Evaluating performance and change in mental health systems serving children and youth: an interorganizational network approach

• Published in: Journal of mental health administration 1997, Vol.24 (1), p.4-22
• Main Authors: Morrissey, J P, Johnsen, M C, Calloway, M O
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent Health Services - organization & administration; Adult; Case management; Child; Child & adolescent mental health; Child Health Services - organization & administration; Children; Children & youth; Collaboration; Community; Community mental health services; Community Mental Health Services - organization & administration; Community support; Coordination; Data collection; Delivery Systems; Evaluation; Evaluation Research; Health care networks; Health services; Health Services Research; Humans; Interinstitutional Relations; Interorganizational networks; Juvenile justice; Medical referrals; Mental health; Mental health care; Mental Health Services; Methods; North Carolina; Organizational Innovation; Outcome and Process Assessment, Health Care; Performance appraisal; Psychiatry; Questionnaires; Research Design; Service delivery; Stakeholders; Statistical analysis; Studies; Time; Urban areas; Youth
• ISSN: 0092-8623; 1094-3412; 1556-3308
• DOI: 10.1007/BF02790476

Planning for the delivery of community mental health services has evolved from models of services within individual agencies to community-wide systems of care, but development of methodologies for assessing system performance has lagged behind. This article presents one approach to system-level assessment by viewing children's mental health systems as an interorganizational network. Data are presented on two county-based child mental health systems in North Carolina that participated in the Robert Wood Johnson Foundation Mental Health Services Program for Youth. Site-specific data on client referrals, fund exchanges, and information flows were collected at two time points (1991 and 1993) to measure the cohesiveness and concentration of the service system using network k-core analyses. In addition, stakeholder ratings of service adequacy, quality, availability, coordination, and overall demonstration project goal attainment were obtained at both time periods. Findings indicate that the rural system was outperforming the urban system at the time of the first survey, but the urban system caught up over the study interval. There was high agreement between the network and stakeholder ratings of system performance at both time periods. The method of data collection and analysis used in this study provides tools that can be used in a variety of settings to assess service system growth and development.