NYC START: A New Model for Securing Community Services for Individuals Hospitalized for First-Episode Psychosis.

Objective: The New York City (NYC) Board of Health amended the city's health code to require hospitals to report to the Department of Health and Mental Hygiene when individuals ages 18-30 are hospitalized for first-episode psychosis (FEP). This study examined the implementation of NYC START, a program that meets patients hospitalized with FEP to offer a voluntary, 3-month critical time intervention provided by social workers and peer specialists to connect individuals to appropriate community mental health services after discharge.

Methods: Service logs completed by program staff were summarized to determine the mean number of contacts received per client per week, types of services provided by social workers and peer specialists, survival analyses of time to discharge from NYC START, and connection rates with community mental health services.

Best practices: Best practices for improving engagement of clients in clinic care.

Mental health clinicians and program administrators must implement effective strategies for engaging and retaining clients in care. At a recent series of forums open to providers from clinics in New York City that was sponsored by the city and state public mental health authorities, high-performing providers described their client engagement strategies. In this column the effective strategies reported are summarized in four areas: the first session, staff training and expertise, productivity measures, and engaging families and support persons.

Inner-city child mental health service use: the real question is why youth and families do not use services.

Objective: This study examines pathways to urban child mental health care as well as explores reasons why care was not received.

Methods: A single group longitudinal design was used to study initial attendance rates at an outpatient child mental health clinic and identify factors associated with initial service use for urban children and their families.

Results: Approximately one-third of families (n = 82) do not follow up with care despite their child being referred and an initial appointment scheduled.

Multiple-family groups for urban children with conduct difficulties and their families.

The authors present the results of two studies designed to improve treatment engagement among urban youths with conduct and oppositional behavioral difficulties. In the first study, information on attitudes about mental health treatment was obtained from 159 adult caregivers of children who were referred to an urban child mental health clinic because of disruptive behavioral difficulties. The caregivers listed insufficient time, lack of transportation, the child's not wanting to attend treatment, and the caregiver's concern that treatment might not help as barriers to service use.