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CHILDREN'S HEALTH INITIATIVE


About the Children's Health Initiative

(mission, method, and results)

Children's Health Initiative Publications

Relevant Children's Health Initiative Resources

Figure 1- MHSPY Model Design and Infrastructure (PDF)

 

About the Children's Health Initiative

Mission

The Children's Health Initiative (CHI) is the research home for a longitudinal, multi-wave study of the effectiveness of a highly coordinated combination of mental health, pediatric and substance abuse services in maintaining Medicaid youth with serious emotional disturbance (SED) in their homes and communities.

The research is focused on the impact of a uniquely integrated clinical intervention provided through the Mental Health Service Program for Youth (MHSPY).

Methods

The Children's Health Initiative monitors and reports on four discrete outcome domains for children with serious emotional disturbance who are at-risk of out-of-home placement: (1) functional status, (2) utilization, (3) cost, and (4) satisfaction. These long-term outcomes were selected by state level advisory group of stakeholders to measure whether a clinically intensive, family-driven system of care, working to maximize continuity of intent across interventions would lead to improved clinical quality and cost-effectiveness.

The study employs a longitudinal, multi-wave process using standardized measures of clinical functioning, service utilization, cost and satisfaction for children ages 3 through 19. Multiple standardized measures are administered to assess the overall level of functioning of the target population and identify the presence of change in mental health status at intake and every six months while the participant is enrolled in the program. These measures include the Child and Adolescent Functional Assessment Scale (CAFAS), Child Global Assessment Scale (CGAS), Child Patient Assessment Tool (PAT), Child Behavior Checklist (CBCL), Youth Self Report (YSR), Teacher Report Form (TRF), Family Centered Behavior Scale (FCBS), as well as a Family, Youth and Agency Satisfaction Surveys. Service utilization data is also maintained on all medical services, including mental health and substance abuse, pharmacy, emergency room use, surgery, medication, lab for all enrolled MHSPY youth.

Results

Analysis of MHSPY results performed by the Children's Health Initiative Research Team, in collaboration with nationally recognized consultants, indicates study participants experience clinically significant improvement (>20 point drop in scores) as measured by the CAFAS. These results are consistent with an unusual degree of engagement in mental health services for the study population in contrast to their documented level of participation in treatment prior to enrollment in the study. Additionally, medical costs (including hospital, ER, etc.) are sixty-four percent (64%) lower than those for the Medicaid standard reference group. Ninety-eight percent (98%) of MHSPY families indicate that their Care Manager "helps them expect good things in the future for themselves and their children", while eighty-three percent (83%) of parents/caregivers report being "satisfied" or "very satisfied" with the help they received.

 

 


MHSPY Publications

Grimes, K. E. (2004). Systems of Care in North America. In Remschmidt, Belfer & Goodyer (Eds.), Facilitating pathways: Care, treatment and prevention in child and adolescent mental health (pp. 35-43). Berlin: Springer.

Grimes, K. E., Kapunan, P. E., & Mullin, B. Children's Health Services in a "System of Care": Patterns of Mental Health, Primary and Specialty Use. Public Health Reports. 2006; 121: 311-323.

Grimes, K. E. & Mullin, B. MHSPY: A Children's Health Initiative for Maintaining At-Risk Youth in the Community. The Journal of Behavioral Health Services & Research. 2006; 33(2): 196-212.

Pires, S. A. & Grimes, K. E. (2006). Clinical decision making approaches for child/adolescent behavioral health care in public sector managed care systems. Promising approaches for behavioral health services to children and adolescents and their families in managed care systems, 8. Tampa, FL: Research and Training Center for Children's Mental Health, Louis de la Parte Florida Mental Health Institute, University of South Florida, 89-99.

 

 


Relevant MHSPY/Children's Health Initiative Resources

www.who.int/mental_health/media

www.jhsph.edu/wchpc/publications

rtckids.fmhi.usf.edu/rtcpubs/promising_approaches -1

rtckids.fmhi.usf.edu/rtcpubs/promising_approaches-2

 


 

 

Contact Info:

Katherine E. Grimes, MD, MPH - Principal Investigator

Sophie Lehar, MA - Senior Research Coordinator
120 Beacon St, 4th Fl.
Somerville, MA 02143

617-503-8456 (phone)
617-503-8470 (fax)