Scott MA, Snowden L, Libby AM. Effects of capitated mental health services on youth contact with the juvenile justice system.
J Am Acad Child Adolesc Psychiatry 2002;
41:1462-9. [PMID:
12447033 DOI:
10.1097/00004583-200212000-00018]
[Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE
To evaluate the association between Medicaid mental health capitation and youth's involvement with the juvenile justice system.
METHOD
A longitudinal, quasi-experimental pre/post design was used. Using administrative databases, juvenile justice contact, defined as any detention or commitment, was assessed for 13,365 Medicaid-eligible youths, aged 10-17 years, who received public mental health services over a 3-year period (1994-1997) in the state of Colorado.
RESULTS
There was no significant effect of financing when secular time was controlled for (interaction financing x time: hazard rate = 0.92, p =.62). The main effects model demonstrates a significant secular trend with juvenile justice contacts decreasing over time for both types of financing (hazard rate = 0.80, p =.002) and a significant effect of financing with eventually capitated sites having higher rates of juvenile justice contact compared with sites that remained fee-for-service (hazard rate = 1.24, p =. 009). Multivariate analyses controlled for demographics, mental health and substance use diagnoses, and other risk factors for juvenile justice contact.
CONCLUSIONS
After adjustment for secular trends, capitation was not associated with a reduction in juvenile justice contact. Nonetheless, these findings provide evidence that capitation did not increase the risk of juvenile justice contact.
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