National Evaluation Data Profile Report Findings from the 24-month outcome study

1. National Evaluation Data Profile Report Findings from the 24-month outcome study One Community Partnership August 18, 2008 Adapted from work by the National Evaluation Team at Macro, International.

2. Key Principles: System of Care • Community-based • Collaboration between multiple service sectors • Driven by family voices • Individualized support based on strengths and needs of child and family • Culturally competent • Includes a system of ongoing evaluation to assure data-based accountability.

3. Study Population 200,000 20,000 2,000 487 266 Data sources: US Bureau of Census 2000; SAMHSA (estimates SED prevalence rate in children to be 9-13%); Henderson Mental Health Center Youth Case Management Monthly Activity Reports

4. Methodology • Demographic and Diagnostic Study • Describes children and families who enter the system of care and identifies their background factors and service needs. • Derived from data provided by case manager and chart reviews. • Includes 487 youth enrolled in ART, BART, or Connections between July 2004–September 2007 who consented to participate in the FMHI evaluation.

5. Demographic Profile: Youth Sources: * Enrollment and Demographic Information Form ** http://www.fldoe.org/eias/flmove/broward.asp Numbers in the OCP category do not add to 100% due to differences in how data are collected. Non Hispanic multiracial (n=16) children are counted twice.

6. Geographic Distribution (n=482) Data source: Demographic and Diagnostic Study, Enrollment and Demographic Information Form

7. Insurance type(N= 487) Data source: Demographic and Diagnostic Study, Enrollment and Demographic Information Form

8. Presenting Problems at Intake*(n=487) *Because childrenmay have more than one presenting problem, this chart adds to >100%. Data source: Data source: Demographic and Diagnostic Study, Enrollment and Demographic Information Form

9. System Involvement at Intake (n=487) * includes Corrections, Juvenile Court, Probation Data source: Demographic and Diagnostic Study, Enrollment and Demographic Information Form

10. Referral Source, by Fiscal Year Data source: Demographic and Diagnostic Study, Enrollment and Demographic Information Form

11. Risk Factors Prior to Intake (n=251-260) Data source: National Evaluation Outcome Study, Caregiver Information Questionnaire-Baseline

12. Primary Participants in Wraparound Meetings Data source: National Evaluation Demographic Study, Enrollment and Demographic Information Form, Chart Reviews, as recorded in HMHC records

13. Other Participants at Wraparound Meetings(n=395) Case manager attendance ranged from 94% in 2004 to 100% in 2007 Data source: Enrollment and Demographic Information Form, Chart Reviews, as recorded in HMHC records

14. Methodology • Longitudinal Outcome Study • Assesses long-term impact of system of care. • Includes subset of demographic sample who agree to participate in longitudinal study. • Families are interviewed at 6-month intervals over a 3-year period. • For this report, youth/families were interviewed at baseline, 6, 12, 18 and 24-month intervals.

15. Stability of living situation – past 6 months

16. School Attendance Intake - 24 Months(n=44) Data source: Education Questionnaire-Revised

17. Grades –Intake to 24 months(n=54) Data source: Education Questionnaire-Revised

18. Disciplinary Actions at Intake Data source: Education Questionnaire-Revised

19. Disciplinary Actions at 24 months

20. Juvenile Justice Involvement Arrests Intake - 24 Months Data source: Delinquency Survey-Revised

21. Juvenile Justice Involvement On Probation Intake - 24 Months Data source: Delinquency Survey-Revised

22. Delinquent Behaviors Intake - 24 Months In the past 6 months, have you . . . ? Hit someone Out of control Damaged property Bullied Skipped school Data source: Delinquency Survey-Revised

23. Self-reported drug or alcohol use (previous 6 months) According to the 2006 National Survey on Drug Use and Health 3.9% of 12-13 year olds, 9.1% of 14-15 years and 16% of 16-17 year olds used illicit drugs in the previous. Source: http://www.oas.samhsa.gov/nsduh/2k6nsduh/2k6Results.pdf Data source: GAIN Quick-R

24. Degree of Substance ProblemsIntake - 24 Months No/minimal Moderate High Higher scores indicate greater dependence. Data source: GAIN Quick-R Urgency of substance problems are only calculated for youth that used in the previous six months.

