Studies in the News is a very current compilation of items significant to the Legislature and Governor's Office. It is created weekly by the State Library's Research Bureau to supplement the public policy debate in California’s Capitol. To help share the latest information with state policymakers, these reading lists are now being made accessible through the State Library’s website. This week's list of current articles in various public policy areas is presented below.

Service to State Employees:

• When available, the URL for the full text of each item is provided.

• California State Employees may contact the State Information & Reference Center (916-654-0206; cslsirc@library.ca.gov) with the SITN issue number and the item number [S#].

• All other interested individuals should contact their local library - the items may be available there, or may be borrowed by your local library on your behalf.

HEALTH

MENTAL HEALTH

Child and Adolescent Bipolar Disorder: An Update from the National Institute of Mental Health. By the National Institute of Mental Health, U.S. Department of Health and Human Services. (The Institute, Washington, DC) 2006. 4 p.

Full Text at: www.nimh.nih.gov/publicat/NIMHbipolarupdate.pdf

["Research findings, clinical experience, and family accounts provide substantial evidence that bipolar disorder can occur in children and adolescents. This report is an update on the findings that bipolar disorder is difficult to recognize and diagnose in youth because it does not fit precisely the symptom criteria established for adults and because its symptoms can resemble or co-occur with those of other common childhood-onset mental disorders. In addition, symptoms of bipolar disorder may be initially mistaken for normal emotions and behaviors of children and adolescents. But unlike normal mood changes, bipolar disorder significantly impairs functioning in school, with peers, and at home with family. Better understanding of the diagnosis and treatment of bipolar disorder in youth is urgently needed. In pursuit of this goal, the National Institute of Mental Health (NIMH) is conducting and supporting research on child and adolescent bipolar disorder."]

[Request #S10730]

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“Exploring Risk Factors for the Emergence of Children’s Mental Health Problems.” By Marilyn J. Essex, University of Wisconsin-Madison, and others. IN: Archives of General Psychiatry, vol. 63 (November 2006) pp. 1246-1256.

Full Text at: archpsycama-assn.org/cgi/reprint/63/11/1246

[“The authors maintain that exploratory studies that generate testable models of how risk factors for childhood mental health problems work together over time are critical for developing effective prevention and treatment strategies. With this in mind, the objective of this study was to build models addressing the following 2 questions: 1) how early can we identify children at risk for mental health problems in third grade? and, 2) how do the risk factors work together over time? A Wisconsin community sample was assessed 8 times, beginning during pregnancy. Three hundred seventy-nine families completed multi-informant reports (mothers, teachers, and children) of children’s mental health symptoms in third grade.… A hypothesis was generated that family socioeconomic status (SES) defined different pathways to symptom severity in low/middle SES families, children were at risk if their mothers were distressed during the infancy period, which was then associated with more generalized maternal and child distress and dysregulation during the preschool period. In high SES families, the picture was more complex, beginning with parental histories of depression and family psychopathology, which then led to greater family stress in the infancy period and maternal and child distress and dysregulation during the preschool period. For all children, social and academic impairment during the school transition was an important mediator.”]

[Request #S10731]

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Beyond Referral: Pediatric Care Linkages to Improve Developmental Health. By Amy Fine and Rochelle Mayer, Georgetown University. (The Commonwealth Fund, New York, New York) December 2006. 66 p.

Full Text at: www.cmwf.org/usr_doc/Fine_beyondreferralpediatriccarelinkagesimprovedevelhlt_976.pdf

[“A growing body of evidence highlights the importance of early development, and points to the need for both actively promoting healthy development and systematically addressing developmental, behavioral, and psychosocial issues early in life. However, many children with or at risk of developmental issues are not being identified early enough, and are not consistently linked to the services and supports they need. Pediatric health care providers have an important role to play in providing developmental care and linking children to needed services and resources within the broader community. While multiple strategies are being tested by pediatricians and others working in child health, to date there has been no study with a primary focus on how pediatric practices link young children and their families to developmental services and supports. This report provides a first step in reviewing the current state of the art on pediatric linkages for developmental care. More specifically, the report: 1) describes the context in which pediatric developmental care and linkage takes place; 2) provides working definitions and a typology for describing linkage strategies; 3) identifies and discusses key linkage strategies used by exemplary practices; and programs; and 4) provides recommendations and next steps for improved linkage.”]

