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Implications of a children’s mental health managed care demonstration evaluation

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Abstract

This article summarizes the major findings of the Fort Bragg Evaluation and considers alternative explanations for the results. The evaluation found that the continuum of care provided a high-quality system of care but was more expensive and produced no better clinical outcomes than traditional services. The possibility of implementation failure at both the systems and services levels is considered and rejected as an explanation for the results. Support for the validity of the measurement, design, and the analysis is also presented. The implications for research and policy are described.

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References

  1. Rivera VR, Kutash K:Components of a System of Care: What Does the Research Say? Tampa: University of South Florida, Florida Mental Health Institute, Research and Training, Center for Children’s Mental Health, 1994.

    Google Scholar 

  2. Bickman L: Improving established statewide programs: A component theory of evaluation.Evaluation Review 1985; 9:189–208.

    Google Scholar 

  3. Bickman L (Ed.):Using Program Theory in Evaluation. San Francisco: Jossey-Bass, 1987.

    Google Scholar 

  4. Bickman L (Ed.):Advances in Program Theory. San Francisco: Jossey-Bass, 1990.

    Google Scholar 

  5. Chen H:Theory-Driven Evaluations. Newbury Park, CA: Sage, 1990.

    Google Scholar 

  6. Chen H, Rossi PH: Evaluating with sense: The theory driven approach.Evaluation Review 1983; 7 283–302.

    Google Scholar 

  7. Yin RK:Case Study Research. Beverly Hills, CA: Sage, 1986.

    Google Scholar 

  8. Yin RK:Applications of Case Study Research. Newbury Park, CA: Sage, 1993.

    Google Scholar 

  9. Bickman L, Schut J, Karver M, et al.:Empirical Approaches toward Understanding Appropriate Care. Tampa: University of South Florida, Florida Mental Health Institute, Research and Training, Center for Children’s Mental Health, 1995.

    Google Scholar 

  10. Weisz JR, Weiss B:Effects of Psychotherapy with Children and Adolescents. Newbury Park, CA: Sage, 1993.

    Google Scholar 

  11. Joint Commission on Accrediation of Health Care Organizations:Consolidated Standards Manual. Oakbrook, IL: JCAHO, 1991.

    Google Scholar 

  12. Joint Commission on Accreditation of Health Care Organizations:Mental Health Accreditation Mannual. Oakbrook, IL: JCAHO, 1993.

    Google Scholar 

  13. Flannery D: Report of the Review of the Quality Assurance Mechanism, at the Fort Bragg Child and Adolescent Mental Health Demonstration. Unpublished manuscript, U.S. Army Health Services Command, San Antonio, TX.

  14. Hedrick T, Bickman L, Rog D:Planning Applied Social Research. Beverly Hills, CA: Sage, 1983.

    Google Scholar 

  15. Lipsey MW, Crosse S, Dunkle J, et al: Evaluation: The state of the art and the sorry state of the science. In: Cordray DS (Ed.):Utilizing Prior Research in Evaluation Planning: New Directions for Program Evaluation. San Francisco: Jossey-Bass, 1985, pp. 7–28.

    Google Scholar 

  16. Lambert EW: Monte Carlo modeling. In: Bickman L (Ed.): Response to the Directorate of Health Care Studies and Clinical Investigations Final Report (Revised). Unpublished manuscript, Vanderbilt University Center for Mental Health Policy, 1993.

  17. Cook T, Shadish W: Social experiments: Some developments over the past fifteen years.Annual Review of Psychology 1994; 45:545–580.

    Article  Google Scholar 

  18. Costner H: The validity of conclusions in evaluation research: A further development of Chen & Rossi theory-driven approach.Evaluation & Program Planning 1989; 12(4):345–353.

    Article  Google Scholar 

  19. Sussman M, Robertson DU: The validity of validity: An analysis of validation study design.Journal of Applied Psychology 1986; 71(3):461–468

    Article  Google Scholar 

  20. Palumbo DJ, Olivrio A: Implementation theory and the theory-driven approach to validity.Evaluation and Program Planning 1989; 12:337–344.

    Article  Google Scholar 

  21. Burns BJ: Mental health service use by adolescents in the 1970s and 1980s.Journal of the Academy of Child and Adolescent Psychiatry 1991; 30(1):144–150.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Vanderbilt Institute for Public Policy Studies, Vanderbilt University, 1207 18th Ave. South, 37212, Nashville, TN

    Leonard Bickman Ph.D. (Professor of Psychology Psychiatry, and Public Policy)

Authors
  1. Leonard Bickman Ph.D.
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Additional information

This research was supported by the U.S. Army Health Services Command (DADA 10-89-C-0013) as a subcontract from the North Carolina Department of Human Resources, Division of Mental Health, Developmental Disabilities, and Substance Abuse Services; and a grant to Dr Leonard Bickman (R01MH-46136-01) from the National Institute of Mental Health. This article is part of a special issue that focuses on the Fort Bragg Evaluation. These articles are best understood when read together. The articles are cross-referenced when it is deemed most appropriate.

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Bickman, L. Implications of a children’s mental health managed care demonstration evaluation. The Journal of Mental Health Administration 23, 107–117 (1996). https://doi.org/10.1007/BF02518647

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