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Zhang Y, Larson M, Ehrhart MG, King K, Locke J, Cook CR, Lyon AR. Inter-organizational alignment and implementation outcomes in integrated mental healthcare for children and adolescents: a cross-sectional observational study. Implement Sci 2024; 19:36. [PMID: 38802827 PMCID: PMC11129427 DOI: 10.1186/s13012-024-01364-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 05/01/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Integrated care involves care provided by a team of professionals, often in non-traditional settings. A common example worldwide is integrated school-based mental health (SBMH), which involves externally employed clinicians providing care at schools. Integrated mental healthcare can improve the accessibility and efficiency of evidence-based practices (EBPs) for vulnerable populations suffering from fragmented traditional care. However, integration can complicate EBP implementation due to overlapping organizational contexts, diminishing the public health impact. Emerging literature suggests that EBP implementation may benefit from the similarities in the implementation context factors between the different organizations in integrated care, which we termed inter-organizational alignment (IOA). This study quantitatively explored whether and how IOA in general and implementation context factors are associated with implementation outcomes in integrated SBMH. METHODS SBMH clinicians from community-based organizations (CBOs; nclinician = 27) and their proximal student-support school staff (nschool = 99) rated their schools and CBOs (clinician only) regarding general (organizational culture and molar climate) and implementation context factors (Implementation Climate and Leadership), and nine common implementation outcomes (e.g., treatment integrity, service access, acceptability). The levels of IOA were estimated by intra-class correlations (ICCs). We fitted multilevel models to estimate the standalone effects of context factors from CBOs and schools on implementation outcomes. We also estimated the 2-way interaction effects between CBO and school context factors (i.e., between-setting interdependence) on implementation outcomes. RESULTS The IOA in general context factors exceeded those of implementation context factors. The standalone effects of implementation context factors on most implementation outcomes were larger than those of general context factors. Similarly, implementation context factors between CBOs and schools showed larger 2-way interaction effects on implementation outcomes than general context factors. CONCLUSIONS This study preliminarily supported the importance of IOA in context factors for integrated SBMH. The findings shed light on how IOA in implementation and general context factors may be differentially associated with implementation outcomes across a broad array of integrated mental healthcare settings.
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Affiliation(s)
- Yanchen Zhang
- College of Education, University of Iowa, 240 S Madison St, Iowa City, IA, 52242, USA.
| | - Madeline Larson
- Center for Applied Research and Educational Improvement, University of Minnesota, Minneapolis, USA
| | - Mark G Ehrhart
- Department of Psychology, University of Central Florida, Orlando, USA
| | - Kevin King
- Department of Psychology, University of Washington, Seattle, USA
| | - Jill Locke
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, USA
| | - Clayton R Cook
- Department of Educational Psychology, University of Minnesota, Minneapolis, USA
| | - Aaron R Lyon
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, USA
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McClendon J, Salem AM, Mallorca MY, McBride AB. Spotlight on Juvenile Justice: Intersecting the Child Welfare System. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00116-3. [PMID: 38460747 DOI: 10.1016/j.jaac.2024.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 01/07/2024] [Accepted: 02/29/2024] [Indexed: 03/11/2024]
Abstract
The authors disclose that this is a fictional case created by the authors. Julian, a 16-year-old adolescent who entered the juvenile justice system facing armed robbery charges, was 8 years old when he entered the child welfare system. He and his younger sister, Jessica, were placed in protective custody after school staff discovered that they were physically abused and witnessed domestic violence. Jessica further disclosed sexual abuse by the mother's boyfriend who was subsequently incarcerated. The siblings were placed together in several foster homes until a biological aunt assumed custody for 2 years. Both children struggled with behavioral problems in school and at home and responded to mental health treatment. The mother participated in substance use treatment, and the children reunified with her by the time Julian was 11 years old.
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Affiliation(s)
- Jasmine McClendon
- University of California, Davis, UC Davis Medical Center, Sacramento, California.
| | | | - Marcia Y Mallorca
- University of California, Davis, UC Davis Medical Center, Sacramento, California
| | - Anne B McBride
- University of California, Davis, UC Davis Medical Center, Sacramento, California
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Yousefi Nooraie R, Qin Q, Wagg A, Berta W, Estabrooks C. Building a communication and support network among quality improvement teams in nursing homes: a longitudinal study of the SCOPE trial. Implement Sci Commun 2024; 5:19. [PMID: 38438921 PMCID: PMC10913450 DOI: 10.1186/s43058-024-00559-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 02/20/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND We applied a longitudinal network analysis approach to assess the formation of knowledge sharing and collaboration networks among care aide-led quality improvement (QI) teams in Canadian nursing homes participating in the Safer Care for Older Persons (in residential) Environments (SCOPE) trial which aimed to support unregulated front-line staff to lead unit-based quality improvement (QI) teams in nursing homes. We hypothesized that SCOPE's communicative and participatory nature would provide opportunities for peer support, knowledge sharing, and collaboration building among teams. METHODS Fourteen QI teams in Alberta (AB) and seventeen QI teams in British Columbia (BC) participated in the study. Communications across nursing homes occurred through a series of 4 collaborative Learning Congresses (training sessions) over a 1-year period. The senior leaders of QI teams participated in two online network surveys about the communication/collaboration between teams in their province, 1 month after the first, and 6 months later, after the fourth Learning Congress. We developed communication and collaboration network maps pertaining to three time points: before SCOPE, at 2 months, and at 9 months. RESULTS Over time, teams made significantly more new connections and strengthened existing ones, within and across regions. Geographic proximity and co-membership in organizational chains were important predictors of connectivity before and during SCOPE. Teams whose members were well connected at baseline disproportionately improved connectivity over time. On the other hand, teams that did not have prior opportunities to connect appeared to use SCOPE to build new ties. CONCLUSIONS Our findings suggest the importance of network-altering activities to the formation of collaboration networks among QI teams across nursing homes. Active strategies could be used to better connect less connected teams and facilitate collaboration among geographically proximate teams. These findings may inform the development of interventions to leverage existing networks and provide new networking opportunities to develop and sustain organizational improvements.
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Affiliation(s)
- Reza Yousefi Nooraie
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA.
| | - Qiuyuan Qin
- Department of Public Health Sciences, University of Rochester, Rochester, NY, USA
| | - Adrian Wagg
- Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Whitney Berta
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, ON, Canada
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Scaggs SJA, Starseed SC, Kluckman M, Tueller S, Yu L. A state-wide analysis of characteristics and predictors of dual system involvement among child victims of human trafficking. CHILD ABUSE & NEGLECT 2024; 147:106530. [PMID: 37979486 DOI: 10.1016/j.chiabu.2023.106530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 10/17/2023] [Accepted: 10/30/2023] [Indexed: 11/20/2023]
Abstract
BACKGROUND The child welfare system is pivotal in identifying and responding to child (younger than age 18) human trafficking victims. Children who have experienced human trafficking-or are at risk of victimization-are increasingly recognized as also being served in the juvenile justice system. Yet little is known about human trafficking victimization among children in the juvenile justice population or among children with child welfare and juvenile justice involvement. OBJECTIVE Building on previous research with child welfare-and juvenile justice-involved children, we investigated characteristics and system experiences among children who have experienced a human trafficking abuse allegation in Florida. PARTICIPANTS AND SETTING The overall study population included all children born on or after January 1, 1993, who had at least one DCF-documented maltreatment allegation before March 1, 2020. This study examined a total of 12,167 allegations in the first set of analyses and the first human trafficking allegation for each child (N = 9300) in the second set of analyses. METHODS Analyses are based on linked administrative data for a cohort of children involved with Florida's Departments of Juvenile Justice (DJJ) and/or Children and Families (DCF). We used descriptive and multivariate logistic regression analyses to document the characteristics of single and dual system-involved children and examine predictors of child welfare, juvenile justice, and dual system involvement. RESULTS (1) Nearly half of children with a human trafficking abuse allegation are involved in DCF at the time of the allegation, (2) females who experienced trafficking are more likely to be involved in DCF (with or without DJJ involvement) than involved in no system, (3) Black children with an alleged trafficking incident were more likely than White children to be involved in both systems compared with DCF only, and (4) children who experienced labor trafficking abuse allegations were less likely than those who experienced sex trafficking to be involved with either system. CONCLUSIONS This study depicts child victims of sex and labor trafficking who are involved with one or both systems in one state.
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Affiliation(s)
- Samuel J A Scaggs
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States.
| | - Stacey Cutbush Starseed
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States
| | - Marianne Kluckman
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States
| | - Stephen Tueller
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States
| | - Lilly Yu
- RTI International, 3040 E. Cornwallis Road, P.O. Box 12194, Research Triangle Park, NC 27709, United States
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Knight DK, Funk RR, Belenko S, Dennis M, Wiese AL, Bartkowski JP, Dembo R, Elkington KS, Flynn PM, Harris PW, Hogue A, Palinkas LA, Robertson AA, Scott CK. Results of a national survey of substance use treatment services for youth under community supervision. HEALTH & JUSTICE 2023; 11:29. [PMID: 37515602 PMCID: PMC10385917 DOI: 10.1186/s40352-023-00233-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 07/17/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Despite the heightened risk for substance use (SU) among youth in the juvenile justice system, many do not receive the treatment that they need. OBJECTIVES The purpose of this study is to examine the extent to which youth under community supervision by juvenile justice agencies receive community-based SU services and the factors associated with access to such services. METHODS Data are from a nationally representative sample of Community Supervision (CS) agencies and their primary behavioral health (BH) partners. Surveys were completed by 192 CS and 271 BH agencies. RESULTS SU services are more often available through BH than CS for all treatment modalities. EBPs are more likely to be used by BH than by CS. Co-location of services occurs most often in communities with fewer treatment options and is associated with higher interagency collaboration. Youth are more likely to receive services in communities with higher EBP use, which mediates the relationship between the availability of SU treatment modalities and the proportion of youth served. CONCLUSION Findings identify opportunities to strengthen community systems and improve linkage to care.
