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APHA Scientific Session and Event Listing

Recorded presentation

Katherine E. Grimes, MD, MPH, Department of Psychiatry, Harvard Medical School/Cambridge Health Alliance, Psychiatric Research and Academic Center, 1493 Cambridge St., Cambridge, MA 02139, 617-204-1402, Katherine_Grimes@hms.harvard.edu and Aaron Kirby, MA, Neighborhood Health Plan, 253 Summer St., Boston, MA 02210.

Objective: The Massachusetts Mental Health Services Program for Youth (MHSPY) is a home and community-based clinical intervention which uses intensely coordinated natural supports in combination with traditional health services to promote the mental health of youth who are at-risk of out-of-home placement and allow them to live in their communities. Methods: A shared governance structure integrates policy, financing and care decisions toward delivery of integrated primary care, mental health, substance abuse, and social services for Medicaid youth. Using blended public agency funding, traditional and non-traditional services are provided within a private, not-for-profit, managed care organization. Individualized, strength-based comprehensive care plans are developed with the family to broadly identify strengths, needs and resources. Formal measures of clinical functioning are collected longitudinally throughout enrollment, along with service utilization, cost and satisfaction. Results: Aggregate analyses based on six years of data show that over 88% of days in the MHSPY program are spent at home, the majority of youth display clinical improvement, including a 45% reduction in risk to self and others. Hospital and ER rates are lowered post-enrollment, primary care health maintenance visits increase and the program has a 95% retention rate among previously “non-compliant” families who have multiple barriers to care. Conclusions: Family driven care drawing upon both formal and informal supports toward an agreed upon goal, individualized for each child, can enhance effectiveness of care. Nesting the clinical intervention within the community provides greater likelihood of sustainability and promotes a message of possibility for family members and neighborhood peers.

Learning Objectives: After attending this presentation, presenters will

• Become familiar with the MHSPY model of integrated, community-based medical and mental health service delivery to at-risk youth.
• Learn innovative, consumer driven measurement strategies for assessing mental health intervention effectiveness for children and families.
• Gain information about methods for maintaining multiply challenged youth in their homes and communities.

Keywords: Child and Adolescent Mental Health, Community-Based Public Health

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation