learning Disability 30.6%

Developmental Disability or Mental Retardation 30.6%

Vision or Hearing Impairment 0.0%

Speech Impairment 38.8%

Physical Disability 4.1%

Other 10.2%

[a] Data reported were collected using the Education Questionnaire–Revised (EQ–R). This instrument collects data on the status of the child/family in the 6 months prior to the interview.[b] Because individuals may have more than one educational placement, educational placements may sum to more than 100%.[c] Includes home-based instruction and combination of home schooling and home-based instruction.[d] Includes hospital, juvenile justice facility, residential treatment center, group home, and group shelter.

[e] Because individuals may have more than one reason for having an IEP, the reasons for having an IEP may sum to more than 100%.



25

Educational Placements[a] at Intake, 6 Months, and 12 Months

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Regular Public Day School 81.3% 89.6% 87.5%

Regular Private Day/Boarding School 16.7% 6.3% 4.2%

Home Schooling[b] 0.0% 0.0% 0.0%

Alternative/Special Day School 8.3% 0.0% 10.4%

School in 24-Hour Restrictive Setting[c] 0.0% 0.0% 0.0%

Postsecondary School 0.0% 0.0% 0.0%

Other 6.3% 4.2% 2.1%

Intake 6 Months 12 Months

n = 48

[a] Data reported were collected using the Education Questionnaire–Revised (EQ–R). This instrument collects data on the status of the child/family in the 6 months prior to the interview. Because children may have more than one type of placement in the 6 months prior to data collection, percentages may sum to more than 100%.[b] Includes home-based instruction and combination of home schooling and home-based instruction.

[c] Includes hospital, juvenile justice facility, residential treatment center, group home, and group shelter.



26

Special Education Placements[a] at Intake

• Caregiver report indicated that 26% of 144 children took special education classes.[b]

45.9%48.6%

5.4%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Self-Contained[c] Resource Services[d] Inclusion[e]

Type of Placement[f]

n = 37

[a] Data reported were collected using the Education Questionnaire–Revised (EQ–R). This instrument collects data on the status of the child/family in the 6 months prior to the interview.[b] This includes children who took special education classes in which either all children or only some children in the class were receiving special education, and children who received any other kind of special education.[c] Self-Contained refers to special education classes in which all the children in the class are receiving special education for all or most of the day.[d] Resource Services refers to special education classes in which all the children leave their general education class to receive special education instruction in specific subjects for a portion of the day.

[e] Inclusion refers to special education provided in the general education class in which some children receive special education and others do not.[f] Because children may have received more than one type of placement over the past 6 months, percentages may sum to more than 100%.



27

School Disciplinary Actions[a] at Intake

Disciplinary Actions in the Past 6 Months

20.4%

2.0% 1.4%

76.2%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Suspended Expelled Suspended and Expelled Neither Suspended Nor Expelled

n = 147




28

School Disciplinary Actions[a] at Intake, 6 Months, and 12 Months

Actions Intake 6 Months 12 Months

Suspended 14.6% 14.6% 22.9%

Expelled 2.1% 0.0% 2.1%

Suspended and Expelled 2.1% 2.1% 0.0%

Neither Suspended Nor Expelled 81.3% 83.3% 75.0%

n = 48




29

Section IV: Child Clinical Measures

This section provides clinical information on the children participating in the Longitudinal Outcome Study. Information on functional impairment, depression, and anxiety is presented, along with information on children’s behavioral and emotional problems. Finally, measures of children’s behavioral and emotions strengths are included in addition to measures of adaptive behaviors. Information in this section was taken from the following instruments:

Columbia Impairment Scale (CIS): The CIS, administered to caregivers, provides a global measure of impairment. CIS scores range from 0 to 52. Higher scores indicate a greater level of impairment. A score of 15 or higher is considered clinically impaired.



30

Section IV: Child Clinical Measures, continued

Child Behavioral Checklist (CBCL 1½– 5): The CBCL 1½–5 is administered to caregivers and measures behavioral and emotional problems in children aged 1½ to 5. The CBCL 1½–5 produces seven narrow-band syndrome scores: emotionally reactive, anxious/depressed, somatic complaints, withdrawn, sleep problems, attention problems, and aggressive behavior; two broadband syndrome scores: internalizing and externalizing; and a total problem score. T-scores between 65 and 69 (93rd and 97th percentile) on the narrow-band syndrome scales are in the borderline clinical range. T-scores 70 or above are in the clinical range. T-scores between 60 and 63 (83rd and 90th percentile) on the internalizing, externalizing, and total problem scales are in the borderline clinical range. T-scores 64 or above are in the clinical range.