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Affiliation(s)
- Danica K Knight
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Avenue, Fort Worth, TX, 76129, USA.
| | - Rod R Funk
- Chestnut Health Systems, 1003 Martin Luther King Jr. Drive, Bloomington, IL, 61701, USA
| | - Steven Belenko
- Temple University, 1801 N. Broad Street, Philadelphia, PA, 19122, USA
| | - Michael Dennis
- Chestnut Health Systems, 448 Wylie Drive, Normal, IL, 61761, USA
| | - Amanda L Wiese
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Avenue, Fort Worth, TX, 76129, USA
| | - John P Bartkowski
- University of Texas at San Antonio, 1 UTSA Circle, San Antonio, TX, 78248, USA
| | - Richard Dembo
- University of Southern Florida, 4202 E. Fowler Avenue, Tampa, FL, 33620, USA
| | - Katherine S Elkington
- Columbia University and New York State Psychiatric Institute, 1051 Riverside Drive, New York, NY, 10032, USA
| | - Patrick M Flynn
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Avenue, Fort Worth, TX, 76129, USA
| | - Philip W Harris
- Temple University, 1801 N. Broad Street, Philadelphia, PA, 19122, USA
| | - Aaron Hogue
- Partnership to End Addiction, Family and Adolescent Clinical Technology & Science (FACTS), 485 Lexington Avenue, 3rd Floor, New York, NY, 10017, USA
| | - Lawrence A Palinkas
- University of Southern California, 669 W. 34th Street, Los Angeles, CA, 90089, USA
| | - Angela A Robertson
- Mississippi State University, 1 Research Blvd., Suite 103, Starkville, MS, 39759, USA
| | - Christy K Scott
- Lighthouse Institute, Chestnut Health Systems, 221 W. Walton, Chicago, IL, 60610, USA
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Purtle J, Nelson KL, Lengnick‐Hall R, Horwitz SMC, Palinkas LA, McKay MM, Hoagwood KE. Inter-agency collaboration is associated with increased frequency of research use in children's mental health policy making. Health Serv Res 2022; 57:842-852. [PMID: 35285023 PMCID: PMC9264471 DOI: 10.1111/1475-6773.13955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 02/08/2022] [Accepted: 02/10/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To determine whether the self-report frequency of inter-agency collaboration about children's mental health issues is associated with the self-report frequency of using research evidence in children's mental health policy and program decision making in mental health agencies (MHAs). DATA SOURCES Primary data were collected through web-based surveys of state (N = 221) and county (N = 117) MHA officials. DESIGN The primary independent variable was a composite score quantifying the frequency of collaboration about children's mental health issues between officials in MHAs and six other state agencies. The dependent variables were composite scores quantifying the frequency of research use in children's mental health policy and program decision making in general and for specific purposes (i.e., conceptual, instrumental, tactical, imposed). Covariates were composite scores quantifying well-established determinants of research use (e.g., agency leadership, research use skills) in agency policy and program decision making. DATA METHODS Separate multiple linear regression models estimated associations between frequency of inter-agency collaboration and research use scores, adjusting for other determinants of research use, respondent state, and other covariates. Data from state and county officials were analyzed separately. PRINCIPAL FINDINGS The frequency of inter-agency collaboration was positively and independently associated with the frequency of research use in children's mental health policy making among state (β = 0.22, p = 0.004) and county (β = 0.39, p < 0.0001) MHA officials. Inter-agency collaboration was also the only variable significantly associated with the frequency of research use for all four specific purposes among state MHA officials, and similar findings we observed among county MHA officials. The magnitudes of associations between inter-agency collaboration and frequency of research use were generally stronger than for more well-established determinants of research use in policy making. CONCLUSIONS Strategies that promote collaboration between MHA officials and external agencies could increase the use of research evidence in children's mental health policy and program decision making in MHAs.
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Affiliation(s)
- Jonathan Purtle
- Department of Public Health Policy & ManagementSchool of Global Public Health, Global Center for Implementation Science, New York UniversityNew YorkNew YorkUSA
| | - Katherine L. Nelson
- Department of Health Management and PolicyDrexel University Dornsife School of Public HealthPhiladelphiaPennsylvaniaUSA
| | | | - Sarah Mc Cue Horwitz
- Department of Child and Adolescent PsychiatryNew York University School of MedicineNew YorkNew YorkUSA
| | - Lawrence A. Palinkas
- Suzanne Dworak‐Peck School of Social WorkUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Mary M. McKay
- Washington University in St. Louis, Brown SchoolSt. LouisMissouriUSA
| | - Kimberly E. Hoagwood
- Department of Child and Adolescent PsychiatryNew York University School of MedicineNew YorkNew YorkUSA
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Alfandari R, Taylor BJ. Community-based multi-professional child protection decision making: Systematic narrative review. CHILD ABUSE & NEGLECT 2022; 123:105432. [PMID: 34922154 DOI: 10.1016/j.chiabu.2021.105432] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/29/2021] [Accepted: 12/02/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Multi-professional approach to child protection decision making is widely promoted by service organisations, although the conditions for this to be effective are little known. OBJECTIVE This systematic narrative literature review explored empirical evidence on the implementation of multi-professional child protection decision making in community settings. Of particular interest were the contextual conditions upon which joint working is build (inputs), aspects of interactional functioning (mediators), and the results of working together (outputs). PARTICIPANTS AND SETTING Five electronic bibliographic databases were selected for the search. The review was restricted to articles published in peer-reviewed journals, in the English language for ten years, from 1st January 2010 to 31st December 2019. Of the 6934 studies retrieved, 30 studies undertaken in six countries were included. METHODS The systematic approach to literature reviewing utilised was 'Systematic Narrative Review'. This approach starts with clearly formulated questions, employs systematic, explicit, and replicable processes for searching the literature to retrieve research, retains quality appraisal limited to publications in peer-reviewed journals, and uses a narrative synthesis. RESULTS The analysis outlined key building blocks that form the structure for collaborative decision making and identified cognitive, relational, and behavioural interactional properties that occur when making decisions together. Limitations of the published literature hinder the ability of making robust inferences about outcomes of collaborative decision-making practice. CONCLUSION The article discusses the next steps for research and implications for policy and practice for promoting useful multi-professional working in child protection decision making in the community.
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Affiliation(s)
| | - Brian J Taylor
- School of Applied Social and Policy Sciences, Ulster University, Northern Ireland.
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Bunger AC, Maguire-Jack K, Yoon S, Mooney D, West KY, Hammond GC, Kranich C. Does mental health screening and assessment in child welfare improve mental health service receipt, child safety, and permanence for children in out-of-home care? An evaluation of the Gateway CALL demonstration. CHILD ABUSE & NEGLECT 2021; 122:105351. [PMID: 34628151 DOI: 10.1016/j.chiabu.2021.105351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/22/2021] [Accepted: 09/28/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Unmet mental health service needs among children in out-of-home care are sometimes attributed to poor assessments and referrals in child welfare. The Gateway CALL project implemented mental health screening, diagnostic assessment, and referral to treatment practices. OBJECTIVE We examined the effectiveness of Gateway CALL for improving children's mental health service receipt, safety, and permanency outcomes. PARTICIPANTS AND SETTING Participants included 538 children (birth to 18 years) in out-of-home placements through a county-based child welfare agency over a 17-month period. METHODS We compared the mental health service receipt, safety, and permanency outcomes for 175 children who received Gateway CALL with 175 children who received "services as usual" identified through propensity score matching. Participant demographics, safety, and permanency outcomes were drawn from child welfare administrative records, and mental health service visits and diagnoses were drawn from Medicaid billing records. RESULTS Gateway CALL appeared to increase the number of mental health service visits children received (z = 2.14, p = 0.032), although not the likelihood of receiving services. In terms of child safety, children in Gateway CALL had a greater number of screened-in calls after the intervention than those in the comparison group [t(348) = -1.92, p = 0.03]; there were no differences in substantiations. There were also no observed effects on permanency. CONCLUSIONS Despite systematic efforts to identify, assess, and refer children to mental health services through the Gateway CALL intervention, substantial unmet mental health service needs among children persisted. Results have implications for designing interventions that promote cross-system service access.
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Affiliation(s)
- Alicia C Bunger
- College of Social Work, The Ohio State University, 1947 College Road, Columbus, OH 43210, USA.
| | - Kathryn Maguire-Jack
- School of Social Work, University of Michigan, 1080 S. University Avenue, Ann Arbor, MI 48109, USA
| | - Susan Yoon
- College of Social Work, The Ohio State University, 1947 College Road, Columbus, OH 43210, USA
| | | | - Kristopher Y West
- Nationwide Children's Hospital, 495 East Main Street, Columbus, OH 43215, USA
| | | | - Christiana Kranich
- College of Social Work, The Ohio State University, 1947 College Road, Columbus, OH 43210, USA
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Akin BA, Collins-Camargo C, Strolin-Goltzman J, Antle B, Nathan Verbist A, Palmer AN, Krompf A. Screening for trauma and behavioral health needs in child welfare: Practice implications for promoting placement stability. CHILD ABUSE & NEGLECT 2021; 122:105323. [PMID: 34537626 DOI: 10.1016/j.chiabu.2021.105323] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 08/29/2021] [Accepted: 09/02/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Although the child welfare field has initiated efforts to use standardized screening for trauma and behavioral health needs, research has rarely examined whether these screenings have influenced permanency outcomes. OBJECTIVE Using data from three states' federal demonstration projects, we examined whether receipt of trauma and behavioral health screening and results of screening were associated with placement stability (i.e., fewer placements). Our inquiry focused on whether similar patterns of statistical associations would be observed in three distinct state settings. PARTICIPANTS AND SETTING Samples comprised children in out-of-home care in three states newly implementing trauma and behavioral health screening. The states included a South Central state, New England state, and a Central Midwestern state. RESULTS In all three states, findings showed children who received screening had a higher number of placements (i.e., placement instability). Likewise, all three states found that children whose screening results indicated greater need, such as higher number of trauma symptoms or lower behavioral health functioning, were more likely to experience a higher number of placements (i.e., placement instability). CONCLUSION Despite differences in screening tools and state-specific approaches, findings suggest that early screenings may provide important information that could be used to identify children's needs, make appropriate service referrals, establish well-matched placements, and support resource parents and birth parents toward better permanency outcomes. Regardless of potential benefits of early screening, it may be underutilized in the field. Future research is needed to replicate these findings and continue to build an evidence base for trauma and behavioral health screening.