[Request #S10732]

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"The Prevention of Depressive Symptoms in Children and Adolescents: A Meta-Analytic Review." By Jason L. Horowitz and Judy Garber. IN: Journal of Consulting and Clinical Psychology, vol. 74, no. 3 (2006) pp. 401-415.

Full Text at: www.apa.org/journals/releases/ccp743401.pdf

["Research on the prevention of depressive symptoms in children and adolescents was reviewed and synthesized with meta-analysis. When all 30 studies were included, selective prevention programs were found to be more effective than universal programs immediately following intervention. Both selective and indicated prevention programs were more effective than universal programs at follow-up, even when the two studies with college students were excluded. Effective sizes for selective and indicated prevention programs tended to be small to moderate, both immediately post-intervention and at an average follow-up of 6 months. Most effective interventions are more accurately described as treatment rather than prevention."]

[Request #S10733]

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“Service Costs of Caring for Adolescents with Mental Illness in a Rural Community, 1993-2000.” By E. Jane Costello, Duke University, and others. IN: American Journal of Psychiatry, vol. 164 (January 2007) pp. 36-42.

Full Text at: ajp.psychiatryonline.org/cgi/reprint/164/1/36

[“This study examines the costs of treating child psychiatric disorders which fall on educational, primary care, juvenile justice, and social service agencies as well as on psychiatric services. The authors estimated multi-agency mental health costs by integrating service unit costs with utilization rates in an 11-county area. Using psychiatric diagnoses made independently of service use records, the authors calculated costs across agencies as well as the extent of unmet need for psychiatric care. Annual parent and child reports were used to measure mental health care needs and units of service across 21 types of settings for the population-based Great Smoky Mountain Study sample of 1,420 adolescents from ages 13 to 16. Unit costs for services were generated from information from service providers and records. The authors calculated costs overall, costs by type of service, and costs by diagnosis. Results indicated that average annual costs per adolescent treated were $3,146. Juvenile justice and inpatient/residential facilities accounted for well over half of the total costs. Costs for youths with two or more diagnoses were twice as much as costs of those with a single disorder. Among adolescents with service needs, 66.9% received no services. Public health insurance was associated with higher rates of specialty mental health care than either private insurance or no insurance. Annual costs across all services were three to four times greater than recent health insurance estimates alone. Many costs for adolescents with mental health problems were borne by agencies not designed primarily to provide psychiatric or psychological services. Only one in three adolescents needing psychiatric care received any mental health services.”]

[Request #S10734]

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State Regulation of Residential Facilities for Children with Mental Illness. By Henry Ireys and others, Mathematica Policy Research. DHHS Publication. No. (SMA) 06-4167. (Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services, Rockville, Maryland) 2006. 76 p.

Full Text at: www.mathematica-mpr.com/publications/pdfs/residfacilchildren.pdf

["There is little national information on the policies and procedures used by States to regulate residential treatment facilities for children with mental illness. As a result, policymakers and program administrators face major difficulties in determining both the effectiveness of current policies and the potential need for new policies that are responsive to emerging trends in child mental health care. Based on a survey of State officials, this report provides the most accurate national data available concerning methods that States use to license and regulate residential facilities for children with mental illness. The information in this report can help Federal and State policymakers improve procedures for monitoring the quality of care provided in these facilities."]

[Request #S10735]

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"Impact of Maltreatment on Children Served in Community Mental Health Programs." By Christine M. Walrath and others. IN: Journal of Emotional & Behavioral Disorders, vol. 14, no. 3 (Fall 2006) pp. 143-156.

["Despite a decline in the incidence of child abuse over the last decade, victimization rates remain troubling. This study used a subset of data from the national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program to investigate and compare the demographic, psychosocial, and service use characteristics and outcomes of children with varying abuse histories referred into community-based mental health services. The lifetime estimate of abuse histories—physical, sexual, or both—among these children is 36.5%. A high level of clinical need across abuse subtypes and a gradient of increasing child and family risk factors differentiated children with and without an abuse history. Children with a reported history of both physical and sexual abuse consistently presented a more troublesome picture of personal and family challenges. Implications for the assessment of clinical needs and the identification of evidence-based interventions to meet the unique needs of these children are discussed.”]

