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Predicting patient deterioration in youth mental health services: community mental health vs. managed care settings
Author(s) -
Warren Jared S.,
Nelson Philip L.,
Burlingame Gary M.,
Mondragon Sasha A.
Publication year - 2012
Publication title -
journal of clinical psychology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.124
H-Index - 119
eISSN - 1097-4679
pISSN - 0021-9762
DOI - 10.1002/jclp.20831
Subject(s) - mental health , warning signs , psychology , warning system , health care , mental health care , psychiatry , medicine , economic growth , transport engineering , engineering , economics , aerospace engineering
Objective: To examine differences across a community mental health system and a private managed care system in the accuracy of a warning system designed to identify youth at risk for deterioration in mental health services. Design: Longitudinal outcome data from the Youth Outcome Questionnaire (Y‐OQ) were examined using multilevel modeling for 2,310 youth ages 4–17 who received outpatient treatment. Results: The warning system correctly identified 69% of cases that ultimately ended in deterioration in the community mental health setting, compared to 61% in the managed care setting. The overall hit rate (overall accuracy in classifying cases as deteriorators/non‐deteriorators) was the same in the two settings (75%). Conclusions: Results are consistent with previous research demonstrating that patient‐focused warning systems can be reasonably accurate in identifying youth cases at risk for treatment failure. © 2011 Wiley Periodicals, Inc. J Clin Psychol 67:1–17, 2011.