The Brief Assessment Checklists (BAC-C,BAC-A): Mental health screening measures for school-aged children and adolescents in foster,kinship, residential and adoptive care

More than half of children and young people in foster, kinship, and residential care, as well as those subsequently adopted from care, have mental health difficulties that require clinical formulation and intervention. While an increasing number of alternate care jurisdictions are instituting universal mental health screening, existing measures may not adequately screen for a range of attachment- and trauma-related mental health difficulties observed among these populations. The Brief Assessment Checklist for Children (BAC-C), and the Brief Assessment Checklist for Adolescents (BAC-A) are 20-item caregiver-report psychiatric rating scales designed to: 1. screen for and monitor clinically-meaningful mental health difficulties experienced by children and adolescents in various types of care; and 2. be safely administered and interpreted by health and social care professionals other than child and adolescent mental health clinicians. The BAC-C/A were also designed to be used as brief casework monitoring tools by foster care and adoption agencies, and for treatment monitoring in CAMHS. The BAC-C and BAC-A were derived from the Assessment Checklist for Children (ACC, 120 items) and Assessment Checklist for Adolescents (ACA, 105 items) respectively. Internal consistency of BAC-C (N = 347) and BAC-A (N = 230) scores were 0.89 and 0.87 respectively. The BAC-C/A were highly accurate in screening for clinical range ACC and ACA scores (area under the curve (AUC) ranging from 0.96 to 0.99), as well as for CBCL clinical range scores (AUCs: BAC-C = 0.89 to 0.92; BAC-A = 0.93 to 0.94). They were moderately accurate in screening for children that caregivers reported had been referred to mental health services (AUCs: BAC-C = 0.74; BAC-A = 0.79). Initial BAC-C/A psychometric properties compare favourably with that of existing screening instruments, including the Strengths and Difficulties Questionnaire and the Brief Problem Monitor (CBCL short form).     

Benefits and costs associated with mutual-help community-based recovery homes: The Oxford House model

We used data from a randomized controlled study of Oxford House (OH), a self-run, self-supporting recovery home, to conduct a cost-benefit analysis of the program. Following substance abuse treatment, individuals that were assigned to an OH condition (n = 68) were compared to individuals assigned to a usual care condition (n = 61). Economic cost measures were derived from length of stay at an Oxford House residence, and derived from self-reported measures of inpatient and outpatient treatment utilization. Economic benefit measures were derived from self-reported information on monthly income, days participating in illegal activities, binary responses of alcohol and drug use, and incarceration. Results suggest that OH compared quite favorably to usual care: the net benefit of an OH stay was estimated to be roughly $29,000 per person on average. Bootstrapped standard errors suggested that the net benefit was statistically significant. Costs were incrementally higher under OH, but the benefits in terms of reduced illegal activity, incarceration and substance use substantially outweighed the costs. The positive net benefit for Oxford House is primarily driven by a large difference in illegal activity between OH and usual care participants. Using sensitivity analyses, under more conservative assumptions we still arrived at a net benefit favorable to OH of $17,830 per person.     

The cost of implementing a jail diversion program for people with mental illness in San Antonio,Texas

Jail diversion programs for people with mental illness are designed to redirect offenders with mental illness into community treatment. Although much has been published about program models and their successes, little detail is available to policy makers and community stakeholders on the resources required to start and implement a jail diversion program and which agencies bear how much of the burden. The current study used data on a model jail diversion program in San Antonio, Texas, to address this research gap. Data on staff costs, client contacts, planning, and implementation were collected for three types of diversion: pre-booking police, post-booking bond, and post-booking docket. An activity-based costing algorithm was developed to which parameter values were applied. The start-up cost for the program was $556,638.69. Pre-booking diversion cost $370 per person; 90% of costs were incurred by community mental health agencies for short-term monitoring and screening (>80% of activities). Post-booking bond and docket diversion cost $238 and $205 per person, respectively; the majority of costs were incurred by the courts for court decisions. Developing a multiple-intercept jail diversion program requires significant up-front investment. The share of costs varies greatly depending on the type of diversion.     

Social networks and getting a home: Do contacts matter?

Under what conditions does one find a new home via one's social network? Does the way in which a house is acquired affect how satisfied one is with the house? We formulate hypotheses on the characteristics of personal networks, the context of the move and their effect on those who attain a house through informal channels and how satisfied they are with the new home. We use a representative dataset from the Netherlands (the Survey of the Social Networks of the Dutch, SSND, n = 1007) to test our arguments. Our results show that buyers with more diverse social networks and renters with larger social networks are more likely to find their home via social contacts. However, finding a home through an informal channel does not enhance their satisfaction with the house that is found.     