[Request #S10736]

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“Critical Connections for Children who are Abused and Neglected: Harnessing the New Federal Referral Provisions for Early Intervention.” By Sheryl Dicker and Elysa Gordon, New York State Permanent Judicial Commission on Justice for Children. IN: Infants & Young Children: An Interdisciplinary Journal of Special Care Practices, vol. 19, no. 3 (July-September 2006) pp. 170-178.

[“This article highlights strategies that link the child welfare, court, and Early Intervention systems to enhance the healthy development of young children in foster care. It spotlights the need for infants and young children in foster care to be referred to the Early Intervention Programs (EIP) and outlines the importance of implementing the New Child Abuse Prevention and Treatment Act Part C referral provisions. It outlines the barriers to the EIP for maltreated children and identifies strategies to ensure referral and successful navigation of the EIP. The authors describe several innovative, collaborative programs that link child protective services, health, mental health, and developmental services and provide cross system training and funding to facilitate early intervention diagnosis and treatment for young children in foster care.”]

[Request #S10737]

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Building Bridges: Mental Health Consumers and Primary Health Care Representatives in Dialogue. By the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration (SAMHSA,) U.S. Department of Health and Human Services. HHS Publication. No. 4040.(The Center, Rockville, Maryland) 2005. 56 p.

Full Text at: download.ncadi.samhsa.gov/ken/pdf/SMA06-4040/Policy_Makers_Booklet.pdf

[“In March 2005, the Center for Mental Health Services (CMHS), sponsored a dialogue between invited consumers of mental health services and representatives of various sectors of the primary health system. In an effort to develop improved mutual understanding, respect, and partnerships, the two dozen participants: 1)identified issues involving mental health consumers and their experiences with primary care providers, including those that both hinder and help recovery; and, 2)developed recommendations regarding attitudinal shifts and systems transformation that can lead to improved mental and general health care responses to people with mental illnesses by primary care and mental health providers. The participants’ findings and recommendations are summarized in this publication to be helpful when engaging in activities that promote mental health systems transformation.”]

[Request #S10739]

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"Implementing the Institute of Medicine Definition of Disparities: An Application to Mental Health Care." By Thomas G. McGuire and others. IN: Health Services Research, vol. 41, no. 5 (October 2006) pp. 1979-2005.

["The authors examine the term ‘disparities’ in health care which refers to the unequal treatment of patients on the basis of race or ethnicity, and sometimes on the basis of gender or other patient characteristics. They state that a consensus has emerged that eliminating disparities should be a major goal of health policy, but the empirical and policy literature fails to agree on what a ‘disparity’ is, and how it should be measured. Empirical research often estimates coefficients of race/ethnicity variables without relating these coefficients to an explicit definition of disparity. In the recent Institute of Medicine (IOM) report, Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care (IOM 2002), defines a disparity as a difference in treatment provided to members of different racial (or ethnic) groups that is not justified by the underlying health conditions or treatment preferences of patients. This definition recognizes the role of socioeconomic differences associated with race/ethnicity as mediators of disparities. To implement the IOM definition, the authors developed a new method for adjusting for health status that can be used with any model, including nonlinear models that quantify use of health care. They compare the magnitude of disparities estimated by this method to a residual race/ethnicity effect that is often interpreted as meaning a disparity.”]

[Request #S10740]

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State Policy Options to Improve Delivery of Child Development Services: Strategies from the Eight ABCD States. By Neva Kaye, National Academy for State Health Policy, and others. (The Academy, Washington, DC) December 2006. 33p.

