Measuring Effective Design and Implementation of an Innovative Child and Adolescent Community Mental Health System in the South Bronx

The Visiting Nurse Service of New York FRIENDS Program, FRIENDS Child and Adolescent Outpatient Clinic and Home-Based Crisis Intervention Programs have served seriously emotionally disturbed (SED) children, adolescents and their families in Community Districts 1 – 4 in the South Bronx since 2000. Combined, the programs serve nearly 650 children and families annually, offering home and community-based: assessment, crisis intervention, psychiatric evaluation and medication, individual, family and group counseling, school-based services, case management and advocacy, linkage, respite and recreation services, and educational support.

In October 2009, we successfully merged each of these discrete programs into one integrated system of care, with a single point of entry. Based on New York City and State evaluations of access to outpatient mental health treatment, it has been shown that reduced number of days between referral and first appointment is directly correlated with higher retention rates and improved treatment outcomes. Using our 2008 client data as a baseline for comparison, we will evaluate visit show rates for first encounters and subsequent visits within the outpatient clinic component of our system, and compare them to city and state averages. Using the same baseline data, we will compare treatment outcomes using a combination of the following tools: GAF scores, Peabody SFSS Scores, Caregiver Strain Questionnaire, school attendance data and Patient Satisfaction Surveys. We expect to show that the integration of programming into one unified system of care allows us to engage families in treatment more rapidly, leading to longer episodes of care and improved treatment outcomes.