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Affiliation(s)
- Becci A Akin
- University of Kansas School of Social Welfare, 1545 Lilac Lane, Twente Hall, Lawrence, KS 66045, USA.
| | - Crystal Collins-Camargo
- University of Louisville, Kent School of Social Work, 2217 S 3rd, Julius John Oppenheimer Hall St, Louisville, KY 40292, USA
| | - Jessica Strolin-Goltzman
- University of Vermont, College of Education and Social Services, 309 Waterman Building, 85 South Prospect Street, Burlington, VT 05405, USA
| | - Becky Antle
- University of Louisville, Kent School of Social Work, 2217 S 3rd, Julius John Oppenheimer Hall St, Louisville, KY 40292, USA
| | - A Nathan Verbist
- Centerstone Research Institute, Inc., 44 Vantage Way, Nashville, TN 37228, USA
| | - Ashley N Palmer
- University of Texas at Arlington School of Social Work, 211 S Cooper St, Arlington, TX 76019, USA
| | - Alison Krompf
- University of Vermont, College of Education and Social Services, 309 Waterman Building, 85 South Prospect Street, Burlington, VT 05405, USA
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Modrowski CA, Chaplo SD, Kerig PK. Advancing Our Understanding of the Risk Factors Associated with Crossover Youth in the Child Welfare and Juvenile Justice Systems: A Trauma-Informed Research Agenda. Clin Child Fam Psychol Rev 2021; 25:283-299. [PMID: 34518924 DOI: 10.1007/s10567-021-00370-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 12/28/2022]
Abstract
Previous research has provided robust evidence demonstrating that a notable proportion of youth become involved in both the child welfare (CW) system and the juvenile justice (JJ) system, a population often referred to as crossover youth. Prior work has identified a number of risk factors associated with crossing over between these systems. However, there are limitations to the extant literature, key among which is a lack of systematic attention to the influence of trauma exposure and posttraumatic sequelae on the crossover trajectory. In contrast, viewing this research through a trauma-informed lens promises to enhance our ability to integrate findings across studies and to derive theoretically derived hypotheses about underlying mechanisms which will better inform future research and the development of effective prevention and intervention efforts. Accordingly, the purpose of this article is to present a trauma-informed research agenda that would strengthen future research in the field. After providing a brief critique of the existing studies that has documented known risk factors associated with the crossover population, we outline ways in which future research could apply relevant theoretical trauma-informed approaches, including developmental traumatology, to further advance our knowledge of risk factors and mechanisms associated with the crossover trajectory. We conclude by discussing policy and system-wide implications related to the proposed research agenda.
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Affiliation(s)
- Crosby A Modrowski
- Alpert Medical School, Brown University/Bradley Hasbro Children's Research Center, 1 Hoppin Street, Suite 204, Providence, RI, 02903, USA.
| | - Shannon D Chaplo
- Frank Porter Graham Child Development Institute, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Patricia K Kerig
- Department of Psychology, University of Utah, Salt Lake City, UT, 84112, USA
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Gopalan G, Kerns SEU, Horen MJ, Lowe J. Partnering for Success: Factors Impacting Implementation of a Cross-Systems Collaborative model Between Behavioral Health and Child Welfare. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2021; 48:839-856. [PMID: 33861385 DOI: 10.1007/s10488-021-01135-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
Abstract
Cross-system implementation efforts can support needed mental health (MH) service utilization among children involved in the child welfare (CW) system. The Partnering for Success (PfS) initiative is one such effort that promotes greater collaboration between the CW and MH providers by building capacity within and across each system. Frontline CW providers learn to accurately identify child MH treatment targets, link families to locally-provided evidence-based treatments (EBTs), and monitor treatment progress. Concurrently, local MH providers are trained along with CW workers to utilize Cognitive Behavioral Therapy plus Trauma-Focused CBT (CBT +), a common elements training and consultation approach focusing on typical MH issues for CW-involved children: Anxiety, Depression, Behavioral Problems, and Traumatic Stress. Finally, agency leadership receive support around promoting implementation and sustainment. This paper examines factors identified by participating CW and MH staff which impacted PfS implementation. Twenty-nine frontline, supervisory, and executive CW and MH providers were interviewed via audio-recorded web-based calls in six focus groups and 10 individual interviews. Factors facilitating implementation success included training/consultation, support from supervisors and agency leadership, improved referral processes, high quality relationships and communication between CW and MH frontline staff, PfS tools and resources, opportunities to use PfS, as well as buy-in from providers and families. Implementation barriers included poor communication between CW and MH providers, conflicts over role expectations, workload and turnover challenges, lack of buy-in, as well as provider (e.g., not aligned with CBT +) and client characteristics (e.g., frequent crises).
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Affiliation(s)
- Geetha Gopalan
- Silberman School of Social Work, Hunter College, City University of NewYork, 2180 3rd Avenue, New York, NY, 10035, USA.
| | | | | | - Jennie Lowe
- Mid-Atlantic Behavioral Health, Wilmington, DE, USA
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Welsh WN, Dembo R, Lehman WEK, Bartkowski JP, Hamilton L, Leukefeld CG, Wiley T. Critical Factors Influencing Interorganizational Relationships Between Juvenile Probation and Behavioral Health Agencies. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2021; 48:233-249. [PMID: 32666324 PMCID: PMC7854784 DOI: 10.1007/s10488-020-01066-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Although interorganizational relationships (IORs) are essential to the effective delivery of human services, very little research has examined relationships between juvenile justice agencies and behavioral health providers, and few studies have identified the most critical organizational and individual-level characteristics influencing IORs. Across 36 sites, juvenile probation officials (n = 458) and community behavioral health providers (n = 91) were surveyed about characteristics of their agencies, themselves, and IORs with each other. Generalized Linear Mixed Models were used to analyze the data. The strongest predictors included Perceived Organizational Support and individual Adaptability. Implications for research, theory and practice are discussed.
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Affiliation(s)
| | | | | | | | | | | | - Tisha Wiley
- National Institute On Drug Abuse, North Bethesda, USA
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13
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Waldo JA, Henderson C, Dauber S, Hogue A. DIfferences in Treatment Trajectories Between Two Profiles of Adolescent Systems Involvement. CHILDREN AND YOUTH SERVICES REVIEW 2021; 121:105811. [PMID: 33446943 PMCID: PMC7802753 DOI: 10.1016/j.childyouth.2020.105811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Of adolescents utilizing behavioral health services, between 45% and 62% (Farmer et al., 2003; Merikangas et al., 2011) become involved in multiple systems (i.e., mental health, juvenile justice, child welfare, and education systems) to meet their behavioral health needs (e.g., Glisson & Green, 2006). Despite their involvement in treatment, these youths often still have unmet needs due to lack of integrated care across systems (e.g., Hawkins, 2009). Adolescent behavior problems may be conceptualized differently to account for the unique needs of youth involved in multiple systems. Using a sample of 433 youth in need of behavioral health treatment services, we: (1) identified distinct classes of systems involvement across four systems, (2) compared youth comprising these classes on demographics and DSM-IV diagnoses, and (3) examined changes in delinquency and substance use over time among the youth comprising the systems involvement class groupings. Using latent class analysis, we identified two distinct classes of adolescent systems involvement: one with heavy involvement in all systems and the other with high involvement in only the education and mental health systems. Latent growth curve analyses using most likely class membership as a predictor demonstrated that adolescents with heavy involvement in all systems showed significantly more decreases in delinquent activity than comparison youth, but less decreases in substance use over a one-year follow-up period. Our findings support that it is clinically useful to examine classes of multiple systems involvement. Treatment providers can use these findings identify whether or not their clients are heavily involved in all systems and tailor their approach accordingly. In addition, researchers can continue to parse out differences in treatment trajectories for multiple systems involved youth as well as the various factors impacting these differences.
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Affiliation(s)
| | - Craig Henderson
- Sam Houston State University, Campus Box 2447, Huntsville, TX 77341
| | - Sarah Dauber
- Center on Addiction, 485 Lexington Avenue, New York, NY 10017
| | - Aaron Hogue
- Center on Addiction, 485 Lexington Avenue, New York, NY 10017
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14
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Bath E, Barnert E, Godoy S, Hammond I, Mondals S, Farabee D, Grella C. Substance Use, Mental Health, and Child Welfare Profiles of Juvenile Justice-Involved Commercially Sexually Exploited Youth. J Child Adolesc Psychopharmacol 2020; 30:389-397. [PMID: 32213099 PMCID: PMC7409582 DOI: 10.1089/cap.2019.0057] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objectives: To describe the substance use profiles of youth impacted by commercial sexual exploitation (CSE) and explore associations between substance use with mental health diagnoses and child welfare involvement. Methods: Data were systematically extracted from the court files of 364 youth who participated between 2012 and 2016 in Los Angeles County's Succeeding Through Achievement and Resilience (STAR) Court, a juvenile delinquency specialty court for youth impacted by CSE. Descriptive statistics and multivariate regression analyses were conducted to quantify associations between youths' substance use with mental health diagnoses and child welfare involvement. Results: Of the 364 youth impacted by CSE involved in the STAR Court, 265 youth had documented contact with a psychiatrist while in court-of whom, 73% were diagnosed with at least one mental health challenge. Before STAR Court participation, 74% of youth were the subject of one or more child welfare referral; of these youth, 75% had prior out-of-home care. Eighty-eight percent of youth reported substance use, the most prevalent illicit substances were marijuana (87%), alcohol (54%), and methamphetamine (33%). Controlling for age and race, youth impacted by CSE with a diagnosed general mood disorder had more than five times the odds of reporting substance use compared with those without a mood disorder diagnosis (adjusted odds ratio [AOR]: 5.80; 95% confidence interval CI: 2.22-18.52; p < 0.001); and youth impacted by CSE with prior child welfare placements had more than two times the odds of reporting substance use (AOR: 2.24; 95% CI: 1.04-4.86; p = 0.039) compared with youth without prior placements. The association between substance use and general mood disorder was significant and positive for all substance use types (AOR = 3.3, p = 0.033 marijuana; AOR = 4.01, p = 0.011 concurrent alcohol and marijuana; AOR = 9.2, p < 0.001, polysubstance use). Conclusions: High prevalence of substance use among juvenile justice-involved youth impacted by CSE combined with strong associations between substance use with both mental health diagnoses and child welfare system history underscores the need for comprehensive, specialized substance use treatment. Findings suggest an important opportunity for multidisciplinary collaboration among mental health providers, child welfare professionals, juvenile justice practitioners, and other care providers for these youth.