Child Behavioral Checklist (CBCL 6–18): The CBCL 6–18 is administered to caregivers and measures behavioral and emotional problems in children aged 6 to 18. The CBCL 6–18 produces eight narrow-band syndrome scores: anxious/depressed, withdrawn/depressed, somatic complaints, social problems, thought problems, attention problems, rule-breaking behavior, and aggressive behavior; two broadband syndrome scores: internalizing and externalizing; and a total problem score. T-scores between 65 and 69 (93rd and 97th percentile) on the narrow-band syndrome scales are in the borderline clinical range. T-scores 70 or above are in the clinical range. On the internalizing, externalizing, and total problem scales, T-scores between 60 and 63 (84th and 90th percentile) are in the borderline clinical range. T-scores 64 or above are in the clinical range.

The CBCL is also comprised of three competence subscales, as well as a Total Competence scale. Higher scores on the competence scales indicate greater competence. The three competence subscales have a T-score range from 20 to 65, with scores under 30 in the clinical range (i.e., less competence) (2nd percentile), scores between 31 and 36 in the borderline clinical range, and scores over 36 below the clinical range (i.e., greater competence). The Total Competence scale has a T-score range from 10 to 80, with scores under 37 in the clinical range (i.e., less competence), scores between 37 and 40 in the borderline clinical range, and scores over 40 below the clinical range (i.e., greater competence).



31

Section IV: Child Clinical Measures, continued

Behavioral and Emotional Rating Scale–Second Edition, Parent Rating Scale (BERS–2C): The BERS–2C is administered to caregivers. It measures children’s emotional and behavioral strengths in six different areas: interpersonal strength, family involvement, intrapersonal strength, school functioning, affective strength, and career strength. Scaled scores on the strength subscales range from 1 to 16, with an average score between 8 and 12. Higher scores indicate greater strengths.

A strength index can be calculated and is based on the sum of the subscale scores, excluding career strength. The strength index ranges from 38 to 161, with an average index in the 90–110 range. A higher index indicates greater overall strengths.

Vineland Screener (VS): The Vineland Screener is administered through a semi-structured interview with a parent or caregiver who is familiar with the child’s activities. One of three versions of the Vineland Screener is administered depending on the child’s age: Vineland Screener 0-Under 3, Vineland Screener 3-5, and Vineland Screener 6-12. The Vineland Screener measures the personal and social sufficiency of children along four domains: communication, daily living skills, socialization, and motor skills. Screener raw scores are summed within each domain, ranging from 0 to 30. These raw scores are converted to equated raw scores, which in turn are converted to standard scores based on the child’s age. Domain standard scores range from 20 to 160, with a mean of 100. Standard scores between 70 and 84 indicate moderately low adaptive behavior. Standard scores below 70 indicate low adaptive behavior.



32

Child Impairment and Anxiety and Adolescent Depression at Intake

Measure Average Score Clinical Impairment Range

Columbia Impairment Scale[a]

Overall Level of Impairment (n = 164) 19.2 15.0 – 52.0

[a] Data reported were collected using The Columbia Impairment Scale (CIS). This instrument collects data on the status of the child/family in the 6 months prior to the interview.



33

Child Competence and Behavioral and Emotional Problems[a] at Intake

Measure CBCL 1½–5

Average Score

Clinical Range

CBCL 6–18

Average Score

Clinical Range

Competence

Social 37.1 (n = 48) <30.0

Activities 38.5 (n = 50) <30.0

School 36.5 (n = 54) <30.0

Total Competence 32.2 (n = 47) <37.0

Behavioral and Emotional Problems

Social Problems 66.0 (n = 55) >=70.0

Thought Problems 64.9 (n = 55) >=70.0

Rule Breaking Behavior 66.4 (n = 55) >=70.0

Emotionally Reactive 66.0 (n = 101) >=70.0

Sleep Problems 60.8 (n = 101) >=70.0

Withdrawn 63.2 (n = 101) >=70.0 61.9 (n = 55) >=70.0

Somatic Complaints 57.9 (n = 101) >=70.0 58.0 (n = 55) >=70.0

Anxious/Depressed 61.8 (n = 101) >=70.0 65.6 (n = 55) >=70.0

Attention Problems 63.1 (n = 101) >=70.0 67.9 (n = 55) >=70.0

Aggressive Problems 69.8 (n = 101) >=70.0 73.9 (n = 55) >=70.0

Internalizing Problems 63.6 (n = 101) >63.0 63.4 (n = 55) >63.0

Externalizing Problems 68.0 (n = 101) >63.0 70.5 (n = 55) >63.0

Total Problems 66.9 (n = 101) >63.0 69.2 (n = 55) >63.0

[a] Shaded areas indicate scales that are not applicable for that version of the Child Behavior Checklist (CBCL). This instrument collects data on the status of the child/family in the 6 months prior to the interview.



