OUTCOMES OF 3 CHILDREN'S PSYCHIATRIC EMERGENCY PROGRAMS

人们对与此相关的比较结果或成本知之甚少 针对精神危机儿童的不同急救方案 以及他们的家人。一种流行的家庭护理模式，用于精神科 14个州的健康设置是基于HomeBuilders计划 为儿童福利人群开发的。这种模式(称为基于家庭的模式 纽约州的危机干预)尚未被评估为 确定其用于治疗精神疾病儿童的结果 危机。该项目的具体目标是建立两个新的 家庭内应急计划、增强的基于家庭的危机干预 (HBCI+)和纽约布朗克斯的危机案例管理(CCM)，并进行比较 这些计划与HBCI的结果，当3个计划都 存在于同一个城市社区。此外，我们还将确定 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+在文化上有能力，并通过休息、父母 倡导灵活的服务费用，CCM使用案例管理和 稍作喘息。 这项研究使用了一项积极的随机对照研究设计， 重复测量，随机分配5-18岁的儿童到2岁 急救服务达到3种救治条件之一。数据收集 在登记时、6周或退伍时和6个月时发生。这个。 评估检查提供者的行为(即，提供的服务)、孩子 结果(例如，功能)、家庭结果(例如，适应性和 凝聚力、育儿自我效能感)、系统结果(例如成本、 限制环境的准入)和提供者结果(例如，工作 任期和满足感)。 一个重要的合作者是福特汉姆的西班牙裔研究中心 大学的作用将是确保HBCI+的文化竞争力， 修改或开发适合于大多数少数人的工具 将同意书和其他材料翻译成西班牙语，以及 收集有关儿童和家庭的后续数据。这项研究将提供 制定政策急需的数据 为儿童和家庭提供有效的精神急救服务。

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.