Full Text at: www.cmwf.org/usr_doc/State_Policy_Options_ABCD.pdf

[“Since 2000, the National Academy for State Health Policy (NASHP) and The Commonwealth Fund have conducted two state learning consortia dedicated to improving the delivery of child development services to young children who are Medicaid beneficiaries. The work of the eight Assuring Better Child Health and Development (ABCD) states has shown that state policies, especially Medicaid policies, can effectively promote improvements in the quality of preventive and developmental services provided to young children. This paper provides a starting point for states seeking to identify and implement policy improvements to achieve two main objectives: 1)improve the identification of young children with or at risk for developmental delays through promoting use of an objective, standardized screening tool; and, 2)improve families' access to follow-up services, including assessment, referral, and care coordination. The policies that govern the operation of any state program can be divided into three groups—policies that define what services the program will cover for which people (coverage), those that establish how much the program will pay for a qualified service (reimbursement), and those that establish how services will be delivered (performance). The paper presents specific policy improvements that emerged from efforts of the eight Assuring Better Child Health Development (ABCD) states that can serve as models and inspiration for states interested in improving developmental services for young children. An overview and some examples of policy changes in the three areas are listed as follows: Improving program coverage (eligibility and benefits); Improving reimbursement; and Improving Performance.”]

[Request #S10741]

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Strategies for Improving Access to Mental Health Services in SCHIP Programs. By Jennifer May, National Academy for State Health Policy. (The Academy, Portland, Maine) 2006. 9 p.

Full Text at: www.nashp.org/Files/Mental_Health_Strategy_2006.pdf

["Management of mental health services for children enrolled in a State Children’s Health Insurance Program (SCHIP) program differs from state to state and even within states as many serve enrollees through multiple delivery systems. This Issue Brief examines strategies and challenges faced by three state SCHIP programs operating 2006: North Carolina, Rhode Island, and Utah. These states wee chosen because they represent different types of delivery systems. Each state reports successful approaches to managing the delivery of mental health services for the SCHIP population.

The National Academy for State Health Policy (NASHP) staff developed this brief in order to highlight opportunities for programmatic improvement in the delivery of mental health services for all SCHIP children. The information used to prepare this brief was collected from state websites and telephone interviews with state staff. Representatives from each of the three states also reviewed a draft of this brief.”]

[Request #S10742]

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“An Exploration into the Internal Dynamics of a School-Based Mental Health Collaboration.” By Kenneth Kury, Boston College, and Gloria Kury. IN: The Journal of School Health, vol. 76, no. 5 (May 2006) pp. 164-168.

[“Schools are moving toward a human service approach that encompasses the physical and mental needs of its students on top of the traditional role of educating. School-based collaborative are one delivery model that satisfies this expanding role. Lacking in the research on this emerging setting, particularly in the realm of mental health, is information that gives insight into the interactions that occur between collaborative partners who may have opposing aims. This study explores 2 outcome measures, timeliness of implementation of the treatment plan and parental satisfaction with the treatment plan and the influence of the professional view of collaborative partners on these outcomes. Archival data were collected from patient charts on 101 Hispanic students, 73.3 % of who were male and the3 sample mean ages was 11.3 years. These data were analyzed using multiple regression techniques. The study results revealed that time to implementation was impacted by the diagnosis alignment of participating partners, a proxy for professional view, as was parental satisfaction. Satisfaction was not influenced by timeliness, indicating alternative outcome desires. This study points to the potential gap between parents and schools. The authors recommend that schools and the mental health providers should educate parents regarding necessity of timely interaction. Additionally, schools should ascertain conditions for parental satisfaction with the education of their child.”]

[Request #S10743]

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Developing a Stigma Reduction Initiative. Prepared for the Substance Abuse and Mental Health Services Administration (SAMHSA.) (Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services Administration, Rockville, Maryland) 2006. 108 p.

Full Text at: download.ncadi.samhsa.gov/ken/pdf/SMA06-4176/Developing_a_Stigma_Reduction.pdf

[“This initiative posits the fact that “ Stigma is one of the more formidable obstacles to a transformed mental health system and that stigma and discrimination against people with mental illnesses leads others to avoid living, socializing or working with, renting to, or employing people with mental illnesses. Stigma leads to low self-esteem and hopelessness. And it deters the public from seeking and wanting to pay for care. Further the initiative addresses the fact that stigma often causes people with mental illnesses to become embarrassed or ashamed that they conceal symptoms and avoid seeking the very treatment, services, and supports they need and deserve. In 2003, the Substance Abuse and Mental Health Services Administration (SAMHSA), which is part of the U. S. Department of Health and Human Services, launched the Elimination of Barriers Initiative (EBI). Based on eight pilot States, the EBI aimed to build awareness of and counter the discrimination and stigma associated with mental illnesses. The EBI laid much of the groundwork for SAMHSA’s National Anti-Stigma Campaign (NASC) and for developing the contents of the Stigma Reduction Initiative. This initiative addresses a number of tools and strategies in the drive to eliminate stigma, namely: Event planning; Partnership development; Outreach to schools and businesses; Mental health resources; Marketing to the general public; and, Grassroots outreach.”]

