SAFE-WA PARTNERS MEETING March 18, 2009 Tacoma, WA. EVIDENCE BASED PRACTICE INSTITUTE. Division of Public Behavioral Health and Justice Policy University of Washington. Outline. Children’s Mental Health Services Children’s Mental Health in Washington State House Bill 1088
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(34 effective interventions cited by Greenberg et al, 1999)
(Elliot, 1999; Henggeler et al., 2003)
TOTAL = 40,526 Children on psychiatric medication
received NO outpatient mental health care*
received outpatient mental health care
Drug classes include:
Legislative goals by 2012:
Increasing community capacity
Improving youth outcomes
UW PBHJP, Nursing, Social Work, CHMC
Sustained training and consultation in MH and Primary Care
Monitor outcomes and quality assurance
Community empowerment and education
Implementation of PfS model
Youth receiving appropriate EBP services
Summary of current projects related to HB1088
Wraparound brings the systems together at the family level – Plans are designed and implemented by a team of people important to the family
The plan is driven by and “owned” by the family and youth
Strategies in the plan include supports and interventions across multiple life domains and settings (i.e., behavior support plans, school interventions, basic living supports, family supports, help from friends and relatives, etc)
Plans include supports for adults, siblings, and family members as well as the “identified youth”
High-quality teamwork and flexible funds leads to enhanced creativity, better plans, and better fit between family needs and services/supports
This in turn leads to greater relevance for families, less dropout
Strengths, needs, and culture discovery and planning process leads to more complete engagement of families
As family works with a team to solve its own problems, develops family members’ self-efficacy
Individualization and strengths focus enhances cultural competence, relevance, and acceptability
Focus on setting goals and measuring outcomes leads to more frequent problem-solving and more effective plans
A project of the UW Children’s Mental Health Evidence Based Practices Institute
1.What is the level of fidelity and quality of wraparound implementation?
2. What outcomes are experienced by individual youth and families, in the following areas:
Youth behavior and functioning,
Family support and resources,
Maintenance in community settings, and
School, community, and juvenile justice outcomes
3. What is the adequacy of community supports for implementing wraparound across the state initiative and for the three funded sites?
18 entered pilot project; 1 dropped out = 15 total
Intake data completed for N=17
11 entered project; 5 dropped out = 6 total
Intake data completed for N=6
7 entered project; 1 dropped out
Intake data completed for N=6
In the first seven months of the program, 30 youth at risk of placement out of the community (e.g., psychiatric hospital, residential treatment, group homes, juvenile detention) have been enrolled in the three pilot counties. Seventeen have been enrolled in Skagit, six in Grays Harbor, and seven in Cowlitz.
As of February 10, 2009, 29 of the 30 (97%) enrolled youth have been maintained in community-based, home-like settings: homes of biological or adoptive parents (73%), homes of relatives or friends (20%), or foster care (7%).
Only one (3%) of the 30 youths has, to date, been placed out of the community (brief stay in juvenile detention due to probation violation).
The avoidance of out of community placement is impressive considering that, according to intake data, in the six months prior to enrollment in the wraparound projects:
29% of enrolled youth had required inpatient hospitalization
17% had experienced some other type of out-of-community placement (e.g., juvenile detention) or had no place to stay
29% had been arrested
25% had been suspended or expelled from school
37% had run away from home
14% had attempted suicide.
School of Medicine
University of Washington
2815 Eastlake Ave Ste 200
Seattle, WA 98102