RESUMO
This article presents the results of a survey of all state directors of mental health programs for children on the agreement with and use of financial policies and practices which promote home- and community-based mental health care for children and adolescents and their families. Whereas only five states reported the implementation of all the financial mechanisms feasible in their states, a majority of states reported the use of mechanisms such as federal funds, state resources and incentives, and flexible funds to encourage the development of community-based care. Results also indicated that states with a local form of government or local district or board that served as the local mental health authority tended to have more of the community-based financial practices in place than did states that contracted directly with providers at the local level.
Assuntos
Serviços de Saúde do Adolescente/economia , Serviços de Saúde da Criança/economia , Serviços Comunitários de Saúde Mental/economia , Assistência Médica/estatística & dados numéricos , Adolescente , Serviços de Saúde do Adolescente/estatística & dados numéricos , Análise de Variância , Atitude do Pessoal de Saúde , Criança , Transtornos do Comportamento Infantil/economia , Serviços de Saúde da Criança/estatística & dados numéricos , Serviços Comunitários de Saúde Mental/estatística & dados numéricos , Coleta de Dados , Serviços de Assistência Domiciliar/economia , Serviços de Assistência Domiciliar/estatística & dados numéricos , Humanos , Administração em Saúde Pública , Estados UnidosRESUMO
Family psychosocial functioning and its relation to psychopathology among adolescents with severe emotional disturbances (SED) was assessed. Subjects were 353 adolescents with SED, ages 12-18, and their parents. During a semi-structured interview, adolescents were administered Family Adaptability and Cohesion Evaluation Scale (FACES-III), Diagnostic Interview Schedule for Children-Child Version (DISC-C), and the Self-Derogation Scale. Parents were administered FACES-IIII and the Child Behavior Checklist (CBCL) in a phone interview. Results indicated that on the FACES-IIII cohesion dimension, both parents and adolescents perceived their family relations as more disengaged and less connected than did normative families (p less than .001). In contrast, only parent FACES-IIII adaptability scores were significantly more extreme than a normative sample (p less than .01). Additionally, both parent and adolescent cohesion scores were significantly correlated with adolescent psychopathology measures: DISC-C conduct disorder (p less than .01), depression (p less than .05), alcohol/marijuana (p less than .01), and CBCL externalizing symptoms (p less than .01). These relationships did not deviate from linearity.
