Understanding the pre-referral factors associated with differential 6-month outcomes among children receiving system-of-care services
The authors of 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 the prereferral characteristics and experiences of children with serious emotional disturbance as they relate to indicators of clinically significant improvement and deterioration during their first 6 months of service. Minority racial/ethnic background, a history of substance and out-of-home placement were identified as predictors of deterioration at 6 months, higher levels of functional impairment, higher levels of caregiver strain, and poorer academic functioning were associated with significantly lower odds of deterioration. Initial service experience was examined in an effort to explain the relationship between identified prereferral characteristics and 6-month change status. Implications are considered and discussed.