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Affiliation(s)
- Eraka Bath
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, California, USA
| | - Elizabeth Barnert
- Department of Pediatrics, David Geffen School of Medicine at UCLA and Mattel Children's Hospital, Los Angeles, California, USA
| | - Sarah Godoy
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
- Jane and Terry Semel Institute for Neuroscience and Human Behavior at UCLA, Los Angeles, California, USA
| | - Ivy Hammond
- School of Social Welfare, UC Berkeley, Berkeley, California, USA
| | - Sangeeta Mondals
- Research Data Analyst, Stanford School of Medicine, Stanford, California, USA
| | - David Farabee
- Department of Population Health, Langone School of Medicine, New York University, New York, New York, USA
| | - Christine Grella
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
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15
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So M, McCord RF, Kaminski JW. Policy Levers to Promote Access to and Utilization of Children's Mental Health Services: A Systematic Review. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2020; 46:334-351. [PMID: 30604005 DOI: 10.1007/s10488-018-00916-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Policies have potential to help families obtain behavioral healthcare for their children, but little is known about evidence for specific policy approaches. We reviewed evaluations of select policy levers to promote accessibility, affordability, acceptability, availability, or utilization of children's mental and behavioral health services. Twenty articles met inclusion criteria. Location-based policy levers (school-based services and integrated care models) were associated with higher utilization and acceptability, with mixed evidence on accessibility. Studies of insurance-based levers (mental health parity and public insurance) provided some evidence for affordability outcomes. We found no eligible studies of workforce development or telehealth policy levers, or of availability outcomes.
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Affiliation(s)
- Marvin So
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway MS-E88, Atlanta, 30341, GA, USA. .,Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA.
| | - Russell F McCord
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway MS-E88, Atlanta, 30341, GA, USA.,Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Jennifer W Kaminski
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Highway MS-E88, Atlanta, 30341, GA, USA
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16
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Van Dongen T, Sabbe B, Glazemakers I. Collaboration for children with complex needs: What adolescents, parents, and practitioners tell us. J Child Health Care 2020; 24:19-32. [PMID: 30686059 DOI: 10.1177/1367493518823906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Children with complex needs require coordinated care and collaboration between the different sectors in child mental health care. These needs and service issues are individually defined and therefore challenging for the mental health system to respond effectively. Different barriers at the organizational and policy level to initiate and maintain collaborative relationships are reported. This research explores the reality of working with a protocol for collaboration (Client Network Consultation (CNC)) by questioning the experiences of adolescents, parents, and practitioners. A qualitative design with semistructured individual interviews is used, guided by the questions from the Wraparound Fidelity Index. Useful and practical insights on effective collaboration result from the in-depth analysis of the interviews. A neutral chairperson, the presence of specialist practitioners, visualization, participation of adolescents, and parents are among the effective elements reported. Some challenges remain; the principle of equality, monitoring the action points resulting from the collaboration and effective crisis management seem very difficult to fully achieve in practice. These results present experiences from adolescents, parents, and practitioners to support an effective collaborative process for working together with children and families with complex needs.
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Affiliation(s)
| | | | - Inge Glazemakers
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Wilrijk, Belgium
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17
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Tung GJ, Williams VN, Ayele R, Shimasaki S, Olds D. Characteristics of effective collaboration: A study of Nurse-Family Partnership and child welfare. CHILD ABUSE & NEGLECT 2019; 95:104028. [PMID: 31229764 DOI: 10.1016/j.chiabu.2019.104028] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 05/20/2019] [Accepted: 05/31/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND In February 2018, President Trump signed into law the Family First Prevention Act, legislation in the United States aimed at providing prevention services for families at risk of entering the child welfare system. The effectiveness of these prevention efforts is dependent on the formation of collaborative relationships between prevention-programs and child welfare. OBJECTIVE To identify factors that influence the ability of the Nurse-Family Partnership (NFP) and Child Protective Services (CPS) to collaborate in serving high-risk mothers and their children. PARTICIPANTS 123 NFP, CPS workers, and community partners. SETTING Seven sites in the U.S. state of Colorado selected to include an array of community sizes, geographies, apparent levels of collaboration, and variations in internal structures and practices. METHODS Using an adapted grounded theory approach, we conducted semi-structured interviews with frontline NFP and CPS workers and supervisors. Interviews were recorded, transcribed, validated, and coded in NVivo 10. RESULTS Alignment of core organizational mission and methods was key in determining collaboration levels between NFP and CPS. Only when workers perceived there to be alignment in organizational mission, did other factors such as program eligibility, communication channels, and risk and safety assessment practices influence the perceived benefits and efforts undertaken to enhance collaboration. CONCLUSIONS High-risk families frequently require services that go beyond the scope of any one organization. As programs that serve high-risk families refine their efforts to serve them effectively, collaborative efforts should focus on examining opportunities and challenges involved in creating greater mission alignment.
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Affiliation(s)
- Gregory J Tung
- Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, CO, United States; Prevention Research Center for Family and Child Health, University of Colorado-Anschutz Medical Campus, Aurora, CO, United States.
| | - Venice N Williams
- Prevention Research Center for Family and Child Health, University of Colorado-Anschutz Medical Campus, Aurora, CO, United States
| | - Roman Ayele
- Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, CO, United States; Denver-Seattle Center of Innovation for Veteran-Centered & Value-Driven Care, VA Eastern Colorado Health Care System, Aurora, CO, United States
| | - Suzuho Shimasaki
- Colorado School of Public Health, University of Colorado-Anschutz Medical Campus, Aurora, CO, United States
| | - David Olds
- Prevention Research Center for Family and Child Health, University of Colorado-Anschutz Medical Campus, Aurora, CO, United States
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18
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Scott CK, Dennis ML, Grella CE, Funk RR, Lurigio AJ. Juvenile justice systems of care: results of a national survey of community supervision agencies and behavioral health providers on services provision and cross-system interactions. HEALTH & JUSTICE 2019; 7:11. [PMID: 31201642 PMCID: PMC6717998 DOI: 10.1186/s40352-019-0093-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 05/22/2019] [Indexed: 05/24/2023]
Abstract
BACKGROUND Youth involved in the juvenile justice (JJ) system have high needs for behavioral health services, especially related to substance use and mental disorders. This study aimed to understand the extent to which elements in the cascade model of behavioral health services for JJ-involved youth are provided to youth by Community Supervision (CS) and/or Behavioral Health (BH) providers. In order to understand interactions across CS and BH systems, this study used a multistage probabilistic survey design to sample CS agencies and their primary BH service providers of substance use and mental health treatment in the United States. Parallel surveys were administered to both CS and BH providers regarding: characteristics of youth served, BH services available, whether services were provided directly and/or by referral, use of evidence-based practices (EBPs), and methods of collaboration, referral, and information exchange across CS and BH providers. RESULTS The findings from weighted national estimates demonstrate that youth referred from CS to the BH programs represent a more severe sub-group of youth under CS supervision. There are established cross-system relationships for assessment and referral for substance use and mental health treatment, but less so for prevention services. Most CS programs refer youth to BH providers for these services, which typically utilize more highly trained staff to provide EBPs to a majority of the youth served. More intensive substance use and mental health treatment, aftercare, and recovery support services were limited in availability. CONCLUSIONS The findings suggest that although many elements in a cascade model of BH services for JJ-involved youth have been implemented within local systems of care through collaboration between CS and BH providers, there are several underdeveloped areas and potential for attrition across the service cascade. Greater attention to providing services to youth with higher levels of severity, aftercare services, and recovery support is warranted within a multi-systemic framework.
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Affiliation(s)
- Christy K Scott
- Chestnut Health Systems, 221 W. Walton St., Chicago, IL, 60610, USA.
| | - Michael L Dennis
- Chestnut Health Systems, 221 W. Walton St., Chicago, IL, 60610, USA
| | | | - Rodney R Funk
- Chestnut Health Systems, 221 W. Walton St., Chicago, IL, 60610, USA
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19
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Herbert JL, Bromfield L. Better Together? A Review of Evidence for Multi-Disciplinary Teams Responding to Physical and Sexual Child Abuse. TRAUMA, VIOLENCE & ABUSE 2019; 20:214-228. [PMID: 29334012 DOI: 10.1177/1524838017697268] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Multi-Disciplinary teams (MDTs) have often been presented as the key to dealing with a number of intractable problems associated with responding to allegations of physical and sexual child abuse. While these approaches have proliferated internationally, researchers have complained of the lack of a specific evidence base identifying the processes and structures supporting multi-disciplinary work and how these contribute to high-level outcomes. This systematic search of the literature aims to synthesize the existing state of knowledge on the effectiveness of MDTs. This review found that overall there is reasonable evidence to support the idea that MDTs are effective in improving criminal justice and mental health responses compared to standard agency practices. The next step toward developing a viable evidence base to inform these types of approaches seems to be to more clearly identify the mechanisms associated with effective MDTs in order to better inform how they are planned and implemented.
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Affiliation(s)
- James Leslie Herbert
- 1 Australian Centre for Child Protection, University of South Australia, Adelaide, South Australia, Australia
| | - Leah Bromfield
- 1 Australian Centre for Child Protection, University of South Australia, Adelaide, South Australia, Australia
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20
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Colvin ML, Thompson HM. Exploring the Experiences of Child Welfare-Focused Therapeutic Service Providers. J Behav Health Serv Res 2019; 47:86-101. [PMID: 30887414 PMCID: PMC7224150 DOI: 10.1007/s11414-019-09654-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The importance of mental and behavioral health for child welfare clients is well-documented; yet, little is known about the challenges therapeutic service providers (TSPs) experience working in child welfare practice. To explore this topic, five focus groups were conducted with 40 TSPs in a contracted mental and behavioral health agency and data were analyzed following an inductive thematic process. Eleven primary challenges were identified, including the difficulty of navigating numerous involved parties, an overwhelmed work environment, legal intersections common to child welfare cases, unrealistic agency expectations, and heighten case complexity when working with child welfare populations. Findings are organized across system, agency, and client levels and add to the understanding of TSP perspectives working with child welfare. Targeted interventions are discussed, such as efforts to promote realistic expectations and training strategies, as well as directions for future research to improve the intersection between child welfare and mental and behavioral health.
