Predicting service utilization with the child and adolescent functional assessment scale in a sample of youths with serious emotional disturbance served by center for mental health services-funded demonstrations

This study investigated level of restrictiveness of living arrangements and number of days in outof-family care at six months postintake, based on the ChiM and Adolescent Functional Assessment Scale, the Child Behavior Checklist, gender, age, and level offamily income at intake

Kay Hodges; Ann Doucette-Gates; Cheong-Seok Kim


Scholarcy highlights

  • Information that assists in predicting subsequent need for services is important to any agency providing services
  • The Child and Adolescent Functional Assessment Scale was designed to assess degree of impairment in youths with emotional, behavioral, psychiatric, psychological, or substance use problems.~ The CAFAS at intake has been shown to be a predictor of subsequent service utilization and costs in the Fort Bragg Evaluation Project. 2'3The youths in this study were primarily living in two-parent families of middle income and were dependents of army personnel who were on Address correspondence to Kay Hodges, Ph.D., professorof psychology and associate director of the Applied Research Unit at Eastern MichiganUniversity,2140 Old Earhart Road, Ann Arbor, MI 48105; e-mail:
  • Active duty or retired.4The CAFAS total score at intake significantly predicted service utilization and cost at 6 and 12 months postintake in the FBEP.3Higher impairment on the CAFAS at intake was significantly related to more restrictive care, higher cost, more bed days, and more days of services
  • The purpose of this study is to examine the relationships of the CAFAS scores at intake with subsequent service utilization patterns for youths reported on in the Center for Mental Health Services national sample
  • Each of these dependent variables was regressed on the CAFAS total score for youth, the Child Behavior Checklist total problem score, gender, categorized age groups, and categorized family income level
  • As for family income, numerous studies have found that use of inpatient care and longer lengths of stay are closely associated with type and extent of insurance coverage.17' 2o-22More recently, having public insurance, as opposed to no insurance or private insurance, was associated with more service use, apparently due to limited insurance benefits related to increased influence of managed care.23Unfortunately, determining whether access to insurance coverage and more generous benefit privileges would explain the findings in this study is not possible since service cost and source of payment are not available for this pooled CMHS data set
  • The findings from the multinomial logit model analysis of most restrictive level of care and the regression analysis for number of days in out-of-family care both attest to the predictive utility of the Child and Adolescent Functional Assessment Scale

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