Mental HEalth Treatment Participation Patterns of Severely Emotionally
Disturbed Children and Adolescents
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Diana Fuery
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5313 College Ave.
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Oakland CA. 94618
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510-601-1189
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FAX: 510-658-5675
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dfuery@earthlink.net
Purpose: Federal and State Legislation requires that mental health
services be provided to "severely emotionally disturbed"(SED) children
and adolescents. These mandated services are to be arranged and paid
for through collaboration between state mental health and state education
departments. The objective of this study was to identify the treatment
use patterns for seriously emotionally disturbed children and youth in
Alameda County, California. In addition, the impact on participation
patterns of both child characteristics and system response variables
was evaluated.
Methods: This paper reported findings from a secondary
analysis of data collected by Alameda County between 1990 and 1996.
The data includes 332 children and adolescents who were designated SED
and were eligible for mental health services. A dependent variable
was created to represent various utilization patterns. A number of
child characteristics and system response variables were found to predict
placement patterns.
Results: Four distinct utilization patterns were identified.
Logistic regressions identified variables which predicted these placement
patterns and chi-square analysis explored the relationship between child
characteristics and system response variables:
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Girls, often, used the emergency care system exclusively for their mental
health needs.
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African-Americans and boys were over-represented in all other utilization
pattern groups.
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A system bias toward externalizing and behaviorally disordered boys was
identified.
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Minority students experienced less stable mental health placements compared
with Caucasian students.
Implications for practice: Most students identified within
schools as eligible for mental health services under federal and state
law have complex psychosocial, educational and mental health needs.
Biases within the placement process impact the treatment efficacy for these
children. A proportion of the SED population is not receiving adequate
treatment. Knowledge of these patterns could improve treatment planning
and follow-up for this vulnerable population.