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Affiliation(s)
- Marianna L Colvin
- School of Social Work, SO303, Florida Atlantic University, 777 Glades Rd, Boca Raton, FL, 33431, USA.
| | - Heather M Thompson
- School of Social Work, SO303, Florida Atlantic University, 777 Glades Rd, Boca Raton, FL, 33431, USA
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21
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Vidal S, Connell CM, Prince DM, Tebes JK. Multisystem-Involved Youth: A Developmental Framework and Implications for Research, Policy, and Practice. ADOLESCENT RESEARCH REVIEW 2019; 4:15-29. [PMID: 30854418 PMCID: PMC6404973 DOI: 10.1007/s40894-018-0088-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 06/23/2018] [Indexed: 05/29/2023]
Abstract
Multisystem-involved youth are children and adolescents concurrently served in the child welfare, behavioral health, and/or juvenile justice systems. These youth are a high risk and vulnerable population, often due to their experience of multiple adversities and trauma, yet little is known about their multiple needs and pathways into multisystem involvement. Multisystem-involved youth present unique challenges to researchers, practitioners, and policymakers. In this article, we summarize the literature on multisystem-involved youth, including prevalence, characteristics, risk factors, and disparities for this population. We then describe a developmental cascade framework, which specifies how exposure to adverse experiences in childhood may have a "cascading" or spillover effect later in development, to depict pathways of multisystem involvement and opportunities for intervention. This framework offers a multidimensional view of involvement across service systems and illustrates the complexities of relationships between micro- and macro-level factors at various stages and domains of development. We conclude that multisystem-involved youth are an understudied population that may represent majority of youth who are already served in another service system. Many of these youth are also disproportionately from racial and ethnic minority backgrounds. Currently, for multisystem-involved youth and their families, there is a lack of standardized and integrated screening procedures to identify youth with open cases across service systems; inadequate use of available instruments to assess exposure to complex trauma; inadequate clinical and family-related evidence-based practices specifically for use with this population; and poor cross-systems collaboration and coordination that align goals and targeted outcomes across systems. We make recommendations for research, practice, and systems development to address the needs of multisystem-involved youth and their families.
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22
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Franz DJ, Griffin AM, Saldana L, Leve LD. A Longitudinal Examination of Service Utilization and Trauma Symptoms among Young Women with Prior Foster Care and Juvenile Justice System Involvement. CHILD WELFARE 2019; 97:199-215. [PMID: 32308211 PMCID: PMC7167304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
We investigated the prediction of young adult service utilization and trauma symptoms from adverse childhood experiences (ACEs) and adolescent mental health symptoms in young women with dual child welfare and juvenile justice system involvement. A sample of 166 females (ages 13 to 17) was followed to examine the transition to young adulthood. Path models indicated that more ACEs were associated with poorer adolescent mental health. Adolescent mental health symptoms were associated with more young adult trauma symptoms and service utilization. Implications for service providers and policy-makers are discussed.
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23
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Pittenger SL, Moore KE, Dworkin ER, Crusto CA, Connell CM. Risk and Protective Factors for Alcohol, Marijuana, and Cocaine Use Among Child Welfare-Involved Youth. CHILDREN AND YOUTH SERVICES REVIEW 2018; 95:88-94. [PMID: 31231146 PMCID: PMC6588184 DOI: 10.1016/j.childyouth.2018.09.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Youth involved in child welfare services (CWS) are at elevated risk for substance use. CWS involvement may provide an opportunity for intervention to prevent subsequent use; however, little is known about mitigating substance use risk in this population. Using data from the second National Survey of Child and Adolescent Well-Being (NSCAW II), the present study examined individual, psychological, and contextual risk factors (e.g., prior substance use, depression, posttraumatic stress, maltreatment experiences) and protective factors (e.g., caregiver monitoring, peer relationships) following CWS involvement (Wave 1) in relation to alcohol, marijuana, and cocaine use 36 months later (Wave 3). The nationally-representative sample of CWS-involved youth was restricted to individuals who were aged 11 years or older at Wave 1 and had at least a partial interview at Wave 3 (N = 763). Three logistic regression models showed that Wave 1 substance use increased the likelihood of marijuana and cocaine use at Wave 3 [marijuana OR = 1.41 (1.19-1.68); cocaine OR = 1.26 (1.07-1.50)] but not binge alcohol use [OR = 1.44 (0.95-2.19)]. Other risk and protective factors had limited predictive value for Wave 3 substance use. The present findings suggest that initiating substance use prior to or at the time of CWS involvement is a critical risk factor for later substance use. Substance use screening and referral to treatment is imperative for CWS-involved youth.
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Affiliation(s)
| | | | - Emily R. Dworkin
- Department of Psychiatry and Behavioral Sciences, University of Washington
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24
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McGihon R, Hawke LD, Chaim G, Henderson J. Cross-sectoral integration in youth-focused health and social services in Canada: a social network analysis. BMC Health Serv Res 2018; 18:901. [PMID: 30486805 PMCID: PMC6264042 DOI: 10.1186/s12913-018-3742-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 11/20/2018] [Indexed: 11/22/2022] Open
Abstract
Background Youth with concurrent substance use and mental health concerns have diverse psychosocial needs and may present to a multitude of clinical and social service sectors. By integrating service sectors at a system level, the diversity of needs of youth with concurrent disorders can be addressed in a more holistic way. The objective of the present study was to quantify the level of cross-sectoral integration in youth-focused services in Canada. Methods Social network analysis (SNA) was used to examine the relationships between eight sectors: addictions, child welfare, education, physical health, housing, mental health, youth justice, and other social services. A total of 597 participants representing twelve networks of youth-serving agencies across Canada provided information on their cross-sectoral contacts and referrals. Results Overall, results suggested a moderate level of integration between sectors. The mental health and the addictions sectors demonstrated only moderate integration, while the addictions sector was strongly connected with the youth justice sector. Conclusions Despite evidence of moderate integration, increased integration is called for to better meet the needs of youth with concurrent mental health and substance use concerns across youth-serving sectors. Ongoing efforts to enhance the integration between youth-serving sectors should be a primary focus in organizing networks serving youth with concurrent mental health and substance use needs.
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Affiliation(s)
- Rachel McGihon
- Centre for Addiction and Mental Health, 80 Workman Way, Toronto, Ontario, M6J 1H4, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Lisa D Hawke
- Centre for Addiction and Mental Health, 80 Workman Way, Toronto, Ontario, M6J 1H4, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Gloria Chaim
- Centre for Addiction and Mental Health, 80 Workman Way, Toronto, Ontario, M6J 1H4, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Joanna Henderson
- Centre for Addiction and Mental Health, 80 Workman Way, Toronto, Ontario, M6J 1H4, Canada. .,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
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25
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Jain S, Cohen AK, Jagannathan P, Leung Y, Bassey H, Bedford S. Evaluating the Implementation of a Collaborative Juvenile Reentry System in Oakland, California. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2018; 62:3662-3680. [PMID: 29426252 DOI: 10.1177/0306624x18755480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Traditional juvenile reentry systems often inadequately meet offenders' complex needs. Policymakers and researchers increasingly recognize the importance of a collaborative community- and development-based reentry system to improve recidivism, youth developmental outcomes, and public safety. Yet, system-level process evaluations of integrated reentry systems are scarce. California's Alameda County juvenile reentry system implemented evidence-based strategies and practices to better serve reentry youth. We report findings from a process evaluation, using data from 15 key stakeholder interviews, focus groups with community-based providers, a reentry system-wide stakeholder survey, site visit observations, and document reviews. We identified strengths, challenges, and lessons learned. System-level strengths included increased multidisciplinary assessments, interagency collaboration, and specialty courts. Challenges included differing agency agendas, limited family and youth engagement, and data sharing. We recommend future researchers and practitioners to further examine and implement integrated system-level processes and organizational change, informed by the ecological-developmental perspective, to help promote positive outcomes for reentry youth.
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Affiliation(s)
| | - Alison K Cohen
- 1 DNA Global, LLC, Oakland, CA, USA
- 2 University of California, Berkeley, School of Public Health & Graduate School of Education, USA
| | | | - Yvette Leung
- 4 Y's Change, Oakland, CA, USA
- 5 Alameda County Health Care Services Agency, San Leandro, CA, USA
| | | | - Sara Bedford
- 3 Department of Human Services, Oakland, CA, USA
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26
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Lyon AR, Whitaker K, Locke J, Cook CR, King KM, Duong M, Davis C, Weist MD, Ehrhart MG, Aarons GA. The impact of inter-organizational alignment (IOA) on implementation outcomes: evaluating unique and shared organizational influences in education sector mental health. Implement Sci 2018; 13:24. [PMID: 29415749 PMCID: PMC5804008 DOI: 10.1186/s13012-018-0721-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 01/30/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Integrated healthcare delivered by work groups in nontraditional service settings is increasingly common, yet contemporary implementation frameworks typically assume a single organization-or organizational unit-within which system-level processes influence service quality and implementation success. Recent implementation frameworks predict that inter-organizational alignment (i.e., similarity in values, characteristics, activities related to implementation across organizations) may facilitate the implementation of evidence-based practices (EBP), but few studies have evaluated this premise. This study's aims examine the impact of overlapping organizational contexts by evaluating the implementation contexts of externally employed mental health clinicians working in schools-the most common integrated service delivery setting for children and adolescents. Aim 1 is to estimate the effects of unique intra-organizational implementation contexts and combined inter-organizational alignment on implementation outcomes. Aim 2 is to examine the underlying mechanisms through which inter-organizational alignment facilitates or hinders EBP implementation. METHODS/DESIGN This study will conduct sequential, exploratory mixed-methods research to evaluate the intra- and inter-organizational implementation contexts of schools and the external community-based organizations that most often employ school-based mental health clinicians, as they relate to mental health EBP implementation. Aim 1 will involve quantitative surveys with school-based, externally-employed mental health clinicians, their supervisors, and proximal school-employed staff (total n = 120 participants) to estimate the effects of each organization's general and implementation-specific organizational factors (e.g., climate, leadership) on implementation outcomes (fidelity, acceptability, appropriateness) and assess the moderating role of the degree of clinician embeddedness in the school setting. Aim 2 will explore the mechanisms through which inter-organizational alignment influences implementation outcomes by presenting the results of Aim 1 surveys to school-based clinicians (n = 30) and conducting semi-structured qualitative interviews. Qualitative data will be evaluated using an integrative inductive and deductive approach. DISCUSSION The study aims are expected to identify intra- and inter-organizational constructs that are most instrumental to EBP implementation success in school-based integrated care settings and illuminate mechanisms that may account for the influence of inter-organizational alignment. In addition to improving school-based mental health, these findings will spur future implementation science that considers the relationships across organizations and optimize the capacity of implementation science to guide practice in increasingly complex systems of care.
