PATTERNS OF YOUTH MH CARE IN PUBLIC SERVICE SYSTEMS

这一应用是为了研究进入和通过多个系统的路径 对儿童和青少年的护理以及护理的短期结果 有严重精神健康问题或有严重精神健康问题的高风险。建议数 这项研究旨在评估跨越和内部的治疗模式 为患有不同疾病的儿童和青少年提供多种护理系统 诊断、心理健康和社会适应问题，涉及 结果。应特别注意儿童和青少年 不同类型的虐待(例如，忽视、情感虐待、 身体虐待、性虐待)和不同的暴力暴露(家庭、 学校、社区、一般文化)和不同的Cre模式 按性别和种族/民族分列的时间。除了仔细记录 进入和通过多个服务关注系统的路径将是 考虑到在不同级别安置的预测因素和结果 年内对护理和估算服务成本的限制性 与结果的关系。 为了实现这些目标，一项为期两年的1850年纵向研究 儿童和青少年(2-17岁)被提议。主题将是 从一天的未结病例列表中挑选出来的 五个儿童服务系统(#年的社会服务、心理健康、SED方案 圣地亚哥的公立学校、少年司法以及毒品和酒精) 这些人通常居住在圣地亚哥市。全 在一天列举中列出的儿童和青少年(大约 6500)将被分配到以下三个阶层之一：(1)2-5岁；(2)6- 17在限制最严格的护理模式中(例如，医院、监狱、 (3)限制较少的6-17岁儿童 关心。关于五个系统中涉及的任何服务的数据 去年将从五个管理信息系统中收集。在此基础上 系统参与模式的类型学(单一服务和多服务 系统护理模式)，并将所有受试者分配到 打字。最终样本将根据系统参与的模式进行分层 以及年龄/护理的限制性。 四个主要种族的不同模式的可能性 群体(非西班牙裔白人、黑人、墨西哥裔美国人和亚洲人 美国人)将被探索。除了采访数据，还有一位双性恋- 服务系统联系人和事件的年度列举将是 并将进行年度服务系统审查。

This application is to study pathways into and through multiple systems of care, as well as short term outcomes of care, for children and adolescents with or at high risk for significant mental health problems. The proposed study is designed to assess patterns of treatment across and within multiple systems of care for children and adolescents with different diagnoses, mental health and social adjustment problems, in relation to outcomes. Particular attention is to be paid to children and adolescents with different types of maltreatment (e.g., neglect, emotional abuse, physical abuse, sexual abuse) and different exposures to violence (family, school, neighborhood, general cultural) and different patterns of cre over time by gender and race/ethnicity. In addition to carefully documenting pathways into and through multiple systems of service attention will be given to predictors and outcomes of placement at various levels of restrictiveness of care and to estimating costs of services over time in relation to outcomes. In order to accomplish these goals, a two year longitudinal study of 1850 children and adolescents (ages 2-17) is proposed. Subjects will be selected from among those listed in a one day enumeration of open cases in five child service systems (social services, mental health, SED programs in the public schools, juvenile justice and drug and alcohol) in San Diego County and who are normally resident in the City of San Diego. All children and adolescents listed in athe one day enumeration (approximately 6500) will be assigned to one of three strata: (1) ages 2-5; (2) ages 6- 17 in athe most restrictive patterns of care (e.g., hospitals, jails, residential group homes; and (3) ages 6-17 in less restrictive patterns of care. Data concerning any service involvement in the five systems over the last year will be gathered from the five MIS's. On the basis of that data a typology of patterns of system involvement (single and multiple service system care patterns) will be developed and all subjects assigned to a type. The final sample will be stratified by pattern of system involvement as well as by age/restrictiveness of care. The potential for differential patterns across four major racial ethnic groups (non-Hispanic whites, Blacks, Mexican Americans, and Asian Americans) will be explored. In addition to the interview data, a bi- annual enumeration of service system contacts and episodes will be conducted and an annual service system review will be conducted.