PATTERNS OF YOUTH MH CARE IN PUBLIC SERVICE SYSTEMS

该应用程序是研究进入和通过多个系统的途径， 儿童和青少年的护理以及护理的短期结果 有严重心理健康问题或有严重心理健康问题的高风险。 拟议 研究旨在评估治疗模式之间和内部 为不同年龄段的儿童和青少年提供多种护理系统 诊断、精神健康和社会适应问题 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）和不同的暴力风险（家庭， 学校，邻里，一般文化）和不同的模式的cre超过 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注意系统的途径将是 预测因素和结果的安置在各级 护理的限制性和估计随着时间的推移， 与成果的关系。 为了实现这些目标，1850年进行了一项为期两年的纵向研究， 儿童和青少年（2-17岁）。 受试者将 从那些在一天内列举的未决案件中选出， 五个儿童服务系统（社会服务，心理健康， 公立学校、少年司法、毒品和酒精） 县和谁通常居住在圣地亚哥市。 所有 儿童和青少年在2001年1月1日的统计中（大约 6500）将被分配到三个层次之一：（1）年龄2-5;（2）年龄6- 17在最严格的护理模式中（例如，医院监狱 （3）年龄在6-17岁之间， 在乎 有关五个系统中涉及的任何服务的数据， 将从五个管理信息系统中收集去年的数据。 根据这些数据 系统参与模式的类型学（单一和多重服务 系统护理模式），并将所有受试者分配到 类型. 最终样本将按系统参与模式分层 以及年龄/护理限制。 在四个主要的种族和民族之间的差异模式的可能性 群体（非西班牙裔白人、黑人、墨西哥裔美国人和亚裔 美国人将探索。 除了采访数据外，还有一个双- 服务系统联系人和事件的年度枚举将 并将每年进行一次服务系统审查。

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.