Population and service characteristics of youth with schizophrenia-spectrum diagnoses in the Hawaii system of care

Impacts of a Medicaid Wraparound Model Demonstration Program on Youth Specialty Mental Health Services Use

Effective coordination of mental health care is critical in Medicaid wraparound model programs for youth. This study examined participation over time in mental health services for youth diverted or transitioned from residential care to a Medicaid wraparound demonstration program. Youth in wraparound had more sustained use of mental health outpatient clinic services than did propensity score matched youth who were not in wraparound. However, the rate of outpatient clinic follow-up after inpatient discharge was no greater in wraparound. Routine assessment of wraparound programs' impacts on receipt of mental health care may inform the development of Medicaid wraparound program performance standards.

School-based approaches to reducing the duration of untreated psychosis

Students with emerging psychosis often experience delays in diagnosis and treatment that impact mental health and academic outcomes. School systems have tremendous potential to improve early identification and treatment of adolescent psychosis. As a community-based resource, schools can support outreach, education, and screening for adolescents with psychosis and engage identified students and their families for treatment. The concept of duration of untreated psychosis (DUP; the gap between symptom onset and treatment initiation) in adolescent psychosis and the potential role of schools in reducing DUP are reviewed. Future directions for clinical care and research needed to support school-based interventions are proposed.

Correlates of schizophrenia spectrum disorders in children and adolescents cared for in community settings

BACKGROUND: This study examined the prevalence and correlates of schizophrenia spectrum disorders (SSD) among a national sample of 9006 children. METHODS: Clinician-assigned diagnoses were used to divide the sample into two groups: children with SSD and children with other Axis I disorders. RESULTS: Three percent of the sample had a SSD diagnosis. African American (OR=1.71, 95% CI: 1.11, 2.65) and Hispanic race/ethnicity (OR=1.96, 95% CI: 1.31, 2.94), a greater number of comorbid psychiatric diagnoses (three diagnoses, OR=2.22, 95% CI: 1.49, 3.31), a history of attempting suicide (OR=1.45; 95% CI: 1.05, 2.02), and past residential treatment (OR=1.59; 95% CI: 1.11, 2.28) were all associated with increased odds of SSD diagnosis. CONCLUSIONS: Although schizophrenia spectrum disorders in youth are rare, children with these disorders present with a distinct risk profile that may inform service planning and delivery and assist in identifying individuals early in the course of their illness.

Burdens and difficulties experienced by caregivers of children and adolescents with schizophrenia-spectrum disorders: a qualitative study

AIM

The purpose of this qualitative study was to investigate the burdens and difficulties associated with the experience of caring for youth with schizophrenia-spectrum disorders.

METHODS

Ten caregivers participated in a modified version of the Knowledge about Schizophrenia Illness interview.

RESULTS

The most common areas of general difficulties reported by caregivers were emotional burdens and the everyday practical demands and sacrifices required in caring for their dependents. RESULTS also suggested high levels of burden for caregivers concerning difficulties with mental health services.

CONCLUSION

Additional work is needed to learn more about the challenges that caregivers of youth with schizophrenia-spectrum disorders are facing, as well as to develop empirically based strategies for helping these caregivers and their dependents.