Long-term effects of a system of care on children and adolescents.

This study evaluates an exemplary system of care designed to provide comprehensive mental health services to children and adolescents. It was believed that the system would lead to more improvement in the functioning and symptoms of clients compared to those receiving care as usual. The project employed a randomized experimental five-wave longitudinal design with 350 families. While access to care, type of care, and the amount of care were better in the system of care, there were no differences in clinical outcomes compared to care received outside the system. In addition, children who did not receive any services, regardless of experimental condition, improved at the same rate as treated children. Similar to the Fort Bragg results, the effects of systems of care are primarily limited to system-level outcomes but do not appear to affect individual outcomes such as functioning and symptomatology.

Comparative outcomes of emotionally disturbed children and adolescents in a system of services and usual care.

OBJECTIVE: This study compared six-month functional and symptom outcomes of children and adolescents with serious emotional disturbance who received services in an exemplary system of care with outcomes of children who received traditional care. The system of care offers a comprehensive and coordinated network of mental health and other necessary services. METHODS: The study used a randomized longitudinal experimental design. Baseline data on symptoms, functioning, and family characteristics were collected from 350 families selected from among those who sought services for children from community agencies in Stark County, Ohio. The families were randomly assigned to either the experimental group, which received services from the system of care, or the control group, which received usual care in the community. Six-month outcome measures of children's symptoms and functioning were compared for the two groups. RESULTS: Although access to care and the amount of care received increased under the system of care, no differences in clinical or functional outcomes were found between the group served in the system of care and the group who received usual care. CONCLUSIONS: The effects of systems of care are primarily limited to system-level outcomes such as access to and cost of care and do not appear to affect clinical outcomes such as functioning and symptoms.