34

Average Scores of Child Behavioral and Emotional Problems[a] for Children Ages 1½ to 5 at Intake and

6 Months

Internalizing and Externalizing

Scores[b]

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0

Data Collection Points

Avera

ge C

BC

L P

rob

lem

Sco

res

Internalizing

Behaviors

61.8 59.0

Externalizing

Behaviors

66.7 62.7

Intake 6 Months

n = 56

Seven Syndrome Scale Scores[b]

Intake

6 Months

Emotionally Reactive

64.5 62.1

Sleep Problems

59.9 59.6

Withdrawn 62.8 61.6

Somatic Complaints

56.9 55.0

Anxious/

Depressed

60.1 58.6

Attention Problems

62.9 61.3

Aggressive Behavior

68.2 63.8

[a] Data reported were collected using the Child Behavioral Checklist 1½–5 (CBCL 1½–5). This instrument collects data on the status of the child/family in the 6 months prior to the interview.

[b] Internalizing and Externalizing scores 64 or above are in the clinical range. Scores on the seven syndrome scales 70 or above are in the clinical range.



35

Reliable Change Index[a] of Child Behavioral and Emotional Problems in Children Ages 1½ to 5 Years[b]

from Intake to 6 Months

7.1% 7.1%

75.0%

60.7%

17.9%

32.1%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Internalizing Problems

(n = 56)

Externalizing Problems

(n = 56)

Subscale

Worsened Remained Stable Improved

[a] The Reliable Change Index (RCI) is a relative measure that compares a child's or caregiver's scores at two different points in time and indicates whether a change in score shows significant improvement, worsening, or stability (i.e., no significant change).[b] Data reported were collected using the Child Behavioral Checklist 1½–5 (CBCL 1½–5). This instrument collects data on the status of the child/family in the 6 months prior to the interview.



36

Average Scores of Child Behavioral and Emotional Problems[a] for Children Ages 6 to 18 at Intake and

6 Months

Internalizing and Externalizing

Scores[b]

20.0

30.0

40.0

50.0

60.0

70.0

80.0

90.0

100.0


Avera

ge C

BC

L P

rob

lem

Sco

res

Internalizing

Behaviors

62.6 61.3

Externalizing

Behaviors

69.9 68.7

Intake 6 Months

n = 41

Eight Syndrome Scale Scores[b]

Intake

6 Months

Withdrawn 61.4 59.8

Somatic Complaints

57.6 58.4

Anxious/

Depressed

65.3 62.2

Social Problems

66.4 64.2

Thought Problems

64.2 62.9

Attention Problems

68.3 66.8

Rule Break Behaviors

66.4 63.7

Aggressive Behavior

72.7 71.3

[a] Data reported were collected using the Child Behavioral Checklist 6–18 (CBCL 6–18). This instrument collects data on the status of the child/family in the 6 months prior to the interview.

[b] Internalizing and externalizing scores 64 or above are in the clinical range. Scores on the eight syndrome scales 70 or above are in the clinical range.



37

Reliable Change Index[a] of Child Behavioral and Emotional Problems in Children Ages 6 to 18 Years[b]

from Intake to 6 Months

12.2%7.3%

68.3% 80.5%

19.5%12.2%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Internalizing Problems

(n = 41)

Externalizing Problems

(n = 41)

Subscale


[a] The Reliable Change Index (RCI) is a relative measure that compares a child's or caregiver's scores at two different points in time and indicates whether a change in score shows significant improvement, worsening, or stability (i.e., no significant change).[b] Data reported were collected using the Child Behavioral Checklist 6–18 (CBCL 6–18). This instrument collects data on the status of the child/family in

the 6 months prior to the interview.



38

Average Child Competence Scores[a] for Children Ages 6 to 18 Years at Intake and 6 Months

20

25

30

35

40

45

50

55

60

65


Avera

ge C

BC

L 6

–1

8 C

om

pete

nce S

co

res[b

]

Activities (n = 38) 37.7 37.5

Social (n = 35) 37.7 41.5

School (n = 40) 36.6 36.4

Intake 6 Months

[a] Data reported were collected using the Child Behavioral Checklist 6–18 (CBCL 6–18). This instrument collects data on the status of the child/family in the 6 months prior to the interview.

[b] Scores under 30 are in the clinical range (i.e., less competent).



39

Caregiver Report of Behavioral and Emotional Strengths[a] at Intake

Strength Subscale[b]

BERS–2C Average Score

BERS–2C

n

Interpersonal Strength

6.7 99

Family Involvement

8.0 99

Intrapersonal Strength

8.8 98

School Functioning

7.4 93

Affective Strength

9.0 99

Career Strength

8.8 86

Strength Index[c]

86.1 93

[a] Data reported were collected using the Behavioral and Emotional Rating Scale–Second Edition, Parent Rating Scale (BERS–2C). This instrument collects

data on the status of the child/family in the 6 months prior to the interview.[b] Strength subscales on the BERS–2C range from 1 to 16. Average scores on both instruments range between 8 and 12. Higher scores indicate greater strength.[c] Strength indexes for the BERS–2C range from 38 to 161, with an average index between 90 and 110. A higher index indicates greater overall strengths.



