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The Columbia Impairment Scale: factor analysis using a community mental health sample
- Authors:
- SINGER Jonathan B., EACK Shaun M., GREENO Catherine M.
- Journal article citation:
- Research on Social Work Practice, 21(4), July 2011, pp.458-468.
- Publisher:
- Sage
The accurate identification of functional impairment is a primary goal of epidemiologists, treatment development researchers, and clinicians. This study aimed to test the factor structure of the parent version of the Columbia Impairment Scale (CIS) in a sample of 280 mothers who brought their children for community mental health (CMH) services, in Pennsylvania, United States. Confirmatory factor analysis (CFA) was used to test the fit of the hypothesised four-factor structure and the empirically validated one-factor structure. Exploratory factor analysis was used to identify what factor structure best fit our sample of distressed mothers. Neither the one- nor the four-factor model fit our sample. The analysis suggested that the CIS was best understood as a 12-item, three-factor model that identified functional impairment: at school/work; in socialising; and at home/family. The authors concluded that these results question the validity of the parent version of the Columbia Impairment Scale in a community mental health sample of mothers and provides support for multidimensional measures of functional impairment.
Intensive, not intrusive: our visits and telephone interviews with individuals and carers who have had contact with Intensive Home Treatment Services and the service providers
- Author:
- MENTAL WELFARE COMMISSION FOR SCOTLAND
- Publisher:
- Mental Welfare Commission for Scotland
- Publication year:
- 2012
- Pagination:
- 33p.
- Place of publication:
- Edinburgh
For several years, there has been a move away from hospital-based care and treatment for people with mental illness, learning disability and related conditions. Intensive home treatment (IHT) is an alternative to hospital admission. This report presents the findings of visits and telephone interviews from October 2011 to February 2012 with individuals who had received IHT and their carers in order to obtain their views of the service. The study covered both adult services and child and adolescent mental health services (CAMHS). Semi-structured interviews were conducted with a total of 106 individuals, 25 carers and 23 service managers. The findings showed an overwhelmingly positive view of IHT, with the vast majority of the individuals and careers highly valuing the service. Local service managers reported that the availability of IHT has reduced the need for hospital admission. There is no overall consistent model of IHT across Scotland. While it is unrealistic to expect a ‘one size fits all’ model for intensive home treatment, the report concludes that all NHS Boards should ensure that they have services to assess and support people at home during times of mental health crises. A number of key messages and recommendations are provided to help to develop further this model of service.
Mental health outcomes of children and youth accessing residential programs or a home-based alternative
- Authors:
- PREYDE Michèle, et al
- Journal article citation:
- Social Work in Mental Health, 9(1-6), 2011, pp.1-21.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Residential treatment centres (RTCs) are 24-hour facilities that offer mental health treatment programmes for children with severe emotional and behavioural disorders. RTCs are among the most restrictive and costly of mental health services. The aim of this study was to document the mental health outcomes of children and youth involved in residential treatment or a home-based alternative, intensive-family service (IFS). Participants were recruited from 5 children’s mental health agencies in Ontario, Canada. Parents or guardians of 106 children entering residential RTCs and 104 entering IFS completed standardised measures of symptom severity and functioning. Data was collected at admission, discharge, and at 1-2 years follow-up. In general, some clinical and psychosocial improvements from admission to discharge and follow up were revealed, although not all measures were statistically significant. Furthermore, many youth continued to function within the clinical range of impairment. Implications for mental health services are discussed.
Parent–child relationships and family functioning of children and youth discharged from residential mental health treatment or a home-based alternative
- Authors:
- PREYDE Michèle, et al
- Journal article citation:
- Residential Treatment for Children and Youth, 28(1), January 2011, pp.55-74.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Family relationships and family functioning can have tremendous implications for youth’s expression of mental health problems and the success of treatment. This study stems from a larger longitudinal study with families and youth from 5 children’s mental health agencies in Ontario, Canada. It aimed to document the family characteristics, nature of family relationships, and level of family functioning for 106 children accessing residential mental health treatment and 104 children accessing the home-based alternative. Parent-reported measures were gathered about youth functioning at programme entry, discharge, and 12 to 18 months after leaving the programme. The results suggest that youth accessing residential treatment have very different family experiences than youth accessing the home-based alternative. Furthermore, the functioning of youth at home improved significantly from admission to discharge, and family functioning was considered ‘healthy’ at follow up; however, family relationships remained problematic. In qualitative interviews with a subsample of youth, varied and complex family relationships were described, and many youth revealed aspirations for positive family engagements.
Alternatives to inpatient mental health care for children and young people (review)
- Authors:
- SHEPPARD Sasha, et al
- Publisher:
- John Wiley and Sons
- Publication year:
- 2009
- Pagination:
- 65p., bibliog.
