DATA FOR COLLABORATION: PREVALENCE ESTIMATES and ACCESS STRATEGIES In MOVING THE SYSTEM FOR SERVING

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DATA FOR COLLABORATION PREVALENCE ESTIMATES
and ACCESS STRATEGIES In MOVING THE SYSTEM FOR
SERVING CHILDREN WITH MENTAL HEALTH NEEDS TOWARDS
TRANSFORMATION
SAMHC Progress Report and Dialogue December 05,
2006 Principal Investigator Karen Blase,
Ph.D. Presentation by Nathaniel Israel, Ph.D.

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Our Sponsors

• This work is funded by the Florida Agency for
  Healthcare Administration with additional funding
  provided by the Florida Substance Abuse and
  Mental Health Corporation

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Presentation Goals

• Describe the context for this study
• Describe the content and literature supporting
  the study
• Describe why this matters to the SAMHC
• Invite responses and next steps

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Opportunities for Transformation

• The Florida DCF has embraced the idea of Mental
  Health Transformation
• Adopted outcome goals in line with the
  Presidents New Freedom Commission on
  Transforming Mental Health in America
• Working to create community-level changes in how
  services are conceived and delivered
• Enjoined state and local committees focused on
  cross-sector collaboration
• Now how do we go about achieving collaboration
  and Transformation?

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Data for Transformation

• 1) Cross Sector Prevalence Study
• 2) Diagram of Cross Sector Finance Flows
• 3) Multi-Level Survey and Description of System
  Change Strategies and Barriers to Change

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Prevalence of MH Needs in Florida

• Why re-examine prevalence rates?
• Dont we already have viable estimates of the MH
  need?
• Dont we already know the rate at which we serve
  children with mental health needs?
• What could we possibly accomplish by revisiting
  this data?

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Rationale for Re-examination

• Because
• Our estimates are a decade old in the meantime
  Floridas demography has shifted
• Children and youth with Mental Health needs often
  receive public services many receive services in
  sectors outside of the formal public MH system
• We can begin a data-based discussion about how we
  organize and allocate resources to provide
  high-quality care

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Study Design

• Use synthetic estimation derive estimates from
  state and regional studies of mental health
  prevalence, apply these estimates to FL
• Specifically look at literatures on prevalence
  rates of MH needs in four different public
  service settings juvenile justice, child welfare
  / protection, education, mental health
• Estimate number of children seen in each sector

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Scope of Literature Review

• Locating Articles that meet Study Criteria
• Standardized Diagnostic Measures
• Well-defined samples
• Clearly defined context
• Recent date of Publication
• Articles / Prevalence by Service Sector
• Juvenile Justice
• Child Welfare / Child Protection
• Education
• Mental Health
• Also look at issues of ethnicity and gender

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SED Prevalence Estimates San Diego
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Knowns and Explorations

• Initial indications of very high MH risk across
  service sectors (Garland, et al., 2001 Nagel et
  al., 2002)
• Risk for MH problems doubles for children below
  poverty line (per Heflinger, 2005 Costello, et
  al., 1998)
• Once poverty taken into consideration, no
  additional risk by ethnicity (Costello, 1998)
• Some indication that risk for MH disorder
  increases with age lower risk ages 2-5, moderate
  risk ages 6-17, heightened risk ages 18-21
  (Costello et al., 2003 Israel, 2006)

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Back to the Future

• These data can assist in Transformation if
• Common goals are identified
• Peoples mental models shift from zero-sum
  beliefs (someone has to lose) to collective
  adaptation beliefs (sustainability)
• True resource sharing occurs to meet goals
• Collective accountability for children

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These Estimates Can Be Helpful if

• Stakeholders
• Recognize that children do not belong to any
  one part of the public system
• Identify groups of children likely to be at risk
  for long-term, costly services
• Generate collective strategies to improve system
  capacity for no wrong door mental health
  treatment

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Your Comments, Please

• Suggestions
• Applications
• Extensions

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Contact me

• Nathaniel Israel, PhD
• E-Mail nisrael_at_fmhi.usf.edu
• Tel. [phone]
• Mail USF / FMHI
• 13301 Bruce B. Downs Blvd, MHC 2433
• Tampa, FL 33612