40

Caregiver Report of Behavioral and Emotional Strengths[a] at Intake, 6 Months, and 12 Months

Strength Subscale[b]

BERS–2 Caregiver Average Score


Interpersonal Strength

(n = 44)

6.5 6.9 7.3

Family Involvement

(n = 44)

8.0 7.9 8.4

Intrapersonal Strength

(n = 43)

8.6 8.8 9.1

School Functioning

(n = 40)

7.4 8.0 8.2

Affective Strength

(n = 44)

8.7 8.9 9.3

Career Strength

(n = 32)

8.4 9.8 9.4

Strength Index[c]

(n = 40)

85.4 87.0 88.8

[a] Data reported were collected using the Behavioral and Emotional Rating Scale–Second Edition, Parent Rating Scale (BERS–2C). This instrument collects

data on the status of the child/family in the 6 months prior to the interview.[b] Strength subscales on the BERS–2C range from 1 to 16 with an average score between 8 and 12. Higher scores indicate greater strength.[c] Strength Index on the BERS–2C ranges from 38 to 161 with an average index between 90 and 110. A higher index indicates greater overall strengths.



41

Reliable Change Index[a] for Caregiver Report of Behavioral and Emotional Strengths[b] from Intake to

12 Months

6.5% 4.3%11.1% 11.9%

4.3%11.4%

65.2%

78.3%71.1% 69.0%

78.3% 65.7%

28.3%

17.4% 17.8% 19.0% 17.4%22.9%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Interpersonal

Strength

(n = 46)

Family Involvement

(n = 46)

Intrapersonal

Strength

(n = 45)

School Functioning

(n = 42)

Affective Strength

(n = 46)

Career Strength

(n = 35)

Strength Subscale


[a] The Reliable Change Index (RCI) is a relative measure that compares a child's or caregiver's scores at two different points in time and indicates whether a change in score shows significant improvement, worsening, or stability (i.e., no significant change).[b] Data reported were collected using the Behavioral and Emotional Rating Scale–Second Edition, Parent Rating Scale (BERS–2C). This instrument collects

data on the status of the child/family in the 6 months prior to the interview.



42

Average Scores of Adaptive Behavior[a] in Children Ages 0 to 5 Years at Intake

Average Standard Score

Domain Intake

Vineland Screener[b]

Communication (n = 108) 95.8

Daily Living Skills (n = 105) 91.5

Socialization (n = 107) 107.0

Motor Skills (n = 107) 97.3

[a] Data reported at intake represent combined data from the Vineland Screener 0-<3, the Vineland Screener 3-5.[b] Standard scores between 70 and 84 indicate moderately low adaptive behavior. Standard scores less than 70 indicate low adaptive behavior.



43

Average Scores of Adaptive Behavior[a] for Children Ages 0 through 5 Years[b] at Intake and 6 Months

Domain Scores[c]

50.0

60.0

70.0

80.0

90.0

100.0

110.0

120.0

130.0

140.0

150.0


Avera

ge S

tan

dard

Sco

res

Communication (n = 70) 96.9 97.4

Daily Living Skills (n = 69) 92.1 92.2

Socialization (n = 70) 108.4 111.6

Motor Skills (n = 59) 98.3 96.5

Intake 6 Months

[a] Data reported represent combined data from the Vineland Screener 0-<3, the Vineland Screener 3-5, and the Vineland Screener 6-12. The Vineland Screener 6-12 is only administered to children who have aged to 6 years or older at follow-up interviews.[b] Children age 5 years at intake may have aged to 6 years at follow-up interviews.[c] Standard scores between 70 and 84 indicate moderately low adaptive behavior. Standard scores less than 70 indicate low adaptive behavior.

[d] Data on motor skills are not collected in the Vineland 6-12.



44

Reliable Change Index[a,b] of Adaptive Behavior in Children Ages 0 through 5 Years from Intake to

6 Months

12.9%18.8% 17.1%

6.8%

75.7% 62.3%

75.7%

83.1%

11.4%

18.8%

7.1% 10.2%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Communication

(n = 70)

Daily Living Skills

(n = 69)

Socialization

(n = 70)

Motor Skills

(n = 59)

Subscale


[a] The Reliable Change Index (RCI) is a relative measure that compares a child’s scores at two different points in time and indicates whether a change in score shows significant improvement, worsening, or stability (i.e., no significant change).[b] Data reported represent combined data from the Vineland Screener 0-<3, the Vineland Screener 3-5. Data from the Vineland Screener 6-12 are not included in the RCI calculation because it is not administered at intake and does not collect data on motor skills.