- Place of publication:
- Chichester
This review aimed to assess the effectiveness, acceptability and cost of mental health services that provide an alternative to inpatient care for children and young people, and to identify the range and prevalence of different models of service that seek to avoid hospitalisation for children and young people. Selection criteria were: randomised controlled trials of mental health services providing specialist care, as an alternative to inpatient mental health care, for children or adolescents aged from five to 18 years who have a serious mental health condition. The control group received mental health services in an inpatient or equivalent setting. Seven randomised controlled trials (recruiting a total of 799 participants) met the criteria, evaluating four distinct models of care: multisystemic therapy (MST) at home, specialist outpatient service, intensive home treatment and intensive home-based crisis intervention (’Homebuilders’ model for crisis intervention). There were small, significant patient improvements reported in both groups in the trial evaluating the intensive home-based crisis intervention using the ’Homebuilders’ model. No differences at follow up were reported in the two trials evaluating intensive home treatment, or in the trials evaluating specialist outpatient services. The quality of the evidence base currently provides very little guidance for the development of services. If randomised controlled trials are not feasible then consideration should be given to alternative study designs, such as prospective systems of audit conducted across several centres, as this has the potential to improve the current level of evidence. These studies should include baseline measurement at admission along with demographic data, and outcomes measured using a few standardised robust instruments.
Stop passing the parcel
- Author:
- KHAN Lorraine
- Journal article citation:
- Community Care, 21.2.08, 2008, pp.22-23.
- Publisher:
- Reed Business Information
Children with mental health problems are being passed between services, often ending up in jail where their problems are only exacerbated. The author, of the Sainsbury Centre for Mental Health, calls for better community-based solutions. The author highlights the need for: early screening and intervention, better integrated working, improved access to services, in-patient treatment assessments, diversion, and better resettlement services.
Children's mental health: creating comprehensive services in a climate of change
- Authors:
- IRVINE Bruce, MORLEY Dinah
- Journal article citation:
- Young Minds Magazine, 51, March 2001, pp.20-21.
- Publisher:
- YoungMinds
Following an article proposing the creation of CAMHS Boards, the authors argue that getting the partnership arrangements right are more important than where child and adolescent services are located.
Waiting in line: stories of young people accessing mental health support
- Author:
- CHILDREN'S SOCIETY
- Publisher:
- Children's Society
- Publication year:
- 2020
- Pagination:
- 52
- Place of publication:
- London
This report explores the experiences of young people accessing mental health support from NHS Children and Young People’s Mental Health Services. It is based on semi-structured interviews carried out with 27 young people aged 11-21 with minority protected characteristics. These included young people from ethnic minority backgrounds, LGBTQ young people, young people with disabilities, and young people with multiple disadvantages. Key challenges identified from interviews with young people were: the fear of stigma and a lack of knowledge in young people and communities about how to seek help and how to support each other through mental ill health. Young people also felt services once accessed were slow and confusing. The report includes direct quotations from the young people interviewed and the journeys of two individuals. The findings suggest that to improve young people's experiences of accessing mental health support services need to be re-designed and re-located in the communities where young people live. (Edited publisher abstract)
Secret practices: interdisciplinary work in child welfare
- Author:
- TAYLOR Alexis A
- Publisher:
- Upfront
- Publication year:
- 2003
- Pagination:
- 202p.,bibliog.
- Place of publication:
- Leicester
This ethnographic study presents a different perspective on Child and Adolescent Mental Health Services: that of the child’s. The author argues that the rights of children encountering this service are as seriously compromised as those of adult mental health service users once were. The evidence challenges the quality of assessments, and shows the powerful influence of technical language and power mongering on constructing realities. Professional work can be self-serving rather than ‘in the best interests of the child’. Some of the fundamental tensions in inter-disciplinary work and ‘joined up thinking’ are exposed. Novel ways of exploring critical decision points and working effectively in groups are presented. There are salutary messages for child welfare practitioners and policy makers, and compelling reasons for radically altering the child welfare system in the UK in order to meet the needs of distressed children. A new ‘architecture of care’ must replace the current monolithic institutions and professional tribes.
Drug and alcohol work in child and adolescent mental health
- Author:
- ROSS Anthony
- Journal article citation:
- Nursing Times, 22.7.03, 2003, pp.26-27.
- Publisher:
- Nursing Times
Provides an overview of the Barnes Unit in Sunderland, which is an adolescent mental health team providing community-based treatment for 16-19 year olds. It shares a way of working with adolescents who have problems with drugs and alcohol, within Child and Adolescent Mental Health Services. Young people with substance misuse problems who do not have mental health problems can also access the service.