Skip to main content

Advertisement

Log in

National Trends in Implementing Wraparound: Results of the State Wraparound Survey, 2013

  • Original Paper
  • Published:
Journal of Child and Family Studies Aims and scope Submit manuscript

Abstract

The wraparound process aims to provide an effective practice-level approach to coordinating care for youths with complex behavioral health needs, and reformed system structures to support such integration of care. The current study provides an update to two prior surveys of state children’s mental health directors, completed in 1998 and 2007, on the extent of wraparound implementation in the United States and implementation supports that have been employed. Results from 2013 found that 100 % of states reported having some type of wraparound program that conformed to the definition and yielded an estimate of 75,000 children and families served via wraparound in that year. States reported a continued increase in use of wraparound standards; however, fewer states reported collection of fidelity data, and availability of internal resources for training and coaching. Over three-quarters of states reported availability of parent to parent peer support, and 46 % of states are supporting wraparound implementation by blending or braiding funding across child-serving systems. Results also revealed that 61 % of states had a centralized oversight entity for wraparound, an important finding given that such “statewideness” was also associated with more youth served, greater accountability, use of standards, and other implementation supports.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Au, M., Simon, S., Chen, A., Lipson, D., Gimm, G., & Rich, E. (2011). Comparative effectiveness of care coordination for adults with disabilities. In Mathematica Policy Research. Princeton, NJ: Center on Health Care Effectiveness.

  • Bertram, R. M., Suter, J. C., Bruns, E. J., & O’Rourke, K. E. (2011). Implementation research and wraparound literature: Building a research agenda. Journal of Child and Family Studies, 20(6), 713–725.

    Article  Google Scholar 

  • Bruns, E. J. (2015). Wraparound is worth doing well: An evidence-based statement. In E. J. Bruns & J. S. Walker (Eds.), The resource guide to wraparound. Portland, OR: National Wraparound Initiative.

    Google Scholar 

  • Bruns, E. J., & Hoagwood, K. E. (2008). State implementation of evidence-based practice for youth, part 1: Responses to the state of the evidence. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 369–373.

    Article  PubMed  Google Scholar 

  • Bruns, E. J., Hoagwood, K. E., Rivard, J. C., Wotring, J., Marsenich, L., & Carter, B. (2008a). State implementation of evidence-based practice for youth: Recommendations for research and policy. Journal of American Academy of Child and Adolescent Psychiatry, 47, 5.

    Google Scholar 

  • Bruns, E.J., Kerns, S.E.U., Pullmann, M.D., Hensley, S., Lutterman, T., & Hoagwood, K.E. (2016). Research, data, and evidence-based treatment use in state behavioral health systems, 2001–2012. Psychiatric Services, 67(5), 496–503.

    Article  PubMed  Google Scholar 

  • Bruns, E. J., Pullmann, M. D., Sather, A., Brinson, R. D., & Ramey, M. (2014a). Effectiveness of wraparound versus case management for children and adolescents: Results of a randomized study. Administration and Policy in Mental Health and Mental Health Services Research, 42, 309–322.

    Article  Google Scholar 

  • Bruns, E. J., Sather, A., Pullmann, M. D., & Stambaugh, L. F. (2011). National trends in implementing wraparound: Results from the state wraparound survey. Journal of Child and Family Studies, 20(6), 726–735.

    Article  Google Scholar 

  • Bruns, E. J., & Suter, J. C. (2010). Summary of the wraparound evidence base. In E. J. Bruns & J. S. Walker (Eds.), Resouce guide to wraparound. Portland, OR: National Wraparound Initiative.

    Google Scholar 

  • Bruns, E. J., Suter, J. C., & Leverentz-Brady, K. (2008b). Is it wraparound yet? Setting quality standards for implementation of the wraparound process. The Journal of Behavioral Health Services & Research, 35(3), 240–252.

    Article  Google Scholar 

  • Bruns, E. J., Walker, J. S., Bernstein, A., Daleiden, E., Pullmann, M. D., & Chorpita, B. F. (2014b). Family voice with informed choice: Coordinating wraparound with research-based treatment for children and adolescents. Journal of Clinical Child and Adolescent Psychology, 43(2), 256–269.

    Article  PubMed  Google Scholar 

  • Bruns, E. J., Walker, J. S., Daleiden, E. L., & Chorpita, B. F. (2013). Enhancing the wraparound process with the managing and adapting practice system: The promise of WrapMAP. Emotional and Behavioral Disorders in Youth, 13, 11–17.

