AN INNOVATIVE CHILDRENS MENTAL HEALTH SERVICE SYSTEM

拟议研究的主要目的是评估以下方面的程度 全面的个性化护理系统有助于改善 严重情绪障碍儿童的临床功能。这 研究的独特之处在于它检查了一种变化的影响 整体护理系统，而不是简单地研究个体的变化 系统的组件(例如，案例管理)。这项研究涉及一个州 制定了一项创新的示范计划，以提供 全面的托管服务。 拟议的项目提供了一个丰富而独特的机会来使用 随机实验设计研究阿司匹林的有效性 全面的管理型医疗体系。总共将有360个家庭参加 随机分配到新系统或照常治疗 收到了。家庭将在入境时接受采访，并在6、12、 24个月后，使用了大量的仪器电池。本研究 将在范德比尔特大学的相关努力的基础上 Ft.的实施和结果。布拉格儿童的心理健康 由陆军和国防部资助的服务系统示范 尼姆。这项评估为研究服务提供了一种经过现场测试的方法。 将在拟议的研究中使用的交付和临床结果。 拟议的研究集中在五个关键问题上： 。一个全面的临床护理系统的结果是什么 严重情绪障碍儿童的日常生活功能 他们的家庭功能正常吗？ 。影响结果的儿童和家庭因素是什么？ 。通过干预获得的收益是否比实现的收益更持久？ 通过标准护理制度？ 。服务利用的模式与创新的 计划和标准护理，以及， 。是否有可预测的服务利用模式 结果发生了积极、持久的变化？

The primary aim of the proposed research is to assess the extent to which a comprehensive system of individualized care leads to improvements in the clinical functioning of children with severe emotional disturbances. This research is distinctive in that it examines the effects of changes in a total system of care, in contrast to simply studying changes in individual components of a system (e.g., case management). The study involves a state that has developed an innovative demonstration program to provide comprehensive and managed services. The proposed project offers a rich and unique opportunity to use a randomized experimental design to study the effectiveness of a comprehensive system of managed care. A total of 360 families will be randomly assigned to either the new system or to treatment as usually received. Families will be interviewed at entry and re-interviewed 6, 12, and 24 months later using an extensive battery of instruments. This study will build upon Vanderbilt University's related efforts in its study of the implementation and outcome of the Ft. Bragg children's mental health services system demonstration funded by the Department of the Army and NIMH. This evaluation affords a field tested methodology to study service delivery and clinical outcomes that will be used in the proposed research. The proposed research focuses on five key questions: . What are the outcomes of a comprehensive system of care on the clinical functioning of children with severe emotional disturbance on the functioning of their families? . What are the child and family factors that influence the outcomes? . Are gains made through the intervention more enduring than those realized through standard care regimes? . How do the patterns of service utilization differ between the innovative program and standard care, and, . Are there patterns of service utilization that are predictive of positive, enduring changes in outcome?