[Request #S10744]

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“Prevalence of and Risk Factors for Lifetime Suicide Attempts Among Blacks in the United States.” By Joe S. Baser, University of Michigan, and others. IN: Journal of American Medical Association, vol. 296, no. 17 (November 2006) pp. 2112-2123.

[“The authors of this study state that “Lack of data on the lifetime prevalence and age at onset of suicide ideation, plans, and attempts among blacks in the United States limits the creation and evaluation of interventions to reduce suicide among black Americans. This study was set up to examine the prevalence and correlates of suicide ideation, planning, and attempts across 2 ethnic classifications of blacks in a nationally representative sample. Data was collected from the National Survey of American Life, a national household probability sample of 5181 black respondents aged 18 years and older, conducted between February 2001 and June 2003, using a slightly modified adaptation of the World Health Organization World Mental Health version of the Composite International Diagnostic Interview. The survey respondents, categorized as African Americans and Caribbean Americans, reported lifetime prevalence of 11.7% for suicide ideation and 4.15 for attempts. The study documents the burden of nonfatal suicidality among US blacks, notably Caribbean black men, and individuals making planned attempts. The authors indicate that advancing research on the transition from suicide planning to attempt is vital to the efficacy of health care professionals’ ability to screen blacks at risk for suicide.”]

[Request #S10745]

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Unclaimed Children Revisited: Challenges and Opportunities in Children's Mental Health: A View From Families and Youth. By Sarah Dababnah and Janice Cooper. Working Paper. No. 1. (National Center for Children in Poverty, Columbia University Mailman School of Public Health, New York, New York) 2006. 44 p.

Full Text at: nccp.org/media/ucr06a_text.pdf

["This report documents critical issues in children’s mental health policy and service delivery from the perspective of stakeholders in the family and youth movement. This report summarizes the Best Practices in Policy for Children’s Mental Health Consultation Meeting with Stakeholders: Family and Youth Perspectives. It was designed to solicit guidance from families and youth involved in the child mental health field."

The authors base their conclusions "on a meeting of youth and family members of children and youth who experience mental health problems and highlight how family-driven and youth guided values and frameworks can improve research, policy, and practice and,ultimately, result in better care and healthier children and youth. They make a list of recommendations that focus on “Promoting collaborative partnerships with families and youth in research; increasing the use of positive outcomes measures; ensuring the dissemination of outcomes data and research through user-friendly techniques and language; and, making family and youth support a funded and essential component of service delivery. They further advocate promoting mental wellness and positive social and behavioral competencies by engaging children and youth in interesting and appropriate activities and requiring cross-system accountability for improved outcomes."]

[Request #S70408]

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[The following studies, reports, and documents have been ordered or requested, but have not yet arrived. Requests may be placed, and copies will be provided when the material arrives..]

“Parent and Teacher Mental Health Ratings of Children Using Primary-Care Services: Interrater Agreement and Implications for Mental Health Screening.” By Jonathon Brown, Johns Hopkins Bloomberg School of Public Health, and others. IN: Ambulatory Pediatrics, vol. 6, no. 6 (November 2006) pp. 347-351.

[“Mental health screening in pediatric primary care settings has become a more common practice to improve the identification and treatment of child mental health problems. This article examines agreement between parents and teachers in their ratings of the mental health of children using primary care. Parents and teachers rarely identified the same child as having mental health problems, and parents failed to detect 52 percent of children the teacher identified as seriously disturbed. The results suggest that screening in primary care may require the development of algorithms to help providers judge when to solicit information from teachers, and that providers need skills to interpret conflicting information from parents and teachers.”]

[Request #S10746]

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