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Affiliation(s)
- Aaron R Lyon
- University of Washington, 6200 NE 74th Street, Suite 100, Seattle, WA, 98115, USA.
| | - Kelly Whitaker
- University of Washington, 6200 NE 74th Street, Suite 100, Seattle, WA, 98115, USA
| | - Jill Locke
- University of Washington, 6200 NE 74th Street, Suite 100, Seattle, WA, 98115, USA
| | - Clayton R Cook
- University of Minnesota, 250 Education Sciences Bldg, 56 East River Road, Minneapolis, MN, 55455, USA
| | - Kevin M King
- University of Washington, 6200 NE 74th Street, Suite 100, Seattle, WA, 98115, USA
| | - Mylien Duong
- University of Washington, 6200 NE 74th Street, Suite 100, Seattle, WA, 98115, USA
| | - Chayna Davis
- University of Washington, 6200 NE 74th Street, Suite 100, Seattle, WA, 98115, USA
| | - Mark D Weist
- University of South Carolina, 1512 Pendleton Street, Columbia, SC, 29208, USA
| | - Mark G Ehrhart
- University of Central Florida, 4111 Pictor Lane, Orlando, FL, 32816-1390, USA
| | - Gregory A Aarons
- University of California San Diego, 9500 Gilman Drive (0812), La Jolla, San Diego, CA, 92093, USA.,Child and Adolescent Services Research Center, San Diego, 92123, CA, USA
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Winkelman TNA, Genao I, Wildeman C, Wang EA. Emergency Department and Hospital Use Among Adolescents With Justice System Involvement. Pediatrics 2017; 140:peds.2017-1144. [PMID: 28970370 DOI: 10.1542/peds.2017-1144] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/09/2017] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Adolescents with justice system involvement have high rates of physical and behavioral health disorders and are potentially high users of costly health care services. We examined emergency department (ED) and hospital use among a national sample of adolescents with various levels of justice involvement. METHODS Cross-sectional analysis using the 2009 to 2014 National Survey on Drug Use and Health. We included adolescents aged 12 to 17 and used multivariable logistic and negative binomial regression models, adjusting for sociodemographic and health differences, to compare ED and hospital use among adolescents with and without justice involvement. RESULTS Our sample included 1375 adolescents with past year arrest, 2450 with past year probation or parole, 1324 with past year juvenile detention, and 97 976 without past year justice involvement. In adjusted analyses, adolescents with any justice system involvement, compared to those without, were more likely to have used the ED (38.5%-39.5% vs 31.0%; P < .001) or been hospitalized in the past 12 months (7.1%-8.8% vs 4.8%; P < .01). After adjustment, adolescents with justice involvement also had more ED visits per 100 person-years (77.7-92.9 vs 62.8; P < .01) and hospital nights per 100 person-years (43.3-53.7 vs 18.0; P < .01). Use was highest among adolescents with justice involvement who reported fair or poor health, an illicit drug use disorder, or a mood disorder. CONCLUSIONS Adolescents with justice involvement had substantially higher rates of ED and hospital use. Providing comprehensive support services to adolescents with justice involvement may improve health care use patterns and reduce health care spending.
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Affiliation(s)
- Tyler N A Winkelman
- Division of General Internal Medicine, Hennepin County Medical Center, Minneapolis, Minnesota; .,Center for Patient and Provider Experience, Minneapolis Medical Research Foundation, Minneapolis, Minnesota
| | | | - Christopher Wildeman
- Department of Policy Analysis and Management, College of Human Ecology, Cornell University, Ithaca, New York
| | - Emily A Wang
- Section of General Medicine and.,Robert Wood Johnson Foundation Clinical Scholars Program, Yale University, New Haven, Connecticut; and
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Van Dongen T, Sabbe B, Glazemakers I. A protocol for interagency collaboration and family participation: Practitioners' perspectives on the Client Network Consultation. J Interprof Care 2017; 32:14-23. [PMID: 29058496 DOI: 10.1080/13561820.2017.1379961] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Interagency collaboration has many advantages, but seems hard to realise in practice. In Belgium, the need for collaboration between the practitioners in the field of child welfare and child psychiatry, especially for children and adolescents with complex health care needs, was identified. Children with complex health care needs require coordinated care and collaboration between the different sectors in child mental health care (child welfare, child psychiatry, disability care). The authors have developed a standardised protocol based on the wraparound principles, which support interagency collaboration with family participation, named Client Network Consultation (CNC). Focus groups evaluated the CNC by eliciting practitioners' views on the structure, content and impact of collaborative interagency protocols with family involvement. Thematic analysis revealed four core themes: (1) Empowering the child and the family; (2) Utilising the strength of the collective; (3) Being considerate versus constructive a dilemma for participants in CNC; and (4) The structure of a protocol offers opportunities and challenges. Results of the study offer implications for daily practice. Several challenges for interprofessional (IP) practice in the complex field of child and adolescent mental health care are described. The value of the CNC protocol to engage families in a clinical process is also discussed.
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Affiliation(s)
- Thirsa Van Dongen
- a Faculteit geneeskunde en gezondheidswetenschappen, Collaborative Antwerp Psychiatric Research Institute , Universiteit Antwerpen , Universiteitsplein 1, Wilrijk 2610 , Belgium
| | - Bernard Sabbe
- a Faculteit geneeskunde en gezondheidswetenschappen, Collaborative Antwerp Psychiatric Research Institute , Universiteit Antwerpen , Universiteitsplein 1, Wilrijk 2610 , Belgium
| | - Inge Glazemakers
- a Faculteit geneeskunde en gezondheidswetenschappen, Collaborative Antwerp Psychiatric Research Institute , Universiteit Antwerpen , Universiteitsplein 1, Wilrijk 2610 , Belgium
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Chuang E, Collins-Camargo C, McBeath B. Organizational supports used by private child and family serving agencies to facilitate evidence use: a mixed methods study protocol. Implement Sci 2017; 12:49. [PMID: 28390421 PMCID: PMC5385079 DOI: 10.1186/s13012-017-0580-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 03/29/2017] [Indexed: 11/24/2022] Open
Abstract
Background Challenges to evidence use are well documented. Less well understood are the formal supports—e.g., technical infrastructure, inter-organizational relationships—organizations may put in place to help overcome these challenges. This study will identify supports for evidence use currently used by private child and family serving agencies delivering publicly funded behavioral health and/or human services; examine contextual, organizational, and managerial factors associated with use of such supports; and determine how identified supports affect evidence use by staff at multiple levels of the organization. Methods We will use a sequential explanatory mixed methods design, with study activities occurring in two sequential phases: In phase 1, quantitative survey data collected from managers of private child and family serving agencies in six states (CA, IN, KY, MO, PA, and WI) and analyzed using both regression and qualitative comparative analysis (QCA) will identify organizational supports currently being used to facilitate evidence use and examine the contextual, organizational, and managerial factors associated with the use of such supports. In phase 2, data from phase 1 will be used to select a purposive sample of 12 agencies for in-depth case studies. In those 12 agencies, semi-structured interviews with key informants and managers, focus groups with frontline staff, and document analysis will provide further insight into agencies’ motivation for investing in organizational supports for evidence use and the facilitators and barriers encountered in doing so. Semi-structured interviews with managers and focus groups with frontline staff will also assess whether and how identified supports affect evidence use at different levels of the organization (senior executives, middle managers, frontline supervisors, and frontline staff). Within- and between-case analyses supplemented by QCA will identify combinations of factors associated with the highest and lowest levels of staff evidence use. Discussion This study will inform efforts to improve sustainment, scale-up, and spread of evidence by providing insight into organizational and managerial strategies that facilitate evidence use, the contexts in which these strategies are most effective, and their effect on evidence use by staff at different levels of the organization.
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Affiliation(s)
- Emmeline Chuang
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, 650 Charles E Young Dr. South, Los Angeles, CA, 90095-1772, USA.
| | - Crystal Collins-Camargo
- Kent School of Social Work, University of Louisville, 2217 S. Third Street, Louisville, KY, 40292, USA
| | - Bowen McBeath
- School of Social Work, Portland State University, PO Box 751, Portland, OR, 97207, USA
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Cappon L. Who decides? The decision-making process of juvenile judges concerning minors with mental disorders. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2016; 46:7-19. [PMID: 27033974 DOI: 10.1016/j.ijlp.2016.02.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Previous research on juvenile judges' decision-making process has neglected the role of the different actors involved in judicial procedures. The decision can be considered as a result of information exchange between the different actors involved. The process of making a decision is equally important as the decision itself, especially when the decision considers minors with mental disorders. The presence and the type of interaction determine the information available to the juvenile judges to make their final decision. The overall aim of this study is to gain insight into the role of all actors, including the juvenile judge, in the juvenile judge's decision-making process in cases relating to minors with mental disorders. Semi-structured interviews were carried out with professional actors (n=32), minors (n=31) and parents (n=17). The findings indicated that the judge's decision is overall the result of an interaction between the juvenile judge, the social services investigator and the youth psychiatrist. The other professional actors, the minors and the parents had only a limited role in the decision-making process. The research concludes that the judge's decision-making process should be based on dialogue, and requires enhanced collaboration between the juvenile court and youth psychiatrists from mental health services. Future decision-making research should pay more attention to the interactions of the actors that guide a juvenile judge's decision.
