The Potential to Reduce Mental Health Disparities Through the Comprehensive Community Mental Health Services for Children and Their Families Program
- 239 Downloads
Few service systems are currently in place with the explicit purpose to reduce youth mental health disparities across socioeconomic status and race–ethnicity, despite substantial interest by the federal government and other institutions to redress health disparities. This study examines the potential for the Comprehensive Community Mental Health Services for Children and Their Families Program to address health disparities, even though this program was not explicitly designed for disparity reduction. Specifically, this study examines whether program sites disproportionately provide services within their catchment areas for youth who come from poor families, who are Black, and who are Hispanic. Data for this study come from 45 sites and 19,189 youth who were enrolled in program sites from 1997 to 2005. Meta-analysis was used to generate Forest plots and to obtain single, pooled estimates of risk ratios and their standard errors across all Children’s Mental Health Initiative communities. The results indicate that in comparison to the targeted catchment area (a) the percentage poor youth in the programs was almost three times higher, (b) the percentage Black in the programs was about twice as high, and (c) the percentage Hispanic in the programs was about the same. These results indicate that the program successfully reaches disadvantaged youth and can bring substantial infrastructure to address youth mental health disparities. In fact, to the extent that the program successfully improves mental health among enrollees it may be serving as one of the largest initiatives to redress health disparities, although its role in disparity reduction is not widely recognized.
Keywordsdisparities systems of care children’s mental health services
This research was supported by National Institute of Mental Health Grant # 1R01MH075828 and carried out at the Johns Hopkins Bloomberg School of Public Health. The views expressed are the opinions of the authors and not those of the National Institute of Mental Health, the National Institute of Health, or the federal government.
- 4.Center for Mental Health Services. Annual Report to Congress on the Evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program, 2001. Atlanta: ORC Macro; 2001.Google Scholar
- 5.National Institute of Mental Health. National Institute of Mental Health Five-Year Strategic Plan for Reducing Health Disparities, 2001; http://www.nimh.nih.gov/strategic/healthdisparities.pdf, last accessed June 10, 2007.
- 6.U.S. Department of Health and Human Services. Healthy People 2010. 2nd ed. With Understanding and Improving Health and Objectives for Improving Health. 2 vols. Washington, DC: U.S. Government Printing Office; 2000, November.Google Scholar
- 7.American Psychiatric Association. Diagnostic and Statistical Manual for Mental Disorders—Fourth Edition. Washington DC: American Psychiatric Association; 1994.Google Scholar
- 8.Stroul BA, Friedman RM. A System of Care for Seriously Emotionally Disturbed Children and Youth. Washington, DC: CASSP Technical Assistance Center, Georgetown University Child Development Center; 1986.Google Scholar
- 9.Center for Mental Health Services. Estimation methodology for children with a serious emotional disturbance (SED). Federal Register. 1997;62:52139–52145.Google Scholar
- 17.Substance Abuse and Mental Health Services Administration. Request for Applications: Cooperative Agreements for Comprehensive Community Mental Health Services for Children and Their Families Program; http://www.samhsa.gov/Grants/2008/sm_08_004.aspx, last accessed November 14, 2007.
- 19.US Census Bureau. Census 2000 Summary File 3—United States. Washington, DC: US Census Bureau; 2002.Google Scholar
- 20.Sharp S, Sterne J. sbe16: Meta-analysis. STATA Technical Bulletin. 1997;38:9–14.Google Scholar
- 21.Stephens RL, Connor T, Nguyen H, et al. The longitudinal comparison study of the national evaluation of the comprehensive community mental health services for children and their families program. In: Epstein MH, Kutash K, Duchnowski AJ, eds. Outcomes for Children and Youth with Behavioral and Emotional Disorders and Their Families: Programs and Evaluation Best Practices. Austin: PRO-ED; 2005:525–550.Google Scholar