45

Section V: Caregiver and Family Measures

This section provides information on caregivers’ perceptions of family functioning and the strain associated with caring for a child with behavioral and emotional problems. Information in this section was taken from the following instruments, which are administered to caregivers:

Caregiver Strain Questionnaire (CGSQ): The CGSQ assesses the extent to which caregivers are affected by the special demands associated with caring for a child with emotional and behavioral problems. The CGSQ is comprised of three subscales which range in severity from 0 to 5. Objective Strain refers to observable disruptions in family and community life (e.g., interruption of personal time, lost work time, financial strain). Subjective Externalized Strain refers to negative feelings about the child such as anger, resentment, or embarrassment. Subjective Internalized Strain refers to the negative feelings that the caregiver experiences such as worry, guilt, or fatigue. Higher scores on each of these scales indicate greater strain. A Global Strain score is calculated by summing the three subscales (i.e., Objective Strain, Subjective Externalized Strain, and Subjective Internalized Strain) to provide an indication of the total impact of the special demands on the family. Global Strain scores range from 0 to 15. As with the individual subscales, higher scores indicate greater strain.

Family Life Questionnaire (FLQ): The FLQ assesses family communication, decision-making, and support and bonding. The FLQ consists of 10 statements describing positive family interactions. Using a 5-point scale, caregivers are asked to rate how often each interaction occurs in their family. Responses range from never (1) to always (5).



46

Caregiver Strain at Intake

Caregiver Strain Questionnaire Subscales[a] Average Score

Objective Strain (n = 188) 2.4

Subjective Externalized Strain (n = 188) 2.1

Subjective Internalized Strain (n = 188) 3.4

Global Strain (n = 188) 7.9

[a] Data reported were collected using the Caregiver Strain Questionnaire (CGSQ). The range in scores for each subscale is 0 to 5; the range in scores for the Global Strain scale is 0 to 15. Higher scores indicate greater strain. This instrument collects data on the status of the caregiver in the 6 months prior to

the interview.



47

Caregiver Strain at Intake, 6 Months, 12 Months, and 18 Months

Caregiver Strain Questionnaire Subscales[a]

Average Score


18 Months

Objective Strain (n = 42) 2.6 2.4 2.0 2.0

Subjective Externalized Strain (n = 42) 2.2 1.9 1.8 1.8

Subjective Internalized Strain (n = 42) 3.5 3.2 2.7 2.6

Global Strain (n = 42) 8.3 7.5 6.5 6.5

[a] Data reported were collected using the Caregiver Strain Questionnaire (CGSQ). The range in scores for each subscale is 0 to 5; the range in scores for the Global Strain scale is 0 to 15. Higher scores indicate greater strain. This instrument collects data on the status of the caregiver in the 6 months prior to

the interview.



48

Reliable Change Index[a] of Caregiver Strain[b] from Intake to 18 Months

6.8%2.3% 0.0%

4.5%

68.2%84.1%

70.5%

52.3%

25.0%

13.6%

29.5%

43.2%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Objective Strain

(n = 44)

Subjective Externalized Strain

(n = 44)

Subjective Internalized Strain

(n = 44)

Global Strain

(n = 44)

Subscale


[a] The Reliable Change Index (RCI) is a relative measure that compares a caregiver's scores at two different points in time and indicates whether a change in score shows significant improvement, worsening, or stability (i.e., no significant change).[b] Data reported were collected using the Caregiver Strain Questionnaire (CGSQ). This instrument collects data on the status of the caregiver in the 6

months prior to the interview.



49

Caregiver Assessment of Family Life[a] at Intake

Our family . . .

64.7%

51.3%

77.0%

53.0%

73.0%

59.4%

44.1%

52.9%

54.8%

55.2%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Talks about fun things and things that make us laugh

(n = 187)

Agrees about things like what to watch on TV or what to eat for dinner

(n = 187)

Spends time together as a family

(n = 187)

Talks about our problems and troubles

(n = 185)

Relies on each other when problems arise

(n = 185)

Does things together outside of our home

(n = 187)

Talks about things that make us angry without fighting

(n = 186)

Can solve problems our child has when they happen

(n = 187)

Deals with crises or major problems without fighting

(n = 186)

Our child talks with members of our family

about things that make him/her happy, sad, or upset

(n = 181)

Fam

ily I

nte

ractions[b

]

[a] Data reported were collected using the Family Life Questionnaire (FLQ). This instrument collects data on the status of the family in the 6 months prior to the interview.

