Category: Dissemination / Implementation
Keywords: Implementation | Health Care System | Public Policy
Presentation Type: Symposium
State- and county-level efforts to implement evidence-based treatments (EBTs) are understudied, and thus little is known about rates and patterns of compliance with state policies aimed at improving the quality of mental health services youth receive in community settings. This study examined compliance with clinical practice guidelines (i.e., recommended “youth service packages”) that were developed by the State of Texas to support a mental health policy that requires the use of EBTs for youth clients. This presentation will describe research efforts to identify types of clients for whom clinics deviated from the guidelines and the implications of those deviations for client outcomes. Medical records were extracted for 727 child and adolescent clients who received mental health treatment at one of 4 community mental health clinics in one Texas County. Sixty percent of clients were male. Ages ranged from 4 to 17 (M = 11.17, SD = 3.85). Ethnicities were: 42% African American, 38% Hispanic, 17% Caucasian, and 3% Asian. Diagnoses included ADHD (50%), depression (37%), anxiety (8%), conduct-related problems (27%), serious mental illness (27%), and other (24%). Fifty percent of clients had more than one diagnosis. Forty-six percent of youths (n = 328) received services that complied with the clinical practice guidelines. Almost all youth received treatment consistent with their problem type (i.e., diagnosis), but not all youth received the recommended level of service intensity, most often receiving less intensive services. Youth with depression (OR = 4.45, p < .01) and severe mental illness (OR = 2.70, p < .05) were more likely to receive more intensive services. Older youth (OR = 1.14, p < .05) and those with worse functioning at intake (OR = 0.97, p < .05) tended to receive less intensive services. Youth who received less intensive services showed less improvement in problem severity (B = 0.344, p = .01) and functioning (B = -0.260, p < .001) over the course of treatment. The presentation will conclude with discussion of study implications for tracking compliance to state mental health policies and related guidelines.
University of Miami
Friday, November 17
10:15 AM – 11:45 AM
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