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Affiliation(s)
- Leen Cappon
- Voluntary postdoctoral researcher, Ghent University, Department of Criminal Law and Criminology, Belgium; Researcher forensic mental health, PC Sint-Jan-Baptist, Suikerkaai 81, 9060 Zelzate, Belgium.
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Cooper M, Evans Y, Pybis J. Interagency collaboration in children and young people's mental health: a systematic review of outcomes, facilitating factors and inhibiting factors. Child Care Health Dev 2016; 42:325-42. [PMID: 26860960 DOI: 10.1111/cch.12322] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 10/23/2015] [Accepted: 12/27/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND In the UK and internationally, there have been increasing calls for interagency collaboration across mental health services for children and young people. However, it is not clear whether such practices do, indeed, have a positive impact and, if so, what factors facilitate and inhibit collaboration across agencies. METHODS Electronic searches were carried out on seven key computerized bibliographic databases. For inclusion in the review, studies needed to report on close working by two or more services that provided mental health support for children and/or young people and that had some systematic collection of qualitative and/or quantitative data. Outcomes were analysed narratively, and facilitating and inhibiting factors were examined using thematic analysis. RESULTS A final sample of 33 studies was identified from 4136 initial records. Outcomes were mixed, with some findings indicating that interagency collaboration was associated with greater service use and equity of service provision, but other suggesting negative outcomes on service use and quality. However, interagency collaboration was perceived as helpful and important by both service users and professionals, and collaborative initiatives were evaluated positively. The factors most commonly identified as facilitating interagency collaboration were good interagency communication, joint trainings, good understandings across agencies, mutual valuing across agencies, senior management support, protocols on interagency collaboration and a named link person. The most commonly perceived barriers to interagency collaboration were inadequate resourcing, poor interagency communication, lack of valuing across agencies, differing perspectives, poor understandings across agencies and confidentiality issues. CONCLUSIONS The results are consistent with findings from previous reviews of interagency collaboration across adult and child services: there were some indications of benefit; and facilitating and inhibiting factors involved working relationships and multi-agency processes, resources and management. The identification of these factors has implications for practitioners, service managers, trainers, commissioners and researchers.
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Affiliation(s)
- M Cooper
- Department of Psychology, University of Roehampton, London, UK
| | - Y Evans
- Department of Psychology, University of Roehampton, London, UK
| | - J Pybis
- Research Department, British Association for Counselling and Psychotherapy, Lutterworth, UK
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Barnert ES, Abrams S, Azzi VF, Ryan G, Brook R, Chung PJ. Identifying best practices for "Safe Harbor" legislation to protect child sex trafficking victims: Decriminalization alone is not sufficient. CHILD ABUSE & NEGLECT 2016; 51:249-62. [PMID: 26520827 DOI: 10.1016/j.chiabu.2015.10.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 09/23/2015] [Accepted: 10/02/2015] [Indexed: 05/11/2023]
Abstract
Several states have recently enacted "Safe Harbor" laws to redirect child victims of commercial sexual exploitation and child sex trafficking from the criminal justice system and into the child welfare system. No comprehensive studies of Safe Harbor law implementation exist. The nine state Safe Harbor laws enacted by 2012 were analyzed to guide state legislators, health professionals, law enforcement agents, child welfare providers, and other responders to the commercial sexual exploitation of children on the development and implementation of state Safe Harbor laws. The authors conducted 32 semi-structured interviews with Safe Harbor experts in these states. Participants conveyed that Safe Harbor legislation signified a critical paradigm shift, treating commercially sexually exploited youth not as criminals but as vulnerable children in need of services. However, Safe Harbor legislation varied widely and significant gaps in laws exist. Such laws alone were considered insufficient without adequate funding for necessary services. As a result, many well-meaning providers were going around the Safe Harbor laws by continuing to incarcerate commercially sexually exploited youth in the juvenile justice system regardless of Safe Harbor laws in place. This was done, to act, in their view, in what was the best interest of the victimized children. With imperfect laws and implementation, these findings suggest an important role for local and state responders to act together to protect victims from unnecessary criminalization and potential further traumatization.
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Affiliation(s)
- Elizabeth S Barnert
- Department of Pediatrics, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095, USA; Children's Discovery & Innovation Institute, Mattel Children's Hospital UCLA, 757 Westwood Plaza, Los Angeles, CA 90095, USA
| | - Susan Abrams
- Children's Law Center of California, 201 Centre Plaza Dr #10, Monterey Park, CA, USA
| | - Veronica F Azzi
- Children's Discovery & Innovation Institute, Mattel Children's Hospital UCLA, 757 Westwood Plaza, Los Angeles, CA 90095, USA
| | - Gery Ryan
- RAND Health, RAND Corporation, 1776 Main St., Santa Monica, CA 90401, USA
| | - Robert Brook
- RAND Health, RAND Corporation, 1776 Main St., Santa Monica, CA 90401, USA; Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095, USA
| | - Paul J Chung
- Department of Pediatrics, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095, USA; Children's Discovery & Innovation Institute, Mattel Children's Hospital UCLA, 757 Westwood Plaza, Los Angeles, CA 90095, USA; RAND Health, RAND Corporation, 1776 Main St., Santa Monica, CA 90401, USA; Department of Health Policy & Management, UCLA Fielding School of Public Health, 640 Charles E Young Dr S, Los Angeles, CA 90024, USA
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Dellor E, Lovato-Hermann K, Wolf JP, Curry SR, Freisthler B. Introducing Technology in Child Welfare Referrals: A Case Study. JOURNAL OF TECHNOLOGY IN HUMAN SERVICES 2015; 33:330-344. [PMID: 27799852 PMCID: PMC5084615 DOI: 10.1080/15228835.2015.1107520] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Access to social services is important for the safety of children and ultimately for reunification of families involved in the child welfare system. The process of linking families to services however, varies by caseworker and can be cumbersome and time-consuming. The DCFS Needs Portal is an internet-based intervention to improve the timing and quality of social service referrals in Los Angeles County We used a case study approach including in-depth interviews, direct observations and user feedback obtained from the Needs Portal to 1) determine perceived benefits and barriers to adopting the Needs Portal and 2) report how the flow of information between users and developers was used to adapt to user needs. Our analyses revealed four major barriers: 1) caseworker apprehension regarding new technology, 2) variation in communication styles by user type, 3) lack of technological infrastructure and 4) competing workplace demands. Information sharing between developers and users has the potential to better meet the needs of users and ultimately maximize utilization of new technology. Although internet-based interventions are designed to inexpensively and effectively coordinate services, emerging interventions may require in-person assistance and modifications in order to succeed.
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Affiliation(s)
- Elinam Dellor
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles
| | | | - Jennifer Price Wolf
- Division of Social Work, California State University, Sacramento; Prevention Research Center
| | - Susanna R. Curry
- Luskin School of Public Affairs, University of California, Los Angeles
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Garcia AR, Greeson JKP, Kim M, Thompson A, DeNard C. From placement to prison revisited: Do mental health services disrupt the delinquency pipeline among Latino, African American and Caucasian youth in the child welfare system? J Adolesc 2015; 45:263-73. [PMID: 26536399 DOI: 10.1016/j.adolescence.2015.10.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 10/03/2015] [Accepted: 10/11/2015] [Indexed: 11/25/2022]
Abstract
Racial and ethnic disparities in delinquency among child welfare-involved youth are well documented. However, less is known about the mechanisms through which these disparities occur. This study explores the extent to which sets of variables predict the occurrence of juvenile delinquency and whether race/ethnicity moderates the strength of the relationships between (1) social, emotional, and behavioral (SEB) problems and delinquency and (2) mental health service use and delinquency. We used a nationally representative sample of 727 African American, Caucasian, and Latino youth between the ages of 12-17 who were referred to the child welfare system. Controlling for age, gender, placement instability, maltreatment history, poverty, and urbanicity, linear regression analyses revealed that African American and Latino youth engaged in more delinquent acts than Caucasian youth did. However, service use decreased the likelihood of engaging in more delinquent acts for African Americans. Additional efforts are needed to illuminate and address the contextual and organizational barriers to delivering effective mental health services as a strategy to reduce racial disparities in delinquent behavior.
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Affiliation(s)
- Antonio R Garcia
- School of Social Policy & Practice, University of Pennsylvania, 3701 Locust Walk, Philadelphia, PA 19104, USA.
| | - Johanna K P Greeson
- School of Social Policy & Practice, University of Pennsylvania, 3701 Locust Walk, Philadelphia, PA 19104, USA
| | - Minseop Kim
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong
| | - Allison Thompson
- School of Social Policy & Practice, University of Pennsylvania, 3701 Locust Walk, Philadelphia, PA 19104, USA
| | - Christina DeNard
- School of Social Policy & Practice, University of Pennsylvania, 3701 Locust Walk, Philadelphia, PA 19104, USA
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Palinkas LA, Fuentes D, Finno M, Garcia AR, Holloway IW, Chamberlain P. Inter-organizational collaboration in the implementation of evidence-based practices among public agencies serving abused and neglected youth. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2015; 41:74-85. [PMID: 22886317 DOI: 10.1007/s10488-012-0437-5] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study examined the role of inter-organizational collaboration in implementing new evidence-based practices for addressing problem behaviors in at-risk youth. Semi-structured interviews were conducted with 38 systems leaders of probation, mental health, and child welfare departments of 12 California counties participating in a large randomized controlled trial to scale-up the use of Multidimensional Treatment Foster Care. Three sets of collaboration characteristics were identified: (1) characteristics of collaboration process, (2) characteristics of the external environment, and (3) characteristics of participating organizations and individuals. Inter-organizational collaboration enables an exchange of information and advice and a pooling of resources individual agencies may require for successful implementation.
