Columbia University Mailman School of Public Health

Study: Michigan’s Mental Health Care System for Children & Youth a National Model
State’s Outcomes-based Approach Employs Evidence-based Practices

New York City, May 26, 2010 – A study conducted in Michigan by a national poverty research center shows the state’s approach to delivering care to children and youth in its public mental health system by focusing on outcomes is a model for health care in the United States.

“Michigan demonstrates that when we start to track outcomes we are more likely to focus on access and quality,” says Janice L. Cooper, PhD, interim director of the National Center for Children in Poverty (NCCP), a think tank based at Columbia University’s Mailman School of Public Health. “Knowledge about evidence-based and effective practices is high in Michigan. We think this is because they are using data on how children are doing to inform decisionmaking about what practices to implement and train on. A major focus of health care reform is on patient-centered outcomes research. Our study shows that Michigan was able to focus on how they can improve their system by getting information on how well children in services are doing. They instituted a quality improvement system that included many different stakeholders.”

Dr. Cooper and Patti Banghart, a research associate at NCCP, report in “Unclaimed Children Revisited: Focusing on Outcomes – A Case Study of the Michigan Level of Functioning Project” that the state’s approach to delivering care to children and youth with the highest need begins with sharing data about children and families with providers, system leaders and the children and families themselves. This accountability and monitoring mechanism is a large part of why, unlike many states, Michigan is able to report on how well the children and families they serve are doing, what types of services are working, and what trends exist for specific conditions. With this information they can better plan and address service gaps, explains Cooper.

Cooper and Banghart examined Michigan’s Level of Functioning Project, a 14-year effort to monitor and improve outcomes for children and youth with severe emotional disturbances, through the use of the “Child and Adolescent Functional Assessment Scale,” which they found has helped improve individual and systems-level decision-making statewide.

NCCP found that:

  • Michigan is a national leader in implementing such a mechanism for state accountability in children’s mental health.
  • The state’s assessment tools allow it to use interventions that work, and address factors that support or impede quality.
  • Michigan’s tools can and should be used to help facilitate communication between mental health care providers and families.
  • Using Michigan as an example, mental health care services providers will benefit from “buy-in” and training in such assessment systems.

“Michigan's statewide effort to monitor child outcomes through the collection of functional assessment data, using learning opportunities to review data, get feedback and improve practice is a promising approach to how systems can enhance their accountability and quality,” says Banghart. “Clinical decision-making is made easier by focusing on how well children in services are doing. Tracking the data also helps to identify populations of children in need, and in turn can help to introduce evidence-based practices to serve children better.”

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The National Center for Children in Poverty (NCCP) is the nation’s leading public policy center dedicated to promoting the economic security, health and wellbeing of America’s low-income families and children. Part of Columbia University’s Mailman School of Public Health, NCCP uses research to inform policy and practice with the goal of ensuring positive outcomes for the next generation.