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Administration and Policy in Mental Health and Mental Health Services Research

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Open Access 26.10.2022 | Original Article

Scaling-up Child and Youth Mental Health Services: Assessing Coverage of a County-Wide Prevention and Early Intervention Initiative During One Fiscal Year

verfasst von: Cole Hooley, Deborah Salvo, Derek S. Brown, Lauren Brookman-Frazee, Anna S. Lau, Ross C. Brownson, Patrick J. Fowler, Debbie Innes-Gomberg, Enola K. Proctor

Erschienen in: Administration and Policy in Mental Health and Mental Health Services Research | Ausgabe 1/2023

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Abstract

Purpose

In the U.S., the percentage of youth in need of evidence-based mental health practices (EBPs) who receive them (i.e., coverage rate) is low. We know little about what influences coverage rates. In 2010, the Los Angeles County Department of Mental Health (LACDMH) launched a reimbursement-driven implementation of multiple EBPs in youth mental health care. This study examines two questions: (1) What was the coverage rate of EBPs delivered three years following initial implementation? (2) What factors are associated with the coverage rates?

Methods

To assess coverage rates of publicly insured youth, we used LACDMH administrative claims data from July 1, 2013 to June 30, 2014 and estimates of the size of the targeted eligible youth population from the 2014 American Community Survey (ACS). The unit of analysis was clinic service areas (n = 254). We used Geographic Information Systems and an OLS regression to assess community and clinic characteristics related to coverage.

Results

The county coverage rate was estimated at 17%, much higher than national estimates. The proportion of ethnic minorities, individuals who are foreign-born, adults with a college degree within a geographic area were negatively associated with clinic service area coverage rates. Having more therapists who speak a language other than English, providing care outside of clinics, and higher proportion of households without a car were associated with higher coverage rates.

Conclusion

Heterogeneity in municipal mental health record type and availability makes it difficult to compare the LACDMH coverage rate with other efforts. However, the LACDMH initiative has higher coverage than published national rates. Having bilingual therapists and providing services outside the clinic was associated with higher coverage. Even with higher coverage, inequities persisted.

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World Health Organization (2010). Nine steps for developing a scaling-up strategy

Titel: Scaling-up Child and Youth Mental Health Services: Assessing Coverage of a County-Wide Prevention and Early Intervention Initiative During One Fiscal Year
verfasst von: Cole Hooley
Deborah Salvo
Derek S. Brown
Lauren Brookman-Frazee
Anna S. Lau
Ross C. Brownson
Patrick J. Fowler
Debbie Innes-Gomberg
Enola K. Proctor
Publikationsdatum: 26.10.2022
Verlag: Springer US
Erschienen in: Administration and Policy in Mental Health and Mental Health Services Research / Ausgabe 1/2023
Print ISSN: 0894-587X
Elektronische ISSN: 1573-3289
DOI: https://doi.org/10.1007/s10488-022-01220-3

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Scaling-up Child and Youth Mental Health Services: Assessing Coverage of a County-Wide Prevention and Early Intervention Initiative During One Fiscal Year