Results of an evaluation of the Child and Adolescent Service System Program (CASSP) in California are reported in this article. Interviews were conducted with human services agency staff (n = 60) and parents of children with serious emotional disturbance (SED; n = 67) regarding changes over the previous 4 years in their local children's service systems. Despite administrative obstacles and significant funding limitations, results indicate that CASSP had a modest, positive impact in the state of California. Specifically, CASSP increased interagency collaboration in human services planning and delivery and positively affected family participation in all aspects of services. CASSP inspired county mental health administrators to be leaders in the effort to establish culturally competent systems of care for children with SED. County agency administrators reported more significant positive changes than did parents of children with SED. Both groups of subjects indicated that many children with SED are not identified by service systems, and the needs of children with SED in the state of California are not adequately addressed.
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References
1.
Abney, V. D., & Gunn, K. (1993). A rationale for cultural competency. The APSAC Advisor, 6(3), 19–22.
2.
American Psychological Association. (1994). Comprehensive & coordinated psychological services for children: A call for service integration.Washington, DC: Author.
3.
Attkisson, C. C., Dresser, K. L., & Rosenblatt, A. (1995). Service systems for youth with severe emotional disorders: System of care research in California. In L. Bickman & D. Rog (Eds.), Children's mental health services: Research, policy, and innovation (pp. 236–280). Beverly Hills, CA: Sage.
4.
Attkisson, C. C., & Rosenblatt, A. (1993). Enhancing school performance of youth with severe emotional disorder: Initial results from system of care research in three California counties. School Psychology Quarterly, 4, 277–290.
5.
Attkisson, C. C., Rosenblatt, A., Dresser, K. L., Baize, H. R., Clausen, J. M., & Lind, S. L. (1997). Effectiveness of the California System of Care Model for children and youth with severe emotional disorder. In C. T. Nixon & D. Northrup (Eds.), Evaluating mental health services: How do programs for children “work” in the real world? (pp. 146–208). Thousand Oaks, CA: Sage.
6.
Behar, L. (1985). Changing patterns of state responsibility: A case study of North Carolina. Journal of Clinical Child Psychology, 14(3), 188–195.
7.
Behar, L. (1988). An integrated state system of services for seriously disturbed children. In J. G. Loony (Ed.), Chronic mental illness in children and adolescents.Washington, DC: American Psychiatric Press.
8.
Behar, L. (1997). The Fort Bragg Evaluation: A snapshot in time. American Psychologist, 52, 557–559.
9.
Behar, L. B., Macbeth, G., & Holland, J. M. (1993). Distribution and costs of mental health services within a system of care for children and adolescents. Administration and Policy in Mental Health, 20, 283–295.
10.
Bickman, L. (1996). A continuum of care: More is not always better. American Psychologist, 51, 689–701.
11.
Bickman, L., Guthrie, P. R., Foster, E. M., Lambert, E. W., Summerfelt, W. T., Breda, C. S., & Heflinger, C. A. (1995). Evaluating managed mental health services: The Fort Bragg experiment.New York: Plenum.
12.
Brown, C. L. (1996). California population totals 32.2 million—January 1, 1996. California Demographics, pp. 1–11. (Available from the California Department of Finance)
13.
Burns, B. J., Thompson, J. W., & Goldman, H. H. (1993). Initial treatment decisions by level of care for youth in the CHAMPUS Tidewater Demonstration. Administration and Policy in Mental Health, 20(4), 231–246.
14.
Children's Mental Health Services Act. (1987). California Welfare and Institutions Code Sections 5565.10–5565.40.
15.
Children's Mental Health Services Act. (1992). California Welfare and Institutions Code Sections 5850–5883.
16.
Cole, R. F., & Poe, S. L. (1993). Partnerships for care: Systems of care for children with serious emotional disturbances and their families. Interim report of the Mental Health Services Program for Youth.Washington, DC: Washington Business Group on Health.
17.
Day, C., & Roberts, M. C. (1991). Activities of the Child and Adolescent Service System Program for improving mental health services for children and families. Journal of Clinical Child Psychology, 20, 340–350.
18.
Demone, H. W., Schulberg, H. C., & Broskowski, A. (1978). Evaluation in the context of developments in human services. In C. C. Attkinsson, W. A. Hargreaves, & M. J. Horowitz (Eds.), Evaluation of human service programs.New York: Academic Press.
19.
Feldman, S. (1997). The Fort Bragg Demonstration and Evaluation. American Psychologist, 52, 560–561.
20.
Feltman, R., & Essex, D. (1989). The Ventura Model Presentation package. (Available from Randall Feltman, Director, Ventura County Mental Health Services, 300 Hillmont Avenue,Ventura, CA 93003)
21.
Flaskerud, J. H. (1986). The effects of culture-compatible intervention on the utilization of mental health services by minority clients. Community Mental Health Journal, 22(2), 127–141.
