Predicting Differential Outcomes for Youth Receiving Intensive Case Management Services in Community Mental Health Settings
Nixon, Carol T.
The goal of this study was to explore the relationship between youth, family, and service characteristics and the differential, parent-reported mental health outcomes experienced by youth receiving intensive case management services. The descriptive and mixed-effects analyses were guided by a conceptual model drawing on the Double ABCX model, among others, that emphasized the ecological nature of youth outcomes. The study found that , more commonly, predictors were associated with youth symptoms and functioning scores at intake rather than mental health outcomes. For example, caregiver strain, age, gender, and length of stay were associated with scores at intake but not with outcomes. Also, predictors were more commonly associated with symptom rather than functioning outcomes. However, several findings have implications for existing services and further research. Youth custody status at intake was associated with outcomes. Youth in relative care improved at a slower rate than did youth in the custody or one or both biological parent(s). Children in foster care relapsed more after being in services for 6 months or more. Parent involvement directly impacted youth outcomes and moderated the relationship between youth/family stressors pile-up and outcomes. When parents were involved, youth symptom scores improved faster during the first 6 months of services. When parent involvement was high, youth symptom change over time is similar regardless of the level of stressors pile-up. However, when parent involvement was low, youth improved more slowly in the first 6 months. Youth whose caregivers were more involved demonstrated less relapse in symptoms after 6 months of services. This study’s findings suggest that the constellation of available family support services needs to be intentionally expanded. Services need to more frequently engage families in nontraditional therapeutic services and provide opportunities to enhance parenting skills, create social support networks, strengthen school and community engagement, and link caregivers to additional services in the community.