Predictors of outcome for children with behavior problems served in public mental health.

This study investigated whether pervasiveness of problems across settings predicted successful reduction of impairment in school, home, and interactions with others after controlling for other variables that may be stronger predictors. The data of 4,434 youths between the ages of 7 and 17 years in public mental health services in Michigan were examined employing logistic regressions, with 4 sets of predictors, as follows: demographic characteristics, risk factors, therapist's perception of impairment in the youth's caregiving environment, and pervasiveness of the youth's problems. The results indicated that pervasiveness of problems was the strongest predictor of poor outcomes for each domain.

The role of monitoring outcomes in initiating implementation of evidence-based treatments at the state level.

This article describes a six-year statewide initiative to help mental health service providers in continuously monitoring the outcomes of youths with serious emotional disturbances who are treated in the public-sector managed behavioral health care system. Participating providers submit outcome data to a state-sponsored evaluator, using the Child and Adolescent Functional Assessment Scale (CAFAS), and receive monthly feedback that identifies youths who are making poor progress in treatment. Additional reports are used to ensure record compliance, monitor at-risk youths, and assist in reviewing the adequacy of treatment plans.