Quality of Publicly-Funded Outpatient Specialty Mental Health Care for Common Childhood Psychiatric Disorders in California

• NCJ Number: 209149
• Journal: Journal of the American Academy of Child & Adolescent Psychiatry Volume: 44 Issue: 2 Dated: February 2005 Pages: 130-144
• Author(s): Bonnie T. Zima M.D.; Michael S. Hurlburt Ph.D.; Penny Knapp M.D.; Heather Ladd M.S.; Lingqi Tang Ph.D.; Naihua Duan Ph.D.; Peggy Wallace M.S.; Abram Rosenblatt Ph.D.; John Landsverk Ph.D.; Kenneth B. Wells M.D.
• Date Published: February 2005
• Length: 15 pages
• Grant Number(s): P30 MH68639; P50 MH546230; P50 MH50313
• Sponsoring Agency: California Dept of Mental Health; National Institute of Mental Health
• Publication Format: Article
• Publication Type: Report (Study/Research)
• Language: English
• Country: United States of America

Annotation

This study evaluated the adherence to quality indicators of care for children receiving outpatient mental health care in public clinics throughout California.

Abstract

The President’s New Freedom Commission on Mental Health (2003) recently noted that the public mental health care system for children is “in disarray.” In California, the estimated number of children with unmet health care needs lingers around 80.6 percent, well above the national average of 64.7 percent. For those receiving mental health care in public facilities, it is important to ensure the quality of care they receive meets with widely accepted quality standards. The current study assessed the extent to which 62 public mental health care clinics adhered to quality indicators for the outpatient care of attention-deficit/hyperactivity disorder, conduct disorder, and major depression in children. Also explored was how adherence to quality indicators varied by child or clinic characteristics. A longitudinal cohort study was conducted of 813 Medicaid children patients drawn from the 62 mental health clinics between August 1998 and May 1999. Their medical records, provided voluntarily from the clinics, were reviewed for scientific evidence and clinical judgment of how well their care met quality indicators. Results indicated high adherence to quality indicators of care for clinical assessment, but only moderate to poor adherence for service linkage, parental involvement, use of evidence-based psychosocial treatment, and patient protection. Most notably, among the patients prescribed psychotropic medication, only 28.3 percent of the records contained documentation on vital sign or laboratory monitoring. Adherence to quality indicators of care varied little by clinic or child characteristics. The findings suggest the need for widespread improvement among the California public mental health care system, with immediate improvement needed for the treatment of children prescribed psychotropic medications. Figure, tables, references