Small-dollar children's savings accounts and children's college outcomes by income level

This is paper two of four in the small-dollar children's savings account series in this issue that examines the relationship between children's small-dollar savings accounts and college enrollment and graduation. This series of papers uses different subsamples to examine three important research questions: (a) Are children with savings of their own more likely to attend or graduate from college; (b) Does dose (no account, only basic savings, savings designated for school of less than $1, $1 to $499, or $500 or more) matter; and (c) Is designating savings for school more predictive than having basic savings alone. Using propensity score weighted data from the Panel Study of Income Dynamics and its supplements we created multi-treatment doses of savings accounts and amounts to answer these questions separately for children from low- and moderate-income (below $50,000; n = 512) and high income ($50,000 or above; n = 345) households. We find that low- and moderate-income children may be more likely to enroll in and graduate from college when they have small-dollar savings accounts with money designated for school. A low- and moderate-income child who has school savings of $1 to $499 prior to reaching college age is over three times more likely to enroll in college and four times more likely to graduate from college than a child with no savings account. These findings lead to policy implications that are also discussed.     

Small-dollar children's saving accounts and children's college outcomes by race

This is paper three of four in the Small-Dollar Children Accounts series that studies the relationship between children's small dollar savings accounts and college enrollment and graduation. The series uses different subsamples to examine three important research questions: (a) Are children with savings of their own more likely to attend or graduate from college? (b) Does dosage (no account, only basic savings, savings designated for school of less than $1, $1 to $499, or $500 or more) matter? And (c) is designating for school more predictive of college enrollment or graduation than having basic undesignated savings alone? Using propensity score weighted data from the Panel Study of Income Dynamics and its supplements we created multi-treatment dosages of savings accounts and amounts to answer these questions separately for black (n = 404) and white (n = 453) children. White children's savings are not significantly related to their college outcomes. Differently, compared to black children without savings accounts, black children are three times more likely to enroll in college when they have school savings of less than $1 and six times more likely when they have school savings of $1 to $499. Further, black children with school savings of $1 to $499 are four times more likely to graduate from college and black children with school savings of $500 or more are three-and-a-half times more likely to graduate from college, compared to those with no savings account. We suggest Child Development Accounts (CDAs) may be a promising tool for helping black children get to and through college.     

Strengthening home and community-based care through Medicaid waivers

States are increasingly using the Medicaid 1915c waiver program to provide community-based long-term care (LTC). We examined state predictors of waiver utilization and expenditures for waivers serving both older and working-age individuals. State level data for the period 1992 to 2001 were used to estimate random effects panel models. States with increased community-based care (e.g., home health agencies) and decreased nursing home bed capacity were positively associated with state per capita rates of use, expenditures, and the share of Medicaid LTC dollars supporting 1915c waivers. States appeared to substitute Medicare for Medicaid services for individuals eligible for both. State per capita income was positively related to each measure. State policies that facilitate decreased institutional and increased community- based capacity appear essential to state efforts to expand access to community-based services. Federal policies that address state resource issues may also spur growth in community-based LTC, which, in most states, continues to be limited.     

A skillset and a stance: Program planning for cultural competence and cultural humility in home visitation

Cultural competence has long been valued in home visitation, with a special focus on adapting home visiting programs to maximize their effects on specific cultures and populations. Critics advocate that traditional cultural competence training focusing on individual, professional skills-building should be replaced by cultural humility approaches that focus on humble engagement of participants. Little is known about how home visiting programs serving broadly diverse populations experience cultural competence and/or cultural humility efforts and initiatives on the ground. Interviews approximately 90−120 min in length were conducted with 34 home visiting program administrators in a large Midwestern state. Interviews were audio-recorded, transcribed, coded thematically, and subjected to content analysis. Two themes were identified from interviews. Respondents emphasized that: 1) cultural competency training was required by home visiting program models, so cultural competency questions were always addressed in home visitation, especially in training for new home visitors; and 2) cultural competence also included many aspects of cultural humility, commitment to continuous self-evaluation and self-reflection on cultural encounters that identified cultural knowledge gaps and sought more information. Respondents did not see cultural competency and cultural humility as oppositional and saw both concepts as important for engaging participants in home visitation.     

Psychopathology,physical complaints and health risk behaviors among youths who were victims of childhood maltreatment: A comparison between home and institutional interventions

Based on investigations of child maltreatment by Child Protective Services (CPS), several children who are identified receive some kind of individual or familial intervention. However, the literature has shown conflicting results in regard to the later functioning of the children who are target of different protective measures in different settings, compared to other youths who receive no intervention. We assessed childhood adversity, psychopathology, physical complaints and health risk behaviors among youths who received one of two different protective interventions during childhood (home vs. institutionalization group), and we compared them with youths who receive no intervention (comparison group). In total, 216 youths participated, with ages ranging from 14 to 23 years (M = 17.05 years, SD = 1.8 years; 105 males, 111 females), including 136 youths that were contacted based on their CPS records completed during their childhood, and 80 youths from the community without CPS identification.     

Developmental outcomes after five years for foster children returned home, remaining in care, or adopted

A substantial proportion of children who enter foster care in the US are infants or toddlers and will exit from foster care before they have been in care for long, either returning home or to adoption. These first years of involvement may predict a significant amount about children's longer term development so understanding developmental outcomes after five years is valuable to understanding if child welfare services (CWS) are serving the intention of promoting the well-being of children. A subsample of 353 infants (less than 13 months of age when investigated by CWS) and subsequently placed into foster care were selected from the National Survey of Child and Adolescent Well-Being. After 66 months, these infants had been reunified, adopted, or were still in foster care. Bivariate comparisons were completed. Statistical controls for maltreatment type and severity, demographic traits, and current caregiver education were implemented to help clarify the role of terminal child welfare placement, current caregiver behaviors, and household income, on eight linear regression models of developmental outcomes. Results support the longstanding tenet of child welfare services policy that remaining in foster care is less developmentally advantageous than having a more permanent arrangement of return home or adoption.     

Behavior problems in children raised by grandmothers: The role of caregiver distress, family resources, and the home environment

Over the past few decades there has been a dramatic increase in children being raised by grandparents due to a variety of factors including child maltreatment, parental abandonment, substance abuse, and incarceration. The purpose of this study is to examine the extent of behavior problems in children being raised by grandmothers and to determine factors in their current environment that are related to child behavior problems. The study draws on McCubbin's resiliency model of family stress, adjustment and adaptation.The sample comprised of 230 children ages 2 to 16 years who were being raised by grandmothers in parent-absent homes. The families were predominantly low income and African American. The grandmothers ranged in age from 37 to 80 years. Grandmothers responded to several self-report measures pertaining to child behavior problems, family resources, social support, and caregiver psychological distress. Trained research assistants completed a standardized observational measure of the home environment.Results indicated that 31.3% of child participants scored in the clinically elevated range for total behavior problems, with 21.3% and 32.6% scoring in the elevated range for internalizing and externalizing behaviors, respectively. Hierarchical regression analyses revealed that of the variables examined, increased psychological distress in grandmothers was most predictive of child behavior problems, followed by less supportive home environments and fewer family resources.Results of the present study underscore the need for interventions that focus on reducing child behavior problems, as well as enhancing the parenting skills of grandmothers raising grandchildren. Findings also support the need for strategies to reduce stress in grandmother caregivers and to improve access to resources needed to provide supportive home environments for their grandchildren.     

Computer usage, destination language proficiency and the earnings of natives and immigrants

This paper uses the concept of a computer as a public good within the household to model the demand for computers at home. It also investigates the determinants, and consequences for earnings, of computer use. The equations are estimated using data on the native born and immigrants from the 2001 Census of Population and Housing in Australia. The multivariate analyses show that recent arrivals are more likely to use computers than the Australian born. The data suggests a high degree of favorable selection in migration as the level of computer use in Australia is much higher than in most of the countries that Australia’s immigrants come from. Those with a higher permanent income (education, household assets) are more likely to have a computer at home, but there is no effect of transitory income (unemployment). Immigrants who are more proficient in English are also more likely to use a computer. The relation between age and computer use is strongly influenced by cohort effects. Using a computer at home is associated with about 7% and 13% higher earnings for native-born and foreign-born men, respectively. For the immigrants, the effects of schooling and English language proficiency on earnings are greater among those who use a computer at home. This suggests complementarity in the labor market. The use of a computer is shown to be a way the foreign born can increase the international transferability of their pre-immigration skills, a finding that has implications for immigrant assimilation policies.

Examining the expertise,experience, and expedience of crisis consultants in Singapore

By most accounts, crisis preparedness in organizations globally has been appalling (0035 and 0250). The situation is no different in Singapore (Wu & Dai, 2001). With crisis expertise often lacking from within organizations, many resort to engaging public relations (PR) agencies to help. This study, which is inspired by Frandsen and Johansen's (2008) study in Denmark, aims to evaluate the contributions of consultants from PR agencies. Adapting indicators to assess professionalism proposed by Lages and Simkin (2003) and Sallot, Cameron and Lariscy (1997) and integrating them with variables from the contingency theory (Pang, Jin, & Cameron, 2010), this study seeks to examine: (1) the level of expertise of consultants in offering crisis management consultancy; (2) the level of experience of consultants offering crisis management consultancy; and (3) the value and expedience of the consultancy services offered. Findings showed that agencies in Singapore hired consultants based on skills such as writing, speaking and ability to manage the media. For some, lack of direct experience was compensated by in-house training. International agencies appeared to have an advantage over the local agencies by virtue of their access to expertise and knowledge from their international network. However, as the majority of agencies had only managed few crises, it was difficult to assess the value these consultants added. Studies examining consultants in PR agencies are rare. It is hoped this study would trigger research around the world.     

Effect of childlessness on nursing home and home health care use

This study examines the likelihood of nursing home and home health care use for childless older Americans. Four research questions are addressed: (1) Are the childless elderly at a greater risk of nursing home and home health care use? (2) Is it childlessness per se or not having children with particular characteristics that affects the likelihood of using these formal long-term care services? (3) Does having additional children beyond the first one have a significant effect on the use of these services? (4) Are the effects of childlessness different on the likelihood of nursing home and home health care use? Longitudinal data from the first (1993) and second (1995) waves of the Asset and Health Dynamics Among the Oldest Old Survey (AHEAD) and multinomial logistic regression models are used for the analyses. Separate models are developed for women and men, each controlling for a variety of demographic, socioeconomic, and health-related characteristics of sample persons. Findings indicate childlessness as an important risk factor, especially for older women's use of nursing home services. Implications of findings for planning for long-term care needs of the baby boom generation are discussed.     

A national evaluation of Safe Schools/Healthy Students: outcomes and influences

The Safe Schools/Healthy Students (SS/HS) Initiative has awarded over $2 billion in grants to more than 350 school districts in partnership with local mental health, law enforcement, and juvenile justice agencies. To estimate the impact of grantee characteristics, grant operations, and near-term outcomes in reducing violence and substance use, promoting mental health, and enhancing school safety, logged odds ratios (LORs) were calculated contrasting Year 3 with Baseline performance from grantee-provided data on seven outcome measures. After comparing grantee performance across outcomes and outcomes across grantees, the LORs were entered as dependent variables in a series of meta-regressions in which grantee characteristics, grant operations, and near-term outcomes were tested after controlling for pre-grant characteristics. Findings indicate that the SS/HS Initiative significantly improved most outcomes, that within-grantee performance varied greatly by outcome, and that random-effects meta-regression appreciably decreased the variance available for modeling. The approach demonstrates that the SS/HS Initiative is effective and that locally collected performance data can be used to estimate grantee success in improving youth outcomes.     

Computer Technology Utilization and Community-Based AIDS Organizations

SUMMARY

This study explores the computer utilization patterns of 107 community-based AIDS organizations in Canada. A questionnaire examined the current hardware/software capacities of agencies, knowledge and use of the Internet and its capabilities as a tool for psychosocial support, and barriers to computerized service provision. It also explored consumers' utilization and knowledge of computer-mediated technologies, and barriers to service. Results suggest agencies have resource-related dilemmas, relating to limited finances, time and personnel capacities. Consumers are challenged by a lack of access to computers, limited awareness of computer-mediated technologies, and other inhibiting factors. Future directions for community-based AIDS organizations are considered.     

Advertising value equivalence—PR's orphan metric

The academic approach to measurement and evaluation has long favoured social science methodologies (0050, 0260 and 0315), but there has been persistent, widespread practice use of advertising value equivalence (AVE) to express the economic and financial value of public relations activity. This paper investigates the evolution of AVE and discusses whether it arose from clippings agencies, press agentry or other influences on public relations, such as advertising and product promotion.     

Characteristics related to family involvement in youth residential mental health treatment

This study examined family involvement among youth in residential mental health treatment facilities in Florida. Data were obtained from the provider reports from January 2005 through December 2007. Treatment episodes were divided into 30-day periods with family involvement measured by the number of contacts by all family members, the mother, and the father. In addition, we examined contacts by all family members for in-person treatment, treatment-related phone contacts, treatment planning, campus visits, and therapeutic home passes. Families averaged 3.4 contacts per 30 days for the 1333 treatment episodes. Sixty-seven percent of the contacts included mothers, while 22% of the contacts involved fathers. A majority of contacts were for family therapy, either by phone (29% of contacts) or in person (43%). Nearly twenty percent of residential stays had no family contact. After the first 30 days of treatment, contacts did not vary significantly over the course of the treatment episode, although there was some evidence that youth with longer treatment episodes had fewer contacts throughout the residential stay. Total contacts were lower for girls than boys, for blacks than whites, and for older youth, and were higher when the youth lived in the same county as the residential treatment provider. Outreach programs could target specific demographic groups with low involvement, and the alternative methods for involvement that use internet conferencing tools should be explored for parents that live far from the treatment provider.