Columbia University Mailman School of Public Health

Unique Tracking System Enables Michigan to Monitor Child Mental Health

New York City, Dec. 15, 2009 - New research on a statewide Michigan initiative designed to help children and teens experiencing serious mental health difficulties has shown that use of a functional assessment scale to track individual progress is instrumental in improving and guiding service provision.

The National Center for Children in Poverty (NCCP), based at Columbia University’s Mailman School of Public Health, has published findings from a case study on Michigan’s Level of Functioning Project (LOF). The LOF is a 10-year-old initiative to monitor and improve outcomes for children and youth with severe emotional disturbances through the use of the Child and Adolescent Functional Assessment Scale (CAFAS). The findings were published as one part of a comprehensive research report entitled Unclaimed Children Revisited: The Status of Children’s Mental Health Policy in the United States.

NCCP researchers collected data about the use of the CAFAS and the LOF through interviews with state and local stakeholders in Michigan, including county and state system leaders, service providers, community leaders, teens, and their families. A majority of the system leaders and service providers were from the state mental health sector; respondents from juvenile justice, child welfare, public health, and education sectors were also included.

The study shows how an efficient, user-friendly tool, supported by sound administrative policy, can be an incredibly valuable aid in assessing and tracking individual child and family functioning, progress, and outcomes,” notes Janice L. Cooper, PhD, the lead author of Unclaimed Children Revisited.

Positive outcomes reported by NCCP include the following:

  • About half of the respondents (49%) recognized that the use of the CAFAS helped them to better monitor outcomes and guide services.
  • Over half of the respondents (60%) believed that having the ability to monitor behavioral functioning objectively was a good way to improve system effectiveness.
  • There was a high level of awareness (80%) among respondents of evidence-based practices – namely, care strategies informed by research.
  • Some respondents (11%) reported that having access to quality data from the CAFAS would help them to gain support by securing increased funding and as a way of showing programs’ success.
  • Some respondents (16%) reported that the use of a common assessment tool creates an opportunity for cross-agency and cross-systems collaboration.
  • About a third of respondents (35%) noted that sharing assessment results can be a valuable tool for engaging families in their children’s care.

Currently, Michigan is the only state that mandates the use of the CAFAS throughout its public mental health system. But, notes Cooper, “the adoption of similar methods elsewhere could markedly improve states’ ability to evaluate individual children, youth, and their families; track their progress; and respond to their evolving needs with appropriate mental health services.”

Sectors including state mental health, juvenile justice, child welfare, and public health can benefit from integrating a functional assessment tool early on, to make the most of opportunities for cross-systems collaboration and care coordination,” adds researcher Patti Banghart, who helped to analyze and report the data.

A summary of case study findings, entitled Focusing on Outcomes: Michigan Case Study of the Level of Functioning Project, can be found in Unclaimed Children Revisited: The Status of Children’s Mental Health Policy in the United States . The complete Michigan case study findings will be available in early 2009.

The National Center for Children in Poverty (NCCP) is the nation’s leading public policy center dedicated to promoting the economic security, health and well-being 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.