Accessing Coordinated Care for Children and Youth

Joseph P. Morrissey, Ph.D., Principal Investigator

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A National Institute of Mental Health research grant allowed the evaluation of clinical care and service system functioning in western North Carolina. The grant to the North Carolina Division of Mental Health, Developmental Disabilities, and Substance Abuse Services ( Lenore Behar, Ph.D., Principal Investigator) is implemented through UNC-CH and Duke University, with Joseph P. Morrissey, Ph.D. and Barbara Burns, Ph.D, as the responsible investigators. The project was developed with the mental health staff in Buncombe and Haywood Counties, NC.

The clinical component of this study examined the effectiveness of case management services (coordinated care) for children. A randomized control trial placed clients with a multi-agency team, including either a designated case manager (experimental condition) or a clinician who performs case management (comparison condition). Interview data was collected to examine changes in client functioning, clinical status, placement, and family impact. Children and parents were reimbursed for their participation in interviews.

The system component examined county-level councils and the inter-organizational service system surrounding the demonstration program. Performance assessments from 1991, including key informant surveys and network analyses, were compared with follow-up assessments in 1993 to determine changes in the service system. Analyses focused on the growth of a coordinated system of care for youth with severe emotional disturbances, and how systems-level variables affect case management services and client outcomes.