5204.0: Wednesday, November 15, 2000 - 2:50 PM

Abstract #15719

Caregivers' experiences with the mental health service plans of severely emotionally disturbed children

Judith A. Cook, PhD1, Genevieve Fitzgibbon, BA1, Melissa Williams, BA1, Jane Burke, MS1, Robert Paulson, PhD2, Heidi Herinckx, MA2, Craig Anne Heflinger, PhD3, and Al Stein-Seroussi, PhD4. (1) Department of Psychiatry/Mental Health Services Research Program, University of Illinois at Chicago, 104 South Michigan Ave, Suite 900, Chicago, IL 60603, (312)422-8180 x19, cook@ripco.com, (2) RRI, Portland State University, 1912 S.W. Sixth Ave, Suite 120, Portland, OR 97201, (3) Center for Mental Health Policy, Vanderbilt University, 1207 18th Ave South, Nashville, TN 37212, (4) Pacific Institute for Research and Evaluation, 104 E. Estes Drive, Suite 206, Chapel Hill, NC 27514

This 5-site multicenter study examines adult caregivers' experiences with children's mental health care provider plans in Medicaid-funded managed care (MC) versus fee-for-service (FFS) settings. Data from 1748 caregivers of children (aged 4-18 years) with severe emotional disturbance (SED) were collected through in-person interviews. When asked to rate their level of satisfaction with the child's mental health plan on a scale from 0 to 10, caregivers of children in FFS plans averaged 8 while those of children in MC plans averaged 7 (r=-.10, p<.001). Controlling for site, ordinary least squares regression analysis of caregivers' perceptions of the degree of service coordination occurring in the child's care revealed that being in the MC condition at baseline was significantly associated with poorer perceived service coordination, all other things being equal. In addition, characteristics of the caregiver, such as higher level of education, depression, and higher caregiver strain were significantly associated with lower perceived service coordination. Children's higher psychiatric symptomatology (CBCL total score) was significantly associated with caregivers' lower pereceived service coordination while other characteristics of the child, such as gender, ethnicity and age, were not significantly associated with service coordination. These results point to the need to further explore the nature and predictors of service coordination for children with SED in MC versus FFS settings.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to: 1) Identify differences in overall satisfaction with mental health care plans between caregivers whose children with SED are being served in MC vs. FFS settings. 2) List the predictors of caregivers' satisfaction with the level of coordination of services provided to children and youth with SED

Keywords: Medicaid Managed Care, Child/Adolescent Mental Health

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA