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There are over 875,000 children in Oregon, and an estimated 100,000 or more of these children

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There are over 875,000 children in Oregon, and an estimated 100,000 or more of these children

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  1. Using State Data to Evaluate Children’s Mental Health Services and Children’s Mental Health Service Needs Marion David, PhDLead Mental Health ResearcherProgram Analysis and EvaluationAddictions and Mental Health DivisionDepartment of Human ServicesSalem ORmarion.david@state.or.us503.945.6193

  2. There are over 875,000 children in Oregon, and an estimated 100,000 or more of these children need mental health services.

  3. The State provides services to many of the children in need. • In a “typical” year: • Over 250,000 Oregonian children are deemed eligible to receive publicly funded mental health services. • The publicly funded service system provides mental health and/or addiction treatment services to well over 30,000 of these eligible children.

  4. The Addictions and Mental Health Division (AMH)of the Oregon Department of Human Servicesadministers Oregon’s publicly funded prevention and treatment services for children and adults at risk for or suffering from mental health disorders, addictive disorders, and/or behavioral disturbances.

  5. The Program Analysis and Evaluation Unit (PAE) • of the Addictions and Mental Health Division • manages / analyzes / interprets data submitted by publicly funded mental health service providers, and mental health service recipients, in order to: • Document expenditures & service provision • Monitor number & types of services used • Assess service demand & service quality • Forecast service & funding needs

  6. Data is information, and information is power.Use the data available to youbut keep in mind that all data have both strengths and limitations. Don’t ignore either.

  7. When trying to make sense of data on children:Consider which children the data describe, and how the data were obtained. Survey administered in school: Describes children in schoolfrom the children’s perspective. Survey mailed to parents: Describes children whose parents respond to the surveyfrom the parent’s perspective. Administrative data obtained in course of diagnosis and treatment: Describe children in treatmentfrom the clinician’s perspective.

  8. Good news: Oregon’s public health system already collects a great deal of data on the mental and physical heath needs of, and services delivered to, Oregonian children.

  9. Caveat: Oregon’s public health system is enormously complex. Not all information on children in the mental health system, or in need of mental health services, is systemically captured in administrative data systems. Also, even when data are captured, the data may not be well integrated. Integrating data housed in different data systems can be difficult – and at times impossible.

  10. Primary administrative data sources(“information systems”, “data bases”) used by the Program Analysis and Evaluation Unit to document, monitor, assess, and forecast mental health services and service needs of children and adults are: CPMS: Client Process Monitoring SystemOP/RCS: Oregon Patient/Resident Care SystemMMIS: Medicaid Management Information System

  11. Client Process Monitoring System (CPMS)Contains data on community-based (outpatient) mental health and chemical dependency treatment services delivered by providers receiving public fundsIncludes demographic and service information collected at the initiation and termination of a treatment episodeFor detailed information on CPMS data elements, see CPMS manuals online: http://www.dhs.state.or.us/mentalhealth/publications/cpmsman_mh.pdfhttp://www.dhs.state.or.us/mentalhealth/publications/cpmsman_ad.pdf

  12. CPMS Data ElementsData about the client, for example: Gender Race/Ethnicity  Date of Birth Place of Residence Household Income Diagnosis (Broadly Categorized)  Years of Education Living Arrangement Arrest History (for Addictions services)Data about the treatment service, for example: When Service Provided Nature of Service Provided Type of Service Provider  Referral Source  Reason for Termination

  13. CPMS Data Example #1: Number of Children in Treatment with a Publicly-Funded Mental Health and/or Addiction Services Provider, 2003 By Age and Gender

  14. CPMS Data Example #2: Common ICD Diagnoses Among Children Receiving Outpatient Mental Health Services, at Initiation of Treatment (2003)

  15. CPMS Data Example #3:Age at First Drug/Alcohol Usevs.Age at Beginning of Alcohol/Drug Treatment, Per ReportChildren in Outpatient Treatment for Chemical Dependency in 2003

  16. CPMS Data Example #4: Amphetamine/Methamphetamine Use by Children in Outpatient Treatment with a Chemical Dependency Service Provider, Per Report1999-2003

  17. CPMS Data Example #5: Drugs Used by Children in Outpatient Treatment with a Chemical Dependency Service Provider, Per Report: 2003By Gender