22.
Friedman, R. M., & Street, S. (1985). Admission and discharge criteria for children's mental health services: A review of the issues and options. Journal of Clinical Child Psychology, 14, 229–235.
23.
Horner, E. R. (1993). California cities, towns, & counties: Basic data profiles for all municipalities & counties.Palo Alto, CA: Information Publications.
24.
Joint Commission on Mental Health of Children. (1969). Crisis in child mental health: Challenge for the 1970s.New York: Harper & Row.
25.
Jordan, D. D., & Hernandez, M. (1990). The Ventura planning model: A proposal for mental health reform. The Journal of Mental Health Administration, 17(1), 26–47.
26.
Kinney, J. M., Madsen, B., Fleming, T., & Haapala, D. A. (1977). Homebuilders: Keeping families together. Journal of Consulting and Clinical Psychology, 45, 667–673.
27.
Knitzer, J. (1982). Unclaimed children.Washington, DC: Children's Defense Fund.
28.
Korbin, J. (1993). Cultural diversity and child maltreatment. The APSAC Advisor, 6(3), 23–25.
29.
Kutash, K., & Rivers, V. R. (1996). What works in children's mental health services? Uncovering answers to critical questions.Baltimore: Brookes.
30.
Leaf, P. J., Alegria, M., Cohen, P., Goodman, S. H., Horwitz, S. M., Hoven, C. W., Narrow, W. E., Vaden-Kiernan, M., & Regier, D. (1996). Mental health service use in the community and schools: Results from the four-community MECA study. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 889–897.
31.
Lourie, I. S., & Isaacs, M. R. (1988). Problems and solutions in the public sector. In J. G. Loony (Ed.), Chronic mental illness in children and adolescents.Washington, DC: American Psychiatric Press.
32.
Macbeth, G. (1993). Collaboration can be elusive: Virginia's experience in developing an interagency system of care. Administration and Policy in Mental Health, 20, 259–282.
33.
Madsen, J., Dresser, K. L., Rosenblatt, A., & Attkisson, C. C. (1994). Evaluation of the California Implementation of the Child and Adolescent Service System Program.San Francisco: UCSF Child Services Research Group. (Available from UCSF CSRG, 44 Montgomery Street, Suite 1450, San Francisco, CA 94104)
34.
Masland, M. C. (1996). The political development of “program realignment”: California's 1991 mental health care reform. Journal of Mental Health Administration, 23(2), 170–179.
35.
Public Health Services Act, Comprehensive Community Mental Health Services for Children and Adolescents with Serious Emotional Disturbance, 42 U.S.C. 290ffet seq. (1992).
36.
Roberts, R. E., Attkisson, C. C., & Rosenblatt, A. (in press). Prevalence of psychiatric disorder among children and adolescents. American Journal of Psychiatry.
37.
Rosenblatt, A., & Attkisson, C. C. (1992). Integrating systems of care in California for youth with severe emotional disturbance. I: A descriptive overview of the California AB 377 Evaluation Project. Journal of Child and Family Studies, 1, 93–113.
38.
Rosenblatt, A., & Attkisson, C. C. (1993). Integrating systems of care in California for youth with severe emotional disturbance. III: Answers that lead to questions about out-of-home placements and the AB377 Evaluation Project. Journal of Child and Family Studies, 2, 119–141.
39.
Rosenblatt, A., & Attkisson, C. C. (1977). Integrating systems of care in California for youth with severe emotional disturbance. IV: Educational attendance and achievement. Journal of Child and Family Studies, 6, 111–127.
40.
Rosenblatt, A., Attkisson, C. C., & Fernandez, A. J. (1992). Integrating systems of care in California for youth with severe emotional disturbance. II: Initial group home expenditure and utilization findings from the California AB 377 Evaluation Project. Journal of Child and Family Studies, 1, 263–286.
41.
Saxe, L., & Cross, T. P. (1997). Interpreting the Fort Bragg Children's Mental Health Demonstration Project: The cup is half full. American Psychologist, 52, 553–556.
42.
Shaffer, D., Fisher, P., Dulcan, M. K., Davies, M., Piacentini, J., Schwab-Stone, M. E., Lahey, B. B., Bourdon, K., Jensen, P., Bird, H. R., Canino, G., & Regier, D. A. (1996). The NIMH Diagnostic Interview Schedule for Children Version 2.3 (DISC-2.3): Description, acceptability, prevalence rates, and performance in the MECA study. Journal of the American Academy of Child and Adolescent Psychiatry, 35, 865–877.
43.
Stroul, B. A., & Friedman, R. M. (1986). A system of care for severely emotionally disturbed children and youth.Washington, DC: CASSP Technical Assistance Center.
44.
VanDen Berg, J. E. (1993). Integration of individualized mental health services into the system of care for children and adolescents. Administration and Policy in Mental Health, 20, 247–257.