25. Internalizing Problem Behaviors and Symptoms Intake - 24 Months Clinical range Ns range from 261 at Intake to 89 at 24 months Data sources: Total Problem T-score: Child Behavior Checklist (6-18)

26. Externalizing Problem Behaviors and Symptoms Intake - 24 Months Clinical range Ns range from 261 at Intake to 89 at 24 months Data sources: Total Problem T-score: Child Behavior Checklist (6-18)

27. AnxietyIntake - 24 Months Ns ranged from 248 at Intake to 74 at 24 months Data sources: Anxiety-Revised Children’s Manifest Anxiety Scale. Total T-scores>60 indicate high levels of anxiety on the RCMAS.

28. DepressionIntake - 24 Months Data sources: Depression-Reynold’s Adolescent Depression Scale 2. Total T-scores > 60 indicate clinical levels of depression on the RADS. Ns ranged from 248 at Intake to 74 at 24 months

29. Caregiver Perspectives of Youth’s Behavioral and Emotional Strengths Intake - 24 Months Average range Higher scores indicate greater strengths. Data Source: Behavioral & Emotional Rating Scale-Caregiver and Youth

30. Youth’s Perspectives on their Behavioral and Emotional Strengths Intake - 24 Months Average range Higher scores indicate greater strengths. Data Source: Behavioral & Emotional Rating Scale-Caregiver and Youth

31. Caregiver Global Strain Intake - 24 Months Lower scores indicate higher functioning OCP Ns range from 263 at Intake to 89 at 24 months NOTE: Global Strain includes stresses due to resources (e.g., time & money), and feelings such as anger or resentment, guilt or fatigue due to caregiving responsibilities. Data Source: Caregiver Strain Questionnaire

32. Service definitions Case management or service coordination involves finding and organizing multiple treatment and support services, and may also include preparing, monitoring, and revising service plans; and advocating on behalf of the child and family. Case managers may also provide supportive counseling. Individual therapy relies on interaction between therapist/clinician and child to promote psychological and behavior change. Medication treatment and monitoring services typically include the prescription of psychoactive medications by a physician (e.g., psychiatrist) that are designed to alleviate symptoms and promote psychological growth. Treatment includes periodic assessment and monitoring of the child’s reaction(s) to the drug.

33. Child Services Received 6 - 24 Months Data Source: Multi-Sector Service Contacts-Revised-Caregiver

34. Service definitions Family therapy involves a variety of family members such as caregivers and/or siblings with or without the child present. Interaction among family members is typically facilitated by a therapist or counselor. Caregiver or family support services are provided to caregivers or siblings (e.g., family activities, behavior management training, parent classes, support groups, individual therapy for caregiver or other family members). These do not recreational activities, behavioral/therapeutic aide, transportation services, respite care, after-school activities or child care which are described in other questions. Informal supports are defined as assistance from persons who provide support to the family without compensation from any formal service system. This type of support includes asking a relative or friends to baby sit a child, support received from someone’s church, etc.

35. Family Services Received 6 - 24 Months NOTE: Family therapy is typically facilitated by a therapist or counselor. Family support may include support groups, parenting classes,behavior management training for caregivers, etc. Informal support is assistance provided without compensation from any formal service system (e.g., support from friends, church, etc.). Data Source: Multi-Sector Service Contacts-Revised-Caregiver

36. Cultural Competency at Intake and 24 Months My primary service provider: Data Source: Cultural Competence and Service Provision-Caregiver

37. Caregiver and Youth Perspectives on Services at 24 Months Very Satisfied Very Dissatisfied Scores range from 0 (strongly negative) to 5 (strongly positive). Scores above 3.5 are regarded as positive Data source: Youth Services Survey for Families-Caregiver and Youth Services Survey

38. Caregiver and Youth Perspectives on Services at 24 Months Very Dissatisfied Neutral Very Satisfied Scores range from 0 (strongly negative) to 5 (strongly positive). Data source: Youth Services Survey for Families-Caregiver and Youth Services Survey

39. Key Child Outcomes24 months after entering System of Care • Most youth continue to live at home with their families. • Youth’s behavioral and emotional functioning improved and remained stable over time: • At home: decrease in symptomatology, anxiety, and depression; • At school: improvement in grades and attendance; and • In the community: decrease in common delinquent behaviors and arrests

40. Key Family Outcomes24 months after entering System of Care • Caregivers report less strain over time. • In general, families were satisfied with the services they received.

41. Recommendations • Use data to drive community decisions. • Use data to drive ongoing fidelity of process in terms of training, cross system involvement, etc • Continue to challenge OCP Oversight Committee to involve families and youth in identifying what families need. • Support Family Voices to continue family, youth and informal support involvement at all levels of decision making (e.g., governance & family team service planning)