Browsing by Subject "Mentally ill children--Texas"
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Item Comparison of foster children and non-foster children with respect to prevalence and treatment patterns of mental disorders in the Texas Medicaid System(2007-05) Gibson, Aaron P., 1978-; Crismon, M. LynnStudies conducted in several states have shown higher prevalence of mental disorders in foster children compared to the general population. Because states have flexibility regarding policy on how services are delivered to foster children, potential exists for interstate differences in foster populations. The objectives of this study were to compare prevalence rates of four common mental disorders (ADHD, bipolar disorder, depression, and PTSD) among foster and non-foster children eligible for Texas Medicaid, and to compare treatment modalities for new cases of depression in the same population. This retrospective database study used Texas Medicaid data from fiscal years 2003 through 2005. A binomial logistic regression model was used to determine the effects of foster status on prevalence rates of these disorders. A multinomial logistic regression model was used to determine the relationship between foster status and treatment modalities for new cases of depression. Significantly higher prevalence rates of the four diagnoses were observed in foster children for all three study years. Prevalence rates of each disorder were: ADHD (19.1-20.3/1,000 [non-foster] and 214.8-236.2/1,000 [foster]); bipolar disorder (1.8-2.8/1,000 [non-foster] and 107.0-138.5/1,000 [foster]); depression (7.6-7.7/1,000 [non-foster] and 221.1-267.8/1,000 [foster]); PTSD (1.1-1.2/1,000 [non-foster] and 87.7-100.2/1,000 [foster]). After adjusting for age, gender, and ethnicity, foster children had significantly greater odds of being diagnosed with ADHD (odds ratio [OR] = 10.73-12.14, p<0.001), bipolar disorder (OR = 38.50-41.01, p<0.001), depression (OR = 32.83-42.04; p<0.001) and PTSD (OR = 60.06-75.02, p<0.001) than non-foster children across all three study years. Among new cases of depression, foster children were significantly more likely to be treated with pharmacotherapy alone, psychotherapy alone, and combination therapy than non-foster children when compared to no treatment (OR = 1.15-2.40, p≤0.047). 47.0% of foster children and 56.9% of non-foster children received no treatment. Prevalence rates of four psychiatric disorders were significantly higher among foster children, confirming findings from previous studies. For depression, foster children were more likely to be receiving pharmacologic and/or non-pharmacologic treatment compared to no treatment than non-foster children. In both groups, there was a very high rate of children with depression who received no treatment.Item Predicting out-of-home placements of children and adolescents with serious emotional disturbance (SED)(2003-12) Yoo, Seo-koo, 1969-; Haynes, Dennis T.; Springer, David W.The purpose of the present study was to examine a set of indicators and factors to predict future out-of-home placements for children and adolescents with serious emotional disturbances (SED). Using characteristics of children and families at intake, this study predicted future out-of-home placements after participation in the Children’s Partnership, a systems of care program funded by the Center for Mental Health Services (CMHS) that serves children and adolescents with SED and their families in Travis County, Texas. A series of hierarchical logistic regression analyses were conducted to evaluate both individual predictors and conceptual models. Contrary to expectation, descriptive indicators (diagnostic information and risk factors) and protective indicators (the BERS and the FAD) were not statistically significant predictors of future out-of-home placements. Only two pathological indicators, as a set, showed a significant contribution to predicting future out-of-home placements. The CAFAS, which is measuring functional impairment of children with SED, demonstrated a strong individual relationship with the dependent variable even after controlling all the other indicators in the model. In addition to examining a set of indicators to predict out-of-home placements for children with SED, this study also explored profile scores of each predictor at intake for children and adolescents with high risk of future out-of-home placements. Results of independent t-tests were quite consistent with the findings observed in the multivariate logistic regression analysis. The children who had outof-home placement at follow-up period showed much severer functional impairment at intake measured by the CAFAS, compared those did not have any out-of-home placement. Overall children in placement group enrolled into the Children’s Partnership with worse symptoms and lower levels of protective factors, compared to children without any out-of-home placement. The findings of the study help clinicians identify children with high risk of out-of-home placement from the beginning and it assists them utilize profile information for their service planning and the early intervention. With several limitations, the study also suggests combining both multivariate and univariate analysis technique is preferable to get a better understanding of each relationship observed in both methods.