The Consistencies and Vagaries of the Washington State Inventory of Evidence-Based Practice: The Definition of "Evidence-Based" in a Policy Context.

As states increasingly establish the importance of evidence-based practice through policy and funding mandates, the definition of evidence-based practice can have a significant impact on investment decisions. Not meeting established criteria can mean a loss of funding for established programs and the implementation disruption of programs without a strong research base. Whether the definition of "evidence-based" is influenced by these high stakes contexts is an interesting question that can inform the larger field about the value and utility of evidence-based practice lists/inventories for disseminating knowledge.

American Indian perspectives on evidence-based practice implementation: results from a statewide Tribal Mental Health Gathering.

Implementation of Evidence-Based Practices (EBP) within American Indian and Alaskan Natives communities is currently an area of debate and contention. There is considerable concern about expanding EBP policy mandates to AI/AN communities as these mandates, either through funding restrictions or other de facto policies, recall past histories of clinical colonization and exploitation by the state and federal government. As a response, work is being done to evaluate indigenous programs and examine strategies for culturally-sensitive implementation.

The Partnership Access Line: evaluating a child psychiatry consult program in Washington State.

Objective: To evaluate a telephone-based child mental health consult service for primary care providers (PCPs).

Design: Record review, provider surveys, and Medicaid database analysis.

Setting: Washington State Partnership Access Line (PAL) program.

Child welfare caseworkers as service brokers for youth in foster care: findings from project focus.

Youth in the foster care system have substantially higher rates of mental health needs compared to the general population, yet they rarely receive targeted, evidence-based practices (EBPs). Increasingly emerging in the literature on mental health services is the importance of "brokers" or "gateway providers" of services. For youth in foster care, child welfare caseworkers often play this role.

Second opinions improve ADHD prescribing in a medicaid-insured community population.

Objective: The appropriate use of psychotropic medications in youths is an important public health concern. In this article, we describe a review process developed to monitor the use of stimulants and atomoxetine for attention-deficit/hyperactivity syndrome (ADHD) in youths receiving fee-for-service Medicaid services.

Method: Washington State Medicaid developed threshold safety parameters for ADHD medications through a process involving the community.

Identifying a negative mood subtype in incarcerated adolescents: relationship to substance use.

Objective: The following study tested the empirical validity and clinical meaningfulness of a negative mood subtype of incarcerated adolescent males (N=270). Differences in alcohol and marijuana use and consequences were examined.

Method: Participants were subtyped according to reports of depressive and anxious symptoms using the Children's Depression Inventory and the Revised Children's Manifest Anxiety Scale.

Transition planning and recidivism among mentally ill juvenile offenders.

Objectives: To determine the extent to which transition planning and community service would predict lower levels of recidivism among mentally ill juvenile offenders.

Design: Review of legal, medical and social service records including examination of 3-month period following community release.

Participants: Juvenile offenders incarcerated for 6 months or more (N = 44) transitioning to community.

Mental health assessments in juvenile justice: report on the consensus conference.

Objective: At national, state, and local levels, there is increasing recognition of the importance of identifying and responding to the mental health needs of youths in the juvenile justice system, as policymakers and practitioners struggle to find ways to address causes and correlates of juvenile crime and delinquency. The proposed guidelines for mental health assessment provide explicit information about how, why, and when to obtain mental health information on justice youths at each important juncture in processing.

Method: A national group of expert researchers and practitioners convened in April 2002.

Clinical utility and policy implications of a statewide mental health screening process for juvenile offenders.

Objectives: This study examined the utility of screening adjudicated juvenile offenders for mental health symptoms at intake to the State of Washington Juvenile Rehabilitation Administration. The authors assessed the ability of a screening measure, the Massachusetts Youth Screening Inventory, second edition (MAYSI-2), to identify youths with mental health problems and co-occurring substance use problems. This study also examined the relationship of these symptoms to treatment utilization both before and after intake to the juvenile justice system.

Families as full research partners: what's in it for us?

This article describes a children's managed mental health care program that incorporates both a family participation service model and a family-initiated evaluation model. The authors begin by tracing the evolution of the family support and the participatory research movements leading to current developments in children's mental health services research. In the King County Blended Funding Project, three service systems pool funds that are spent flexibly by child and family teams.

Racial differences in the criminalization of the mentally ill.

"Criminalization," the hypothesis that mentally ill persons are diverted to the criminal justice system, has been difficult to confirm. The few relevant studies have examined aspects of the mental health or the criminal justice systems, but not both. This study compares state hospital admissions with the admission of mentally ill persons to state prisons.

Children on child protective service caseloads: prevalence and nature of serious emotional disturbance.

A multivariate, criterion-referenced approach was used to assess prevalence of serious emotional disturbance among children on protective service case loads. Of 140 recipients of protective services, 72% were statistically indistinguishable from children in Washington State's most intensive mental health treatment programs. School problems, substance abuse, and antisocial behaviors were common in the sample, as were family histories of mental illness or substance abuse.

Service needs of severely disturbed children.

Background: As one piece of a statewide Children's Mental Health System Analysis conducted in Washington State, the specific service needs of severely emotionally disturbed children were investigated.

Methods: The primary case-workers of 3398 children under the care of the state responded to a survey of the child's treatment history, social and clinical condition, and service needs. Service need data on the 2455 children in the sample who were classifiable as severely emotionally disturbed were examined using log linear analysis.

Prevention of psychiatric disorders in children.

Mental health professionals have the capability to identify children who are at risk of developing psychiatric disorders. Early intervention with these children can help prevent significant maladjustment and reduce their future need for mental health services. The authors review studies of environmental and temperamental factors associated with children's vulnerability and resilience to psychiatric disorders.

The mentally ill in prisons: a review.

Mentally ill persons who have been charged with crimes present difficult dilemmas for correctional authorities and mental health system administrators. The authors examine the scope of the problem, the legal issues and treatment needs of this population during incarceration, and the obstacles in caring for them after their eventual release from prison. They recommend that mentally ill offenders be afforded the same level of mental health care available to mentally ill residents in other institutions and in the community.

Children's mental health services: a parent perspective.

Parents of severely emotionally and behaviorally disturbed children rarely have the opportunity to participate in the policy-making processes that affect their children's welfare. In the present study, a structured parent interview was developed as part of Washington State's Child and Adolescent Services System Program (CASSP). Thirty-five parents of disturbed children provided information about their children's problems and services histories.

Survey of the utilization of psychiatrists and psychologists for hospitalized children.

Although interest by psychiatrists and psychologists in consultation to pediatric settings has increased in the past few years, little is known about how frequently they have been involved in providing psychosocial services to hospitalized children. The authors distributed a 20-item questionnaire to 136 pediatricians and 12 head nurses, representing 22 hospitals throughout Washington State. The questionnaire was designed to assess the disciplines involved in providing psychosocial care, the availability of various personnel, teaching functions, funding of services, and perceived need for further services.