[b] Percentages reported combine the responses 'Most of the Time' and 'Always'.



50

Caregiver Assessment of Family Life[a] at Intake, 6 Months, 12 Months, and 18 Months

Our family . . .

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Talks about fun things and things that

make us laugh

(n = 40)

60.0% 75.0% 70.0% 70.0%

Agrees about things like what to watch on

TV or what to eat for dinner

(n = 40)

42.5% 45.0% 57.5% 45.0%

Spends time together as a family

(n = 40)

82.5% 75.0% 80.0% 75.0%

Talks about our problems and troubles

(n = 39)

56.4% 56.4% 69.2% 61.5%

Relies on each other when problems arise

(n = 39)

74.4% 87.2% 84.6% 79.5%


[a] Data reported were collected using the Family Life Questionnaire (FLQ). This instrument collects data on the status of the family in the 6 months prior to the interview. Percentages reported combine the responses 'Most of the Time' and 'Always'.



51

Caregiver Assessment of Family Life[a] at Intake, 6 Months, 12 Months, and 18 Months, continued

Our family . . .

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Does things together outside of our home

(n = 41)

51.2% 56.1% 68.3% 65.9%

Talks about things that make us angry

without fighting (n = 41)

39.0% 43.9% 56.1% 48.8%

Can solve problems our child has when

they happen (n = 41)

46.3% 41.5% 63.4% 58.5%

Deals with crises or major problems

without fighting (n = 40)

47.5% 70.0% 62.5% 62.5%

Our child talks with members of our family

about things that make him/her happy,

sad, or upset (n = 38)

28.9% 50.0% 65.8% 52.6%


[a] Data reported were collected using the Family Life Questionnaire (FLQ). This instrument collects data on the status of the family in the 6 months prior to the interview. Percentages reported combine the responses 'Most of the Time' and 'Always'.



52

Section VI: Service Experience

This section provides information on the service experiences of children, youth, and families in systems of care. Information from this section was taken from the instruments listed below. Since the intent is to capture information related to system of care services, these instruments are administered only after the families had been enrolled in a system of care program for 6 months. All instruments are administered to caregivers with the exception of the Youth Service Survey, which is administered to youth aged 11 and older.

Multi-Sector Service Contacts–Revised (MSSC–R): The MSSC–R identifies the services received, the service setting/location, and satisfaction with services delivered. The measure is collected at follow-up time periods from caregiver interviews. It captures information on services received by both youth and their families.

Cultural Competence and Service Provision Questionnaire (CCSP): The CCSP contains 16 items that measure caregiver ratings on the importance of cultural factors in service planning and delivery and how well the primary service provider addressed cultural issues while providing services to the child and family.

Youth Service Survey for Families (YSS–F): The YSS–F assesses the caregiver’s perception of his/her system of care service experiences. The measure assesses perceptions of service across the following five domains: 1) access, 2) participation in treatment, 3) cultural sensitivity, 4) satisfaction, 5) outcomes. Scores on each domain range from 1 to 5. Higher scores indicate a positive service experience in that domain.



53

Service Setting/Location[a] between Intake and 6 Months

49.6%

70.4%

0.9%

11.3%

23.5%

3.5%

13.9%

60.0%

3.5%

0.0%

11.3%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Mental Health Clinic or Private Practice

(n = 115)

School

(n = 115)

Juvenile Court/Probation

(n = 115)

Social Services/Child Welfare Offices

(n = 115)

Community Location

(n = 115)

Psychiatric Hospital/unit

(n = 115)

Medical Hospital

(n = 115)

Home

(n = 115)

Residential Setting

(n = 114)

Jail/Youth Detention

(n = 114)

Other Setting

(n = 71)

Lo

cati

on

[b

]

[a] Data reported were collected using the Multi-Sector Service Contacts–Revised (MSSC–R) questionnaire. This instrument collects data on the services received by the child/family in the 6 months prior to the interview.

[b] Because participants can have received services in multiple settings, percentages may sum to more than 100%.



54

Child and Family Service Use[a] between Intake and 6 Months

• Caregiver reports at 6 months indicated that, on average, children received 4.0 types of services between intake and 6 months (n = 115).