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Affiliation(s)
- Lawrence A Palinkas
- School of Social Work, University of Southern California, 669 W. 34th Street, Los Angeles, CA, 90089-0411, USA,
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Zajac K, Sheidow AJ, Davis M. Juvenile Justice, Mental Health, and the Transition to Adulthood: A Review of Service System Involvement and Unmet Needs in the U.S. CHILDREN AND YOUTH SERVICES REVIEW 2015; 56:139-148. [PMID: 26273119 PMCID: PMC4530519 DOI: 10.1016/j.childyouth.2015.07.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Although adolescents are the primary focus of juvenile justice, a significant number of young people involved with this system are considered transition age youth (i.e., 16-25 years of age). The aim of this review is to summarize the specific needs of transition age youth with mental health conditions involved with the juvenile justice system, identify the multiple service systems relevant to this group, and offer recommendations for policies and practice. A comprehensive search strategy was used to identify and synthesize the literature. Findings highlight the paucity of research specific to transition age youth. Thus, we also summarized relevant research on justice-involved adolescents, with a focus evaluating its potential relevance in the context of the unique milestones of the transition age, including finishing one's education, setting and working towards vocational goals, and transitioning from ones' family of origin to more independent living situations. Existing programs and initiatives relevant to transition age youth with mental health conditions are highlighted, and nine specific recommendations for policy and practice are offered.
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Affiliation(s)
- Kristyn Zajac
- Family Services Research Center, Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | | | - Maryann Davis
- Transitions Research and Training Center, Systems and Psychosocial Advances Research Center, Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA, USA
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Harper CR, Kuperminc GP, Weaver SR, Emshoff J, Erickson S. Leveraged resources and systems changes in community collaboration. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2014; 54:348-357. [PMID: 25267252 DOI: 10.1007/s10464-014-9678-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Most models of community collaboration emphasize the ability of diverse partners to come together to enact systematic changes that improve the health of individuals and communities. The ability of these groups to leverage resources is thought to be an important marker of successful collaboration and eventual improvements in community health. However, there is a paucity of research addressing linkages between systems change activities and leveraged resources. This study used a sample of collaboratives (N = 157) that received technical assistance and funding through the Georgia Family Connection Partnership (GaFCP) between 2006 and 2007. Data were collected from collaborative report of activities and funding, member ratings of collaborative functioning, and characteristics of the communities served by the collaboratives drawn from US Census data. Cross-lagged regression models tested longitudinal associations between systems change activities and leveraged dollars. The results indicated that systems change activities predict increased leveraging of resources from state/federal and private partners. However, there was no evidence that systems changes were linked with leveraging resources from local groups and agencies. These findings have important implications for providing technical assistance and training to health partnerships. Furthermore, future research should consider the relative strength of different systems change activities in relation to the ability of coalitions to leverage resources.
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Affiliation(s)
- Rongbing Xie
- Department of Health Care Organization and Policy; School of Public Health; The University of Alabama; Birmingham
- South Central Preparedness and Emergency Response Learning Center; Alabama Public Health Training Center; The University of Alabama; Birmingham
| | - Bisakha Pia Sen
- Department of Health Care Organization and Policy; School of Public Health; The University of Alabama; Birmingham
| | - E. Michael Foster
- Department of Health Care Organization and Policy; School of Public Health; The University of Alabama; Birmingham
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Hebert S, Bor W, Swenson CC, Boyle C. Improving collaboration: a qualitative assessment of inter-agency collaboration between a pilot Multisystemic Therapy Child Abuse and Neglect (MST-CAN) program and a child protection team. Australas Psychiatry 2014; 22:370-373. [PMID: 24944298 DOI: 10.1177/1039856214539572] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Child protection inter-agency collaboration is characterized by strengths and problems. Some literature notes positive attitudes and high trust between teams. However, difficulties with communication, confidentiality, roles, boundaries and divergent paradigms reconciling child protection and parent mental health needs have been documented. This study investigated whether a pilot model of intensive family intervention for maltreated children and associated intensive inter-agency cooperation delivered an effective collaboration. METHOD At the completion of the pilot program, a child protection team was interviewed. A qualitative assessment by semi-structured group interview format of inter-agency collaboration was undertaken and evaluated by a thematic analysis. RESULTS The analysis identified: strong endorsement of the collaborative model; no changes in perception of referred patients; changes in treatment approaches. No perceived conflict between child protection and parent mental health needs were noted. CONCLUSIONS The changes noted may be due to the unique structure and functioning of the pilot Multisystemic Therapy Child Abuse and Neglect program, which encouraged high levels of team communication, strong client engagement, availability and intensive treatment of child and parent mental health problems. The implications for future collaborations are discussed as well as limitations of the study.
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Affiliation(s)
| | - William Bor
- Director of Mater Centre for Service Research in Mental Health, KidsinMind Research and; Senior Lecturer, University of Queensland, Mater Research Institute, Mater Hospital, Brisbane, QLD, Australia
| | - Cynthia C Swenson
- Professor and Associate Director Family Services Research Center, Medical University of South Carolina, Charleston, SC, USA
| | - Christopher Boyle
- Senior Practitioner, Department of Communities, Brisbane, QLD and; Child Safety Service Centre, Brisbane, QLD, Australia
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Chuang E, Wells R, Aarons GA. Identifying Depression in a National Sample of Caregivers Investigated in Regard to Their Child's Welfare. Psychiatr Serv 2014; 65:911-7. [PMID: 24686832 PMCID: PMC4182297 DOI: 10.1176/appi.ps.201300010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Identifying depression is the first step in provision of treatment across service settings but can be challenging for non-mental health providers. This study examined how caseworker identification of depression among parents and other caregivers during the child welfare investigation or assessment process varies as a function of agency, caseworker, and case characteristics. METHODS Data were drawn from the second National Survey of Child and Adolescent Well-Being (NSCAW II), a national probability sample of children referred to U.S. child welfare agencies between February 2008 and April 2009. The study sample comprised 889 parents and other caregivers whose children initially remained at home and whose confidential responses on the World Health Organization Composite International Diagnostic Interview Short Form indicated a major depressive episode within the past 12 months. Weighted logistic regression examined predictors of caseworker identification of caregiver depression at the agency, caseworker, and case levels. RESULTS Investigative caseworkers identified mental health needs of only 38% of caregivers. Caseworkers were more likely to identify caregiver mental health needs when child welfare agency policy specified use of a standardized mental health assessment and when the maltreatment report came from a health or mental health provider versus other sources, such as teachers or family members. Investigative caseloads were negatively associated with identifying depression. CONCLUSIONS Structured mental health assessments may help non-mental health professionals identify mental health needs among vulnerable populations.
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Topitzes J, Mersky JP, Reynolds AJ. From child maltreatment to violent offending: an examination of mixed-gender and gender-specific models. JOURNAL OF INTERPERSONAL VIOLENCE 2012; 27:2322-2347. [PMID: 22279130 PMCID: PMC3797999 DOI: 10.1177/0886260511433510] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Research suggests that child maltreatment predicts juvenile violence, but it is uncertain whether the effects of victimization persist into adulthood or differ across gender. Furthermore, we know little about the mechanisms underlying the victim-perpetrator cycle for males and females. Consequently, this study analyzed associations between child maltreatment and a number of adult measures of violent offending within mixed-gender and gender-specific models. Along with main effects, the study directly tested the moderating effects of gender on the maltreatment-violence link and analyzed theory-informed gender-specific mediators. Data were derived from the Chicago Longitudinal Study, a panel investigation of 1,539 low-income minority participants born in 1979 or 1980. Child welfare, juvenile court, and criminal court records informed the study's explanatory and outcome measures. Prospectively collected covariate and mediator measures originated with parent, teacher, and self-reports along with several administrative sources. Results indicated that child maltreatment, ages 0 to 11, significantly predicted all study indicators of violence in the full sample and most study outcomes in the male and female subsamples. In no instance did gender moderate the maltreatment-violence association. Late childhood/early adolescence environmental instability, childhood externalizing behaviors, and adolescent peer social skills fully mediated the maltreatment-violence nexus among males. Adolescent externalizing behavior partially mediated the relationship of interest among females. Evidence also indicated that internalizing processes protected females who had been maltreated in childhood against perpetrating violence later in life. Implications of results are discussed.
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Affiliation(s)
- James Topitzes
- University of Wisconsin-Milwaukee, Enderis Hall Room 1057, P.O. Box 1057, Milwaukee, WI 53201, USA.
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Chuang E, Lucio R. Interagency Collaboration between Child Welfare Agencies, Schools, and Mental Health Providers and Children's Mental Health Service Receipt. ACTA ACUST UNITED AC 2011. [DOI: 10.1080/1754730x.2011.9715625] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Kraus de Camargo O. Systems of care: transition from the bio-psycho-social perspective of the International Classification of Functioning, Disability and Health. Child Care Health Dev 2011; 37:792-9. [PMID: 22007978 DOI: 10.1111/j.1365-2214.2011.01323.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The transition process of vulnerable adolescents, including those with complex health conditions, occurs in all domains of their life. Systems of care are usually designed but also restricted within certain aspects of life, as addressed by health, education and social welfare. The need for a co-ordinated approach to support the transition process has been voiced before, but usually publications focus on one system of care, usually the healthcare system or the education system. Recent moves, especially in the UK, are trying to integrate these different systems allowing for a more integrated transition process. This article illustrates how these developments are represented within the framework of the International Classification of Functioning, Disability and Health (ICF) and provides arguments that favour a greater integration of systems of care. METHODS Examples of systems of care from North America and the EU (Germany and the UK) are described. They were selected from a literature search using the terms 'systems of care', 'transition' and 'transitional care' in different combinations. Further supportive information derives from personal experience working in some of these systems in different countries. The systems were analysed according to the components of health they address within the ICF. RESULTS In order to assist adolescents in transition of services, there is a consensus that the approach should be individualized. The overall goal of any intervention or service should be to achieve optimal functioning of the patients. In the framework of the ICF, this means that biomedical and contextual (psychosocial) issues need to be taken into consideration. This requires an exchange of information between the different systems or the integration of those systems involved with the patient. CONCLUSION To facilitate transition, it has been shown that close collaboration between agencies, a transdisciplinary approach of the professionals involved and the use of key workers are helpful.
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