A 4-year study of 27 system-of-care sites designed to provides mental health services to children and adolescents, found that despite many changes in each local service system, no site was able to fully implement all 16 key attributes comprising an ideal system-of-care model (including sites with previous system-building experience). (Contains…

This article reviews recent changes in the mental health system's response to children and adolescents with serious emotional disabilities, emphasizing developments in service delivery and service demonstration research and evaluation efforts. The role of research is examined in terms of its critical importance in improving the system of care for…

This article examines the relationship between an adolescent with behavior disorders, his family, and the system of care, through a single case analysis. The methodology used to collect the case record and interview data and to analyze and graphically illustrate the data are presented to demonstrate use of qualitative data in program evaluation.…

This article presents a description of the Child and Adolescent Services Assessment, a self- and parent-report instrument designed to assess use of mental health services by children, ages 8 to 18. The article provides information on interviewer training, coding of data, and psychometric data on clinical samples, and presents a case study.…

Three customary performance guidelines (therapeutic relationship, satisfaction, and parent involvement) believed to be indicators of quality care were tested for their ability to account for improved mental health outcomes among 240 adolescent clients. Results showed statistically significant relationships between these commonly accepted measures…

Using data from three sites, a study examined service use and expenditures under systems-of-care. The sites provided children with a full range of mental health services. Per-child expenditures were high, but for two sites, those expenditures were within the range of expenditures in other innovative attempts at service delivery. (Contains…

This introductory article provides an overview of the national evaluation conducted within the original 22 grantee communities funded from 1993 to 1999. The history and underlying foundations of the evaluation are presented. Specific evaluation questions and components are outlined, and issues that evolved out of the evaluation process are…

A survey of 37 system-of-care sites constituting 31 programs for children with serious mental health challenges found high family participation in such activities as modification of questionnaires, collecting data, and reviewing results. Low family participation was reported in the hiring of staff and data processing. Most families were…

A study compared practice-level variables between two sites that have been implementing system-of-care (SOC) principles for at least 5 years and two traditional service systems. Overall, SOC sites scored significantly higher than non-SOC sites in the child-centered and family-focused, community-based, and cultural competence domains. (Contains…

This article examines how researchers can apply analytical and methodological tools traditionally used in health policy analysis to study the multiple levels of systems-of-care impacts for students with emotional and behavior disorders. Where possible, results from existing systems-of-care education studies illustrate how these analyses and…

This commentary summarizes findings from previous articles on system-of-care mental health programs for children and adolescents with emotional and behavioral disorders. It addresses characteristics of participating children and families, system measurement system development, costs and sustainability, and family participation in program…

Rethinking and expanding the theory of change underlying systems of care are recommended to support development of the knowledge base for understanding what systems of care can be expected to accomplish. Three domains of knowledge are presented as necessary to understanding the relationship between systems-level change and services. (Contains…

This study examined the cross-ethnic equivalence of several measures commonly used to tap contextual correlates (i.e., parental symptomatology, family relations, peer relations) of serious emotional disturbance in children. Subjects were 117 juvenile offenders with diagnosed substance abuse or dependence disorders and considerable psychiatric…