  18. Oregon Patient/Resident Care System (OP / RCS)Contains data on inpatient mental health treatment services delivered by providers receiving public funds Primary resource for tracking persons civilly or criminally committed for mental health treatment Includes demographic and service informationcollected at intake and upon discharge from the hospital

  19. OP/RCS Data ElementsData about the client, for example: Name Gender Race/Ethnicity  Age Place of Residence DiagnosesData about the service episode, for example: Hospital providing service  Date, type, and duration of civil/criminal commitment  Reason for admission to inpatient setting  Reason for discharge

  20. OP/RCS Data Example (Adult Population): Average Daily Population in Oregon State Hospital Forensic Units, 1990 - 2004

  21. Medicaid Management Information System (MMIS)Contains data on all health care services (physical health, mental health, and chemical dependency) associated with a claim for Medicaid reimbursementData are collected at each encounterDatabase includes information on demographics, eligibility, service provision, charges, and payments

  22. MMIS Data ElementsData about the client, for example: Medicaid ID  Service eligibility Gender Race/Ethnicity  Date of Birth Diagnoses Data about the service episode, for example: Service provider  Date and type of service (medical procedures) Billings associated with the service

  23. MMIS Data Example #1: Average Daily Population of Children in Fee-for-Service Residential Beds, 1990 - 2006

  24. MMIS Data Example #2: Proportion of Children in Fee-for-Service Residential Beds who were “Household of One”, 1990 - 2006

  25. MMIS Data Example #3: Percent of Served Children Hospitalized (in FY 2004/05 ) After Receipt of Outpatient Mental Health Service (in FY 2004/05): By MHO

  26. Additional Data Sources Used By the Addictions and Mental Health DivisionQuestionnairesYouth Services Survey for Families(Service Recipients)Oregon Healthy Teens Survey (School Children)Databases Maintained by Other State AgenciesChild Welfare Services Information SystemJuvenile Justice Information System 

  27. Standardized and validated survey developed through the Federal Center for Mental Health Services • Administered annually to statewide sample of parents/guardians of mental health service recipients • Measures caregivers’ perception of mental health services • received by their children with respect to: • Service access • Family participation in service delivery • Cultural sensitivity of services • Appropriateness of services • Treatment Outcomes Youth Services Survey for Families

  28. Performance Domain Age Group 2-12 years 13-17 years 2003 2002 2003 2002 Access 79% 72% 71% 73% Participation 73% 71% 60% 62% Cultural Sensitivity 95% 89% 82% 90% Appropriateness 64% 65% 62% 54% Outcome 53% 51% 56% 52% Youth Services Survey Example: Percent of Survey Respondents Reporting a Positive Experience with Respect to Each of Five Service Performance Domains (2002 and 2003, By Age of Child)

  29. Coordinated through the State Office of Disease Prevention and Epidemiology (Partners: Oregon Dept. of Education, Oregon Dept. of Human Services,Oregon Commission on Children and Families, Governor’s Commission on Juvenile Justice, Oregon Progress Board, Oregon Research Institute) Administered annually to a stratified random statewide sample of 8th and 11th graders Oregon Healthy Teens Surveyhttp://www.dhs.state.or.us/dhs/ph/chs/youthsurvey/yrbsdata.shtml

  30. Measures: • Access to and use of alcohol/tobacco/other drugs • Personal safety behaviors and perceptions • Behaviors related to diet and exercise • Extracurricular activities • Sexual activity • Health conditions and access to care • Peer and family influences on risk behaviors Oregon Healthy Teens Surveyhttp://www.dhs.state.or.us/dhs/ph/chs/youthsurvey/yrbsdata.shtml

  31. Oregon Health Teens Survey Example: Percent of Oregon’s Eighth Graders Who Report Drinking Alcohol, 2001-2005: By Gender

  32. Summary

  33. Children’s mental health care needs are an important component of their overall health care needs.

  34. Data on children’s mental health needs, and data on the extent to which those needs are being met, are critical to formulating effective policies and plans for prevention and intervention.

  35. Considerable data on the mental health needs of children in Oregon, and the mental health services provided to children in Oregon, are available from the State.

  36. These data, like all data, have strengths and weaknesses. When using data to inform decisions and to formulate policies, the best strategy is to consider and weigh a variety of data derived from different sources.

  37. Questions

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