Local Evaluation of Systems of Care

The Early Childhood Systems of Care have been working to evolve promising practices that establish and improve existing linkages between the childrenís mental health system and the early childhood, child welfare, and health care systems. Key stakeholders from these systems have engaged in collaborative planning processes designed to actively implement early childhood mental health systems of care. These efforts bring together agencies, organizations, professionals, family members, and others with an interest in the funding and delivery of services to children with serious emotional disturbance in a cooperative effort to improve and increase mental health services and supports for these children.

Over the six-year federal funding period, the early childhood systems of care are designed to improve and increase mental health and non-mental health services and supports provided for very young children consistent with system-of-care principles and best practices; link a newly created system of care with elements of the early childhood, child welfare, and health care systems; and provide comprehensive training and technical assistance to ensure that these linkages remain in place. Among the policies adopted by the early childhood systems of care is the use of more appropriate assessment tools for young children to evaluate and track developmentally specific outcomes. The following table provides an overview of the evaluation tools that are implemented as part of the local evaluation.

Measures for Sarasota Partnership for
Children's Mental Health
Construct Measures Description
Parenting/Family Context Parenting Stress Index - Short Form (Abidin, 1995) Measure of child, parent and situational characteristics associated with the presence of parenting stress and dysfunctional parenting. Three subscales: parental distress, parent-child difficult interaction & difficult child - 36-items.
Center for Epidemiology Depression Scale (CES-D) Measures existence and severity of depressive symptoms.
Addiction Severity Index (ASI) Semi-structured interview designed to address seven potential problem areas in substance-abusing respondents (To be collected at baseline only).
TWEAK Screen for risk of drinking during pregnancy (for biological mothers, to be collected at baseline only).
4Pís Screen for alcohol and/or drug abuse/dependence.
Trauma Exposure / Symptoms Traumatic Events Screening Inventory (TESI) Screen for exposure to potentially traumatic events (To be collected at baseline only).
Social / Emotional Challenging Behaviors Brief Infant-Toddler Social Emotional Assessment (BITSEA) Social-emotional screener for children 12-36 months.
Devereux Early Childhood Assessment-Social Emotional Measures protective factors and screens for behavioral concerns (2-5 years) (Will be used for children 37 months to 4 years, 11 months).


Wraparound Fidelity Assessment System

The Wraparound Fidelity Assessment System (WFAS) is a multi-method approach to assessing the quality of individualized care planning and management for children and youth with complex needs and their families. WFAS instruments include interviews with multiple stakeholders, a team observation measure, a document review form, and an instrument to assess the level of system support for wraparound.

Currently we are using the Wraparound Fidelity Index 4.0 (WFI-4) of the WFAS to support program planning and research. The findings will help guide program planning, training, and quality assurance as well as evaluate whether the wraparound process has been adequately implemented and contributed to successful outcomes. The WFI-4 interviews are organized by the four phases of the wraparound process (Engagement and Team Preparation, Initial Planning, Implementation, and Transition). In addition, the 40 items of the WFI interview are keyed to the 10 principles of the wraparound process, with 4 items dedicated to each principle. In this way, the WFI-4 interviews are intended to assess both conformance to the wraparound practice model as well as adherence to the principles of wraparound in service delivery.

Since January 2008, the evaluation team integrated the WFI-4 into 6 month and 12 month follow up interviews with caregivers. Although the WFI is designed with 4 forms (caregiver, youth, facilitators, and other team members), we follow standards of practice that note that reports from Caregivers show the greatest variability and are best associated with outcomes.

Team observations using the Team Observation Measure (TOM) started during October 2009, and we are sampling 20% of the scheduled team meetings. The findings will help guide program planning, training, and quality assurance as well as evaluate whether the wraparound process has been adequately implemented and contributed to successful outcomes.


School district web-based survey

The focus of this study was on mental health interventions for students in Sarasota County schools. Respondents included school administrators, health practitioners and mental health staff.


 

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