OUTCOMES OF 3 CHILDREN'S PSYCHIATRIC EMERGENCY PROGRAMS

很少有人知道的比较结果或相关的成本， 不同的紧急护理方案，为儿童在精神危机 和他们的家人。 一种流行的家庭护理模式，用于精神疾病， 在14个州的健康设置，是基于住房建设者计划 为儿童福利人群开发的。 此模型（称为基于家庭的 纽约州的危机干预）尚未进行评估， 确定其结果时，用于治疗儿童精神病 危机 该项目的具体目标是建立两个新的 家庭紧急方案，加强家庭危机干预 (HBCI+）和危机个案管理（CCM）在纽约州布朗克斯，并比较 这些项目的结果与HBCI的结果，当所有3个项目 都存在于同一个城市。 此外，我们将确定 儿童和家庭在哪种模式下体验到最好的结果。 HBCI将客户与服务联系起来，并教授育儿和沟通 技能，HBCI+是文化上的能力，并与喘息增强，父母 倡导，灵活的服务美元，CCM使用案例管理和 喘息 该研究采用阳性对照随机研究设计， 重复测量，将5-18岁的儿童随机分配到2 三种治疗条件之一的紧急服务。 数据收集 在入组时、6周或出院时以及6个月时发生。的. 评估检查提供者行为（即，提供的服务），儿童 结果（例如，功能），家庭结果（例如，适应性和 凝聚力，育儿自我效能），系统结果（例如成本， 对限制性设置的接纳），以及提供者结果（例如，工作 任期和满意度）。 一个重要的合作者是福德姆的西班牙裔研究中心 大学的作用将是确保HBCI+的文化能力， 修改或开发适合于大多数少数人的工具 人口，将同意书和其他材料翻译成西班牙语， 收集关于儿童和家庭的后续数据。 此项研究将提供 迫切需要数据来制定关于建立 为儿童和家庭提供有效的精神病紧急服务。

Little is known about the comparative outcomes or costs associated with different programs of emergency care for children in psychiatric crisis and their families. A popular model of infamily care, used in mental health settings in 14 states, is based on the Homebuilders program developed for a child welfare population. This model (called Home-Based Crisis Intervention in New York State) has not been evaluated to determine its outcomes when used for treatment of children in psychiatric crisis. The specific aims of this project arc to establish two new in-family emergency programs, enhanced Home-Based Crisis Intervention (HBCI+) and Crisis Case Management (CCM) in The Bronx, NY and to compare the outcomes of these programs with those of HBCI when all 3 programs exist in the same urban community. Additionally we will determine which children and families experience the best outcomes with which model. HBCI links clients to services and teaches parenting and communication skills, HBCI+ is culturally competent and enhanced with respite, a parent advocate, and flexible service dollars, and CCM uses case management and respite. The research uses a positive controlled randomized study design with repeated measures, randomly assigning children 5-18 years presenting to 2 emergency services to one of the 3 treatment conditions. Data collection occurs on enrollment, at 6 weeks or discharge, and at 6 months. The. evaluation examines provider behavior (i.e., services provided), child outcomes (e.g., functioning), family outcomes (e.g., adaptability and cohesion, parenting self-efficacy), system outcomes (e.g. costs, admissions to restrictive settings), and provider outcomes (e.g., job tenure and satisfaction). An important collaborator is the Hispanic Research Center at Fordham University whose role will be to ensure cultural competence of HBCI+, modify or develop instrumentation appropriate for the largely minority population, translate consent forms and other materials into Spanish,and collect follow-up data on children and families. The study will provide data urgently needed for policy development regarding establishment of effective psychiatric emergency services for children and families.