by Alan J. Litrownik, Heather N. Taussig, John A. Landsverk and Ann F. Garland
Two hundred and ninety five youth between 11 and 17 years of age who entered an emergency shelter care facility reported on their prior involvement with mental health and criminal justice systems. More than a quarter indicated a prior arrest, 10.5% reported a hospital admission, and 43.1% said they had received counseling. An overall logistic regression model revealed that youth who had received counseling prior to entry were almost 3 times more likely to be released to an adult who was not a relative or friend than youth who had not received counseling. Implications for the coordination of services from multiple sectors are discussed.
by Lee W. Badger, Michael Berbaum, Patricia A. Carney, Allen J. Dietrich, Mary Owen and John T. Stem
This study investigates the relationships among patient's gender, physician's gender, and physician's inquiries about depression symptoms and psychological stressors, treatment and subsequent medical record notation of depression in primary care. One hundred and forty-six physicians at three sites were visited twice by a standardized patient (SP) who enacted either major depression with a psychosocial presentation or minor depression with a somatic presentation. Each of the two cases was portrayed by both male and female SPs who were assigned randomly to physicians. Results showed high rates of inquiry about depression symptoms and treatment, but rates varied considerably by presentation and across physician-patient gender combinations. Male physicians explored symptoms and discussed a diagnosis with female patients significantly more often than with male patients. Both male and female physicians recommended counseling more often for patients with the somatic presentation when they were female than when they were male. Record notations followed the same gender pattern.
by William R. Nugent and Charles Glisson
Few studies have examined the extent to which public children's service systems respond to the mental health problems of children in state custody. This is an important issue because previous research suggests that little attention is given to children's mental health service needs when judicial and service decisions are made about children who enter state custody. The current study addresses the issue by examining the extent to which one state's children's service system is responsive versus reactive to the mental health problems of the children in its care. A responsive system is one in which services are provided to meet each child's unique mental health needs. A reactive system is one in which service providers take actions to avoid providing needed mental health services. Our results describe a service system that is more reactive than responsive to children's mental health problems.
by Jeanne C. Rivard, Matthew C. Johnsen, Joseph P. Morrissey and Barbara E. Starrett
This paper describes results of a secondary analysis of interorganizational network data collected in an evaluation of a system-level intervention that was designed to integrate service delivery across multiple sectors serving children with serious emotional disturbances. Data measuring the extent of interorganizational response exchange were analyzed to investigate changes in patterns of interagency collaboration involving child welfare and juvenile justice sectors. A general pattern of increasing resource exchanges over time is characterized as relatively modest but important in demonstrating incremental growth in cooperative interorganizational relationships. Findings are consistent with reports documenting the project's implementation and qualitative impressions of agency respondents.
by Arlene Rubin Stiffman, Diane Elze, Eric Hadley-Ives and Sharon Johnson
In 1994 and 1996, the Youth Services Project interviewed 792 youths from St. Louis City. Although the youths showed a high need for mental health services (20% met diagnostic criteria), less than half of the youths with problems received services. Past contact with a social service provider, but not a teacher, physician, etc., significantly predicted care for mental health problems (odds ratio = 1.5). Social service professionals (largely social workers) served more youths than did any other profession. Of youths with persistent problems, 25% received services from social service professionals, 3% from MD/PhD level psychiatrists or psychologists, 7% from primary care medical doctors, 12% from teachers/coaches, 15% from other helpers, and 37% received no services at all.
by Mingliang Zhang, Kathryn M. Rost and John C. Fortney
This study examined the relationship between costs of treating physical problems and costs of treating depression, for 322 rural residents with depression. Multiple regressions were used to control for sociodemographics, depression severity, and physical and mental health comorbidities at baseline. The results indicated a $1.42 (n = 322) reduction in the costs of treating physical problems for a $1.00 increase in the costs of treating depression. The reduction was $2.61 (p < 0.05) among those receiving depression treatment (n = 125). These findings suggest a net savings from depression treatment, in addition to other benefits such as improved systems and functioning and increased productivity.
Transcribed by Ruth Wilson
21 October 1999