Support Services

3.5%

17.4%

2.6%

18.3%

0.0%

0.0%

27.8%

20.9%

32.2%

3.5%

10.4%

18.3%

51.3%

0.9%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Family Preservation (n = 115)

Case Management (n = 115)

Day Treatment (n = 115)

Behavioral/Therapeutic Aide (n = 115)

Independent Living (n = 114)

Transition (n = 115)

Family Support (n = 115)

Recreation Activities (n = 115)

Afterschool Programs (n = 115)

Transportation (n = 115)

Respite (n = 115)

Flexible Funds (n = 115)

Informal Support (n = 115)

Vocational Training (n = 115)




55

Child and Family Service Use[a] between Intake and 6 Months

Outpatient & Inpatient Services

51.3%

7.8%

27.0%

17.7%

75.7%

12.2%

0.0%

1.7%

0.9%

0.0%

0.9%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Assessment or Evaluation

(n = 115)

Crisis Stabilization

(n = 115)

Medication/Monitoring

(n = 115)

Group Therapy

(n = 113)

Individual Therapy

(n = 115)

Family Therapy

(n = 115)

Residential Camp

(n = 115)

Inpatient Hospitalization

(n = 115)

Residential Treatment Center

(n = 115)

Therapeutic Group Home

(n = 115)

Therapeutic Foster Care

(n = 115)




56

Child and Family Service Use[a] at 6 Months, 12 Months, and 18 Months

Support Services

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Family Preservation (n = 32) 6.3% 6.3% 0.0%

Case Management (n = 32) 21.9% 6.3% 15.6%

Day Treatment (n = 33) 6.1% 3.0% 3.0%

Behavioral/Therapeutic Aide (n = 32) 28.1% 18.8% 21.9%

Independent Living (n = 32) 0.0% 0.0% 0.0%

Transition (n = 33) 0.0% 0.0% 0.0%

Family Support (n = 32) 43.8% 28.1% 28.1%

6 Months 12 Months 18 Months




57

Child and Family Service Use[a] at 6 Months, 12 Months, and 18 Months, continued

Support Services

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Recreation Activities (n = 32) 21.9% 25.0% 18.8%

After School Programs (n = 32) 37.5% 50.0% 50.0%

Transportation (n = 33) 9.1% 12.1% 18.2%

Respite (n = 32) 12.5% 21.9% 28.1%

Flexible Funds (n = 32) 18.8% 9.4% 18.8%

Informal Support (n = 32) 28.1% 34.4% 78.1%

Vocational Training (n = 32) 3.1% 0.0% 0.0%





58


Outpatient Services

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Assessment or Evaluation (n = 33) 57.6% 42.4% 39.4%

Crisis Stabilization (n = 32) 12.5% 12.5% 6.3%

Medication/Monitoring (n = 33) 27.3% 30.3% 48.5%

Group Therapy (n = 31) 16.1% 9.7% 6.5%

Individual Therapy (n = 33) 69.7% 75.8% 72.7%

Family Therapy (n = 32) 12.5% 9.4% 15.6%





59


Inpatient Services

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Residential Camp (n = 33) 0.0% 0.0% 0.0%

Inpatient Hospitalization (n = 33) 0.0% 0.0% 9.1%

Residential Treatment Center (n = 33) 3.0% 0.0% 3.0%

Therapeutic Group Home (n = 33) 0.0% 0.0% 0.0%

Therapeutic Foster Care (n = 33) 0.0% 0.0% 3.0%





60

Cultural Competence[a] at 6 Months

How important is it that . . .

58.7%

49.6%

17.4%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

You and your child have a service

provider who understands the

customs, practices, and traditions

of your child’s racial/ethnic group?

(n = 121)

The beliefs, traditions, and

practices of your child’s racial or

ethnic group be included in service

planning and provision?

(n = 121)

The person you and your child

have seen most often is of the

same racial/ethnic group as your

child?

(n = 121)

Care

giv

er

Op

inio

n[b

]

[a] Data reported were collected using the Cultural Competence and Service Provision (CCSP) Questionnaire. This instrument collects data on the services received by the child/family in the 6 months prior to the interview.

[b] Percentages reported combine the responses 'Very Important' and 'Extremely Important'.



61

Cultural Competence[a] at 6 Months, continued

My primary service provider . . .

92.7%

92.5%

96.2%

96.3%

99.1%

92.7%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Understood the beliefs that I, my

child, and my family may have

about mental health

(n = 109)

Understood that their culture

might be different from the culture

of my family

(n = 106)

Respected my family’s religious or

spiritual beliefs

(n = 106)

Treated me and my child with

respect

(n = 109)

Understood that people of my

racial or ethnic group are not all

alike

(n = 108)

Understood my needs

(n = 109)

Pro

vid

er

Beh

avio

r[b

]

[a] Data reported were collected using the Cultural Competence and Service Provision (CCSP) Questionnaire. This instrument collects data on the services

received by the child/family in the 6 months prior to the interview.[b] Percentages reported combine the responses 'Most of the Time' and 'Always'.