    Google Scholar 

  • Bruns, E. J., Walker, J. S., Zabel, M., Matarese, M., Estep, K., Harburger, D., & Pires, S. (2010). Intervening in the lives of youth with complex behavioral health challenges and their families: The role of the wraparound process. American Journal of Community Psychology, 46(3–4), 314–331.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bruns, E. J., Weathers, E. S., Suter, J. C., Hensley, S., Pullmann, M. D., & Sather, A. (2014c). Psychometrics, reliability, and validity of a wraparound team observation measure. Journal of Child and Family Studies, 24(4), 979–991.

    Article  PubMed Central  Google Scholar 

  • Burchard, J. D., & Clarke, R. T. (1990). The role of individualized care in a service delivery system for children and adolescents with severely maladjusted behavior. Journal of Mental Health Administration, 17(1), 48–60.

    Article  PubMed  Google Scholar 

  • Burns, B. J. (2002). Reasons for hope for children and families: A perspective and overview. In B. J. B. K. Hoagwood (Ed.), Community treatment for youth: Evidence-based intervention for severe emotional and behavioral disorders (pp. 3–15). New York: Oxford University Press.

    Chapter  Google Scholar 

  • Center for Healthcare Strategies, Inc. (2012). Medicaid Financing for Family and Youth Peer Support: Center for Health Care Strategies, Inc.

  • Costello, E. J., Messer, S. C., Bird, H. R., Cohen, P., & Reinherz, H. Z. (1998). The prevalence of serious emotional distrurbance: A re-analysis of community studies. Journal of Child and Family Studies, 7, 411–432.

    Article  Google Scholar 

  • Faw, L. (1999). The state wraparound survey. In B. J. Burns & S. K. Goldman (Eds.), Systems of Care: Promising practices in children’s mental health, 1998 series. Washington, DC: Center for Effective Collarboration and Practice, American Institutes for Research.

    Google Scholar 

  • Greenhouse, S. W., & Geisser, S. (1959). On methods in the analysis of profile data. Psychometrika, 24, 95–112.

    Article  Google Scholar 

  • Grimes, K. E., Schulz, M. F., Cohen, S. A., Mullin, B. O., Lehar, S. E., & Tien, S. (2011). Pursuing cost-effectiveness in mental health service delivery for youth with complex needs. Journal of Mental Health Policy and Economics, 14(2), 73–86.

    PubMed  Google Scholar 

  • Institute of Medicine. (2003). Committee on identifying priority areas for quality improvement. Priority areas for national action: Transforming health care quality. Washington, DC: National Academies Press.

    Google Scholar 

  • Jeong, S., Lee, B. H., & Martin, J. H. (2014). Evaluating the effectiveness of a special needs diversionary program in reducing reoffending among mentally ill youthful offenders. International Journal of Offender Therapy and Comparative Criminology, 58(9), 1058–1080.

    Article  PubMed  Google Scholar 

  • Lombrowski, B., Griffin-Van Dorn, A., & Castillo, M. (2008). Youth advocates: What they do and why your wraparound program should hire one. In E. J. Bruns & J. S. Walker (Eds.), The resource guide to wraparound. Portland, OR: National Wraparound Initiative.

    Google Scholar 

  • Marshall, C., & Rossman, G. B. (1999). Designing qualitative research (3rd ed.). Thousand Oaks, CA: Sage Publications Inc.

    Google Scholar 

  • McDonald, K. M., Sundaram, V., Bravata, D. M., Lewis, R., Lin, N., Kraft, S. A., et al. (2007). Closing the quality gap: A critical analysis of quality improvement strategies (Vol. 7: Care Coordination). Rockville, MD: Agency for Healthcare Research and Quality.

  • Neylon, K., Shaw, R., & Lutterman, T. (2014). State mental health agency-controlled expenditures for mental health services, state fiscal year 2013, National Association of State Mental Health Program Directors. Alexandria, VA: National Association of State Mental Health Program Directors.

    Google Scholar 

  • Osher, T. W., & Penn, M. (2010). How family partners contribute to the phases and activities of the wraparound process. In E. J. Bruns & J. S. Walker (Eds.), The resource guide to wraparound. Portland, OR: National Wraparond Initiative.

    Google Scholar 

  • Pires, S. A., Grimes, K. E., Allen, K. D., Gilmer, T., & Mahadevan, R. M. (2013). Faces of Medicaid: Examining children’s behavioral health service utilization and expenditures. Hamilton, NJ: Center for Health Care Strategies Inc.

    Google Scholar 

  • Pullmann, M. D., Bruns, E. J., & Sather, A. K. (2013). Evaluating fidelity to the wraparound service model for youth: Application of item response theory to the Wraparound Fidelity Index. Psychological Assessment, 25(2), 583–598.

    Article  PubMed  PubMed Central  Google Scholar 

  • Simons, D., Pires, S. A., Hendricks, T., & Lipper, J. (2014). Intensive care coordination using high-quality wraparound for children with serious behavioral health needs: State and community profiles. Hamilton, NJ: Center for Healthcare Strategies, Inc.

