Evaluation Findings - SAMHSA Store - Substance Abuse and Mental ...

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Table 5: DSM–IV Axis I and Axis II Diagnoses at Intake, Grant Communities Initially Funded in 1999–2006 Clinical Diagnoses a (n = 21,820) Mood Disorders 35.0% Attention-Deficit/Hyperactivity Disorder (ADHD) 34.1% Oppositional Defiant Disorder 24.6% Adjustment Disorders 12.4% Posttraumatic Stress Disorder and ASD 8.9% Anxiety Disorder 6.9% Conduct Disorder 7.0% Disruptive Behavior Disorder 6.3% Substance Use Disorders 5.8% Learning, Motor Skills, and Communication Disorders 4.0% Impulse Control Disorders 3.4% Mental Retardation 3.1% Schizophrenia and Other Psychotic Disorders 2.8% Autism and Other Pervasive Developmental Disorders 2.9% Personality Disorders 1.2% V Code b 6.7% Other 9.3% a The diagnoses listed are not just primary diagnoses. Because children may have more than one diagnosis, the percentages may sum to more than 100% b V Code refers to Relation Problems, Problems Related to Abuse or Neglect, and additional conditions that may be a focus of clinical attention . To What Extent Do Outcomes for Children, Youth, and Families Improve over Time After receiving services in systems of care, children/youth and their families showed substantial improvements in areas such as behavioral and emotional problems, level of functioning, school attendance and performance, involvement with law enforcement, and strain on families and other caregivers. In addition to improving in many areas, some children/youth and their families showed stability on other dimensions, also reflecting positive findings given the severity and complexity of their diagnoses and presenting problems. When multiple measures are considered, 72 percent of children and youth show The Comprehensive Community Mental Health Services for Children and Their Families Program Evaluation Findings 2006–2008 Annual Report to Congress ● Page 12 improvement on at least one clinical measure, and 77 percent show improvement on at least one functional measure after 24 months. Findings related to improvement and stability are highlighted below for each outcome area, with specification as to whether the results are derived from the entire group of 81 communities initially funded in 1999 through 2006 or from a subgroup of these communities. In addition, the instrument or measure used to derive each of the findings is specified. Improvement and stability were measured using Reliable Change Indices (Jacobson, Roberts, Berns, & McGlinchey, 1999) where appropriate.
Clinical Outcomes Child/Youth’s Behavioral and Emotional Problems Were Reduced Children/youth showed clinically significant reductions in their behavioral and emotional problems after receiving services within systems of care. In all communities (Child Behavior Checklist): Improvements were found in 31 percent of children/youth after 6 months of services; improvements increased to 48 percent at 24 months of services. Approximately 93 percent of children/youth showed improvement or maintained stability in their symptoms 24 months after entering services. Figure 3: Change in Children and Youth’s Overall Behavioral and Emotional Problems from Intake to 6 Months, Intake to 12 Months, Intake to 18 Months, and Intake to 24 Months, Grant Communities Initially Funded in 1999–2006, Outcome Sample (CBCL 4–18) 90.7% 91.2% 91.9% 93.3% Intake to 6 Months Intake to 12 Months Intake to 18 Months Intake to 24 Months (n = 1,306) z = 12.40, p = .00 Youth’s Self-Reported Behavioral and Emotional Problems Were Reduced Youth reported significantly lower levels of depression and anxiety after receiving services within systems of care. In communities initially funded in 2002– 2006 (Revised Children’s Manifest Anxiety Scale; Reynolds Adolescent Depression Scale–2nd Edition): After 6 months in services, 13 percent of youth reported less depression, and after 24 months in services this change nearly doubled to 25 percent (statistically significant). The percentage of youth reporting less anxiety doubled from 16 percent after 6 months in services to 32 percent after 24 months in services (statistically significant). Over 90 percent of children/youth reported either improved or stable symptoms of depression and anxiety after 24 months. The Comprehensive Community Mental Health Services for Children and Their Families Program Evaluation Findings 2006–2008 Annual Report to Congress ● Page 13
Page 1 and 2: Comprehensive Community Mental Heal
Page 3 and 4: U.S. Department of Health and Human
Page 5 and 6: Program Overview The Comprehensive
Page 7 and 8: Figure 1: System of Care Theory-Bas
Page 9 and 10: Figure 2: Timeline of System of Car
Page 11 and 12: In addition, at the request of SAMH
Page 13 and 14: Table 2: Core Components of the Nat
Page 15: Table 4: Baseline Characteristics:
Page 19 and 20: Figure 4: Change in Caregiver Repor
Page 21 and 22: Figure 6: Change in Children’s or
Page 23 and 24: Caregiver Adequacy of Available Tim
Page 25 and 26: months after entering systems of ca
Page 27 and 28: Figure 11: Change in Percentage of
Page 29 and 30: Youth were least satisfied with the
Page 31 and 32: Figure 15: Average Infrastructure R
Page 33 and 34: How Well Are Communities Implementi
Page 35 and 36: Organizational characteristics, suc
Page 37 and 38: To What Extent Do Systems of Care I
Page 39 and 40: Sustainability Strategies (continue
Page 41 and 42: child’s mental health needs are m
Page 43 and 44: References Achenbach, T. M. (1991).
Page 45 and 46: Reynolds, C. R., & Richmond, B. O.
Page 47 and 48: Appendices
Page 49 and 50: Practice-Based Evidence: Practice-b
Page 51 and 52: Appendix B System of Care Communiti
Page 53 and 54: Project Name Catchment Area State Y
Page 55 and 56: Project Name Catchment Area State P
Page 57 and 58: Nak-Nu-Wit Project Name Catchment A
Page 59 and 60: Funded Communities Date Number 1993
Page 61 and 62: Definition of Indicators Child and
Page 63 and 64: 2006-2008 Annual Report to Congress
Page 65 and 66: Appendix D National Evaluation Comp
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National Evaluation Study Component
Page 69 and 70:
Appendix E Descriptive and Outcomes
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2006-2008 Annual Report to Congress
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Demographic Characteristics, Clinic
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Table E-4: Baseline Child and Famil
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Table E-4: Baseline Child and Famil
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Table E-5: Baseline Characteristics
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