Clinical characteristics and outpatient mental health service use of transition-age youth in the USA.

This study examines diagnostic and service utilization patterns of transition-age youth in outpatient care derived from the 2007 nationally representative Client/Patient Sample Survey. Comparisons between 16-17, 18-21, and 22-25 year olds are highlighted. Among transition-age outpatients, the oldest youth had the highest rates of depression and bipolar disorder and co-occurring medical and substance use problems. Controlling for sociodemographic and clinical characteristics, 18-21 year olds were less likely to receive individual therapy than 16-17 year olds, but there were no age group differences in receipt of specialized therapy or psychotropic medication. Female gender and Hispanic ethnicity were positively associated with the number of services received and specialized service use, respectively; youth with private insurance were more likely than those with public insurance to receive psychotropic medication. Implications are discussed regarding access to and adequacy of services provided for young people in the critical transition to adulthood, especially with the implementation of the 2010 Affordable Care Act.

Organizational factors and the implementation of family to family: contextual elements of systems reform.

In efforts to reform the child welfare system, agency leaders must involve staff at all levels; yet, little research has been done to determine which organizational factors encourage or inhibit staff engagement. Employees from an urban child welfare agency were invited to complete a survey regarding organizational effectiveness and its influence on reform efforts. The results show how these findings can be used by managers to improve practice, specifically through increased information sharing with stakeholders.