Caseload Segregation/Integration: A Measure of Shared Responsibility for Children and Adolescents

Abstract

In this article, we introduce a child-focused measure of the degree to which local systems of care share responsibility for children and adolescents (the Caseload Segregation/Integration Ratio) and apply this measure to three service sectors in each of Vermont's 10 mental health service areas. The analysis focuses on caseload overlap among three service sectors: community mental health programs, the state child protection agency, and special education for an emotional or behavioral disability. Because the three service sectors do not share unique person identifiers, probabilistic population estimation was used to derive unduplicated counts of the number of children and adolescents served. Caseload integration was found to be positively related to the size of the mental health service sector, negatively related to the size of the child protection service sector, and unrelated to the size of the special education emotional behavioral service sector.

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References

Banks, S.M. , & Pandiani, J.A. (1998). The use of state and general hospitals for inpatient psychiatric care. American Journal of Public Health, 87, 1637-1644.

Bickman, L. , Summerfelt, W.J. , & Noser, K. (1997). Comparative outcomes of emotionally disturbed children and adolescents in a system of services and insured care. Psychiatric Services, 48, 1543-1548.

Burns, B.J. , Costello, E.J. , Angold, A. , Tweed, D. , Stangl, D. , Farmer, E.M.Z. , & Erkanli, A. (1995). Children's mental health service use across service sectors. Health Affairs, 14(3), 147-159.

Feller, W. (Ed.) (1957). An introduction to probability theory and its application (2nd ed.). New York: Wiley.

Morrissey, J.P. , Johnsen, M.C. , & Calloway, M.O. (1998). Methods for system-level evaluations of child mental health service networks. In M. H. Epstein , K. Kutash , & A. Duchnowski (Eds.), Outcomes for children and youth with emotional disorders and their families (pp. 297-326). Austin, TX: PRO-ED .

Morrissey, J.P. , Tausig, M. , & Lindsey, M.L. (1985). Network analytic methods for mental health services system research: A comparison of two community support systems (DHHS Publication No. ADM 85-1383). Washington, DC: U.S. Government Printing Office.

Pandiani, J.A. , Banks, S.M. , & Gauvin, L.M. (1997). A global measure of access to mental health services for a managed care environment. The Journal of Mental Health Administration, 24, 268-277.

Pandiani, J.A. , Banks, S.M. , & Schacht, L.M. (1998a). Personal privacy vs. public accountability: A technological solution to an ethical dilemma. Journal of Behavioral Health Services and Research, 25, 456-463.

Pandiani, J.A. , Banks, S.M. , & Schacht, L.M. (1998b). Using incarceration rates to measure mental health program performance. Journal of Behavioral Health Services and Research, 25, 300-311.

10.

Stroul, B.A. , & Friedman, R.M. ( 1986). A system of care for children and youth with severe emotional disturbances (rev. ed.). Washington, DC: Georgetown University, Child Development Center, CASSP Technical Assistance Center.

11.

Stroul, B.A. , Lourie, I.S. , Goldman, S.K. , & Katz-Leavy, J.W. (1992). Profiles of local systems of care for children and adolescents with severe emotional disturbances (rev. ed.). Washington, DC: Georgetown University, Child Development Center, CASSP Technical Assistance Center.

12.

Van de Ven, H.A. , & Ferry, D.L. (1980). Measuring and assessing organizations. New York: Wiley.

13.

Warren, R. , Rose, S. , & Bergunder, A. (1974). The structure of urban reform. Lexington, MA: D. C. Heath.