    Google Scholar 

  • Soni, A. (2009). The five most costly children’s conditions, 2006: Estimates for the U.S. Civilians Noninstitutionalized Children, Aged 0–17 (Statistical Brief #242). Rockville, MD: Agency for Healthcare Research and Quality.

  • Stroul, B. A., Blau, G., & Sondheimer, D. (2008). Systems of care: A strategy to transform children’s mental health care. In B. A. Stroul & G. Blau (Eds.), Effective strategies for expanding the system of care approach: A report on the study of strategies for expanding systems of care (pp. 3–24). Baltimore: Paul H. Brookes Publishing Co.

    Google Scholar 

  • Suter, J. C., & Bruns, E. J. (2009). Effectiveness of the wraparound process for children with emotional and behavioral disorders: A meta-analysis. Clinical Child and Family Psychology Review, 12(4), 336–351.

    Article  PubMed  Google Scholar 

  • Tolan, P., & Dodge, K. (2005). Children’s mental health as a primary care and concern: A system for comprehensive support and services. American Psychologist, 60(6), 601–614.

    Article  PubMed  PubMed Central  Google Scholar 

  • U. S. Census Bureau. (2009). American FactFinder. Retrieved September 2009, from http://www.census.gov/.

  • Urdapilleta, O., Wang, Y., Varghese, R., Kim, G., Busam, S., & Palmisano, C. (2012). National evaluation of the Medicaid demonstration home and community based alternatives to psychiatric residential treatment facilities (pp. 1–166). IMPAQ International, LLC.

  • U.S. Deperpartment of Health and Human Services (2013). Informational bulletin on coverage of behavioral health services for children, youth and young adults with significant mental health conditions. Rockville, MD: Centers for Medicare & Medicaid Services. Retrieved November 2013, from www.medicaid.gov/federal-policy-guidance/downloads/CIB-05-07-2013.pdf.

  • U.S. Public Health Services. (2001). Youth violence: A report of the Surgeon General. Rockville, MD: U.S. Department of Health and Human Services Administration, Center for Mental Health Services, National Institutes of Health, National Institutes of Mental Health.

  • Walker, J. S., & Bruns, E. J. (2006a). Building on practice-based evidence: Using expert perspectives to define the wraparound process. Psychiatric Services, 57(11), 1579–1585.

    Article  PubMed  Google Scholar 

  • Walker, J. S., & Bruns, E. J. (2006b). The wraparound process: Individualized, community-based care for children and adolescents with intensive needs. In J. Rosenberg & S. Rosenberg (Eds.), Community mental health: Challenges for the 21st century (pp. 47–57). New York, NY: Routledge.

    Google Scholar 

  • Walker, J. S., Bruns, E. J., & Penn, M. (2008). Individualized services in systems of care: The wraparound process. In B. A. Stroul & G. M. Blau (Eds.), The system of care handbook: Transforming mental health services for children, youth, and families (pp. 127–153). Baltimore, MD: Paul H Brookes Publishing.

    Google Scholar 

  • Walker, J. S., Koroloff, N. M., & Bruns, E. J. (2010). Defining “necessary” services and supports: Why systems of care must take direction from service-level processes. Evaluation and Program Planning, 33(1), 49–52.

    Article  PubMed  Google Scholar 

  • Walker, J. S., & Matarese, M. (2011). Using a theory of change to drive human resource development for wraparound. Journal of Child and Family Studies, 20(6), 791–803.

    Article  Google Scholar 

  • Walker, J. S., & Sanders, B. (2011). The community supports for wraparound inventory: An assessment of the implementation context for wraparound. Journal of Child and Family Studies, 20(6), 747–757.

    Article  Google Scholar 

  • Yoe, J. T., Ryan, F. N., & Bruns, E. J. (2011). Mental health service expenditures among youth before and after enrollment into wraparound Maine: A descriptive study. Report on Emotional & Behavioral Disorders in Youth, 11(3), 61–66.

    Google Scholar 

Download references

Acknowledgments

The authors would like to acknowledge that funding for this work was provided by the Child, Adolescent, and Family Branch of SAMHSA, through a Task Order with the American Institutes of Research. No potential conflicts of interest exist. We would like to thank the 55 respondents from the 49 states who completed the 2013 State Wraparound Survey. This research involved collection of non-sensitive, de-identified information for the purpose of program evaluation, and hence, no informed consent or human subjects review was required.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to April Sather.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sather, A., Bruns, E.J. National Trends in Implementing Wraparound: Results of the State Wraparound Survey, 2013. J Child Fam Stud 25, 3160–3172 (2016). https://doi.org/10.1007/s10826-016-0469-7

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10826-016-0469-7

Keywords

Navigation