Predicting patient deterioration in youth mental health services: community mental health vs. managed care settings

J Clin Psychol. 2012 Jan;68(1):24-40. doi: 10.1002/jclp.20831. Epub 2011 Oct 11.

Abstract

Objective: To examine differences across a community mental health system and a private managed care system in the accuracy of a warning system designed to identify youth at risk for deterioration in mental health services.

Design: Longitudinal outcome data from the Youth Outcome Questionnaire (Y-OQ) were examined using multilevel modeling for 2,310 youth ages 4-17 who received outpatient treatment.

Results: The warning system correctly identified 69% of cases that ultimately ended in deterioration in the community mental health setting, compared to 61% in the managed care setting. The overall hit rate (overall accuracy in classifying cases as deteriorators/non-deteriorators) was the same in the two settings (75%).

Conclusions: Results are consistent with previous research demonstrating that patient-focused warning systems can be reasonably accurate in identifying youth cases at risk for treatment failure.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Community Mental Health Services / standards*
  • Female
  • Humans
  • Male
  • Managed Care Programs / standards*
  • Mental Disorders / therapy*
  • Mental Health Services
  • Outpatients / classification*
  • Outpatients / psychology
  • Predictive Value of Tests
  • Sensitivity and Specificity
  • Surveys and Questionnaires / standards*
  • Treatment Failure