62

Cultural Competence[a] at 6 Months, continued


87.7%

99.1%

84.7%

93.5%

86.0%

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Used his/her knowledge of my

child and family’s culture to better

meet our needs

(n = 106)

Spoke the same language that I

or my child speak, or interpreters

were available to assist us

(n = 109)

Was willing to include my spiritual

or religious beliefs and practices

when he/she provided services to

my family

(n = 98)

Was flexible and provided services

to meet our cultural needs

(n = 107)

Told me how to get services I

needed or wanted if they were not

being provided to me or my child

(n = 107)

Pro

vid

er

Beh

avio

r[b

]

[a] Data reported were collected using the Cultural Competence and Service Provision (CCSP) Questionnaire. This instrument collects data on the cultural

competency of the child's/family's service provider in the 6 months prior to the interview.[b] Percentages reported combine the responses 'Most of the Time' and 'Always'.



63

Caregiver Opinion of Cultural Competence[a] at 6 Months and 12 Months

How important is it that . . .

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Care

giv

er

Op

inio

n[b

]

You and your child have a service

provider who understands the customs,

practices, and traditions of your child’s

racial/ethnic group? (n = 73)

54.8% 57.5%

The beliefs, traditions, and practices of

your child’s racial or ethnic group be

included in service planning and

provision? (n = 73)

49.3% 42.5%

The person you and your child have seen

most often is of the same racial/ethnic

group as your child? (n = 73)

16.4% 20.5%

6 Months 12 Months


received by the child/family in the 6 months prior to the interview.[b] Percentages reported combine the responses 'Very Important' and 'Extremely Important'.



64

Cultural Competence[a] at 6 Months and 12 Months, continued


0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Pro

vid

er

Beh

avio

r[b

]

Understood the beliefs we may have

about mental health (n = 59)

94.9% 88.1%

Understood that their culture might be

different from ours (n = 59)

94.9% 89.8%

Respected my family’s religious or

spiritual beliefs (n = 59)

98.3% 96.6%

Treated me and my child with respect (n

= 60)

96.7% 100.0%

Understood that people of my racial or

ethnic group are not all alike (n = 60)

100.0% 96.7%

Understood my needs (n = 60) 93.3% 98.3%

6 Months 12 Months





65

Cultural Competence[a] at 6 Months and 12 Months, continued


0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Pro

vid

er

Beh

avio

r[b

]

Used their knowledge of our culture to

better meet our needs (n = 56)

89.3% 92.9%

Spoke the same language we speak, or

interpreters were available (n = 60)

100.0% 100.0%

Willing to include my spiritual or religious

beliefs and practices (n = 54)

85.2% 90.7%

Was flexible and provided services to

meet our cultural needs (n = 59)

91.5% 94.9%

Told me how to get services I needed if

not provided (n = 59)

83.1% 89.8%

6 Months 12 Months





66

Caregiver Perspective on Services[a] at 6 Months

Perspectives on Services Caregiver:

% Reporting Positively[b]

Access to Services 89.5% (n = 114)

Participation in Treatment 86.0% (n = 114)

Cultural Sensitivity 95.5% (n = 112)

Satisfaction with Service 77.2% (n = 114)

Outcome 60.5% (n = 114)

[a] Data reported were collected using the Youth Services Survey for Families (YSS–F), Abbreviated Version and the Youth Services Survey (YSS), Abbreviated Version. These instruments collect data on the caregiver's/youth's satisfaction with the services received in the 6 months prior to the interview.[b] Scores for each item range from 1 to 5. A mean domain score above 3.5 is regarded as positive.



67

Caregiver Perspectives on Services[a] at 6 Months, 12 Months, and 18 Months

Caregiver Perspectives on Services Percentage Reporting Positively[b]


Access to Services (n = 31) 87.1% 93.5% 90.3%

Participation in Treatment (n = 31) 87.1% 96.8% 93.5%

Cultural Sensitivity (n = 31) 93.5% 96.8% 93.5%

Satisfaction with Services (n = 31) 80.6% 87.1% 80.6%

Outcome (n = 31) 67.7% 61.3% 71.0%

[a] Data reported were collected using the Youth Services Survey for Families (YSS–F), Abbreviated Version. This instrument collects data on the status of the child/family in the 6 months prior to the interview.

[b] Scores for each item range from 1 to 5. A mean domain score above 3.5 is regarded as positive.



68

Disclaimer

Site-specific Data Profile Reports (DPRs) are designed for use by local communities, the national evaluation team, and program partners. Members of the national evaluation team and program partner organizations should not distribute these reports to others outside of their organization or use the reports for purposes other than technical assistance. Only the grant communities themselves and the Child, Adolescent, and Family Branch of the Center for Mental Health Services can approve the sharing of site-level information. In addition, grant communities must provide their express permission for sharing of site-specific information.

The views expressed in written conference materials or publications and by speakers and moderators at HHS-sponsored conferences, do not necessarily reflect the official policies of the Department of Health and Human Services, nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

national evaluation of the comprehensive community mental ... · national evaluation of the...

Documents