A machine learning approach for identifying predictors of success in a Medicaid-funded, community-based behavioral health program using the Child and Adolescent Needs and Strengths (CANS)

Children and Youth Services Review, Journal Year: 2021, Volume and Issue: 126, P. 106010 - 106010

Published: April 1, 2021

The CANS is the most popular measurement tool in System of Care (SoC), with potential to generate an estimated 1.9 million evaluations per year United States. This dataset has broad for decision support and outcomes monitoring, yet many SoC services do not leverage this information asset. We report here results a pilot project which we applied machine learning methods data purpose identifying clinical profiles associated improvement public community-based behavioral health program Pennsylvania. analyzed over 7,000 from 3,385 children who participated Pennsylvania's Medicaid-funded rehabilitation (BHRS) during 2013–2019. A gradient boosting classifier was developed identify likely experience total score on while participating BHRS. Separate models were constructed without autism spectrum disorder (ASD). CANS-based also identified. Analyses run using Python Sci-Ki version 0.20.3 Linearly Interpretable Model-agnostic Explanations (LIME) 0.1.1.33. mean age BHRS participants 9.85 years (standard deviation: 3.47) majority white (54%) or African American (11.5%). median length stay 963 days (range: 541–2,008) 39% (N = 1,330) had diagnosis ASD. 49.9% improvement. Precision 70% 79% ASD, respectively. Fourteen ASD (mean probability profile 0.95, range: 0.88–1.0) 55 such identified improvement: 0.91, 0.86–1.0). Machine can be have high These may utility as adjunct existing systems services.

Language: Английский

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Overview of Ten Child Mental Health Clinical Outcome Measures: Testing of Psychometric Properties with Diverse Client Populations in the U.S.

Administration and Policy in Mental Health and Mental Health Services Research, Journal Year: 2021, Volume and Issue: 49(2), P. 197 - 225

Published: Sept. 5, 2021

Abstract While many standardized assessment measures exist to track child mental health treatment outcomes, the degree which such tools have been adequately tested for reliability and validity across race, ethnicity, class is uneven. This paper examines corpus of published tests psychometric properties ten used in U.S. outpatient care, with focus on breadth testing these domains. Our goal assist care providers, researchers, legislators understanding how cultural mismatch impacts measurement accuracy select appropriate characteristics their client populations. We also highlight avenues needed research that are common use. The list was compiled from (1) state Department Mental Health websites; (2) a survey California county behavioral agency directors; (3) exploratory literature scans research. Ten met inclusion criteria; each one systematic review psychometrics conducted. Diversity participant samples examined as well differences by gender, race or socio-economic class. All showed adequate validity, however half lacked diverse all three domains Asian American/Pacific Islander Native American children. ASEBA, PSC, SDQ had broadest testing.

Language: Английский

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Mental health symptoms of youth initiating psychiatric care at different phases of the COVID-19 pandemic

Child and Adolescent Psychiatry and Mental Health, Journal Year: 2022, Volume and Issue: 16(1)

Published: Sept. 30, 2022

Abstract Objective To examine differences in caregiver and youth reported mental health symptoms for initiating treatment through phases of the Coronavirus Disease (COVID-19) pandemic, compared with symptomology prior year. Study design This retrospective study analyzes group (Pediatric Symptom Checklist; PSC-35) based on 7874 seeking publicly funded programs during California’s Stay-At-Home order (March–May, 2020) prolonged pandemic (May–December, COVID-19 as matching groups 2019. Results Youth entering services, their caregivers, significantly increased internalizing, externalizing, attention-related phase, but not acute stay-at-home phase small effect sizes. Group comparison analyses did detect a larger Sexual Gender Diverse (SGD) who identify lesbian, gay, bisexual, asexual, transgender, Two-Spirit, queer, and/or intersex, Black, Indigenous, People Color (BIPOC). Conclusions A large-scale before suggests that was disrupted throughout 2020.

Language: Английский

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A Scoping Review of Mental Health and Wellbeing Outcome Measures for Children and Young People: Implications for Children in Out-of-home Care

Journal of Child & Adolescent Trauma, Journal Year: 2023, Volume and Issue: 17(2), P. 159 - 185

Published: Sept. 4, 2023

Abstract Purpose One of the challenges for mental health research is lack an agreed set outcome measures that are used routinely and consistently between disciplines across studies in order to build a more robust evidence base how better understand young people’s effectively address diverse needs. Methods This study involved scoping review reviews on consensus use wellbeing with children people. We were particularly interested identify if there differences recommended people care experience including those developmental disabilities. Findings identified 41 reviews, which two had focus child welfare settings, three childhood trauma 14 focused Overall, our highlights diversity within field. 60 measures, only nine by than one review. Conclusions Our need greater agreement measures. While value identifying can be any or person, researchers take into account additional considerations when working disabilities, ensure accessible sensitive their life experiences.

Language: Английский

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Recognizing Adolescent Depression with Parent- and Youth-Report Screens in Pediatric Primary Care

The Journal of Pediatrics, Journal Year: 2021, Volume and Issue: 233, P. 220 - 226.e1

Published: Feb. 3, 2021

Language: Английский

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U.S. Child Behavioral Health Quality Measures: Advancing a National Research Agenda

Journal of Abnormal Child Psychology, Journal Year: 2020, Volume and Issue: 48(6), P. 745 - 756

Published: April 14, 2020

Language: Английский

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Regulators, Payors, and the Impact of Measurement-Based Care on Value-Based Care in Psychiatry

Child and Adolescent Psychiatric Clinics of North America, Journal Year: 2020, Volume and Issue: 29(4), P. 743 - 754

Published: July 8, 2020

Language: Английский

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Measurement-based Data to Monitor Quality: Why Specification at the Population Level Matter?

Child and Adolescent Psychiatric Clinics of North America, Journal Year: 2020, Volume and Issue: 29(4), P. 703 - 731

Published: July 29, 2020

Language: Английский

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A linear optimization approach to decision support with CANS data

Research Square (Research Square), Journal Year: 2023, Volume and Issue: unknown

Published: Oct. 19, 2023

This research is meant to make a contribution the field of Communimetric (CMX) algorithms (Lyons, 2004, 2009). science underscoring behavioral health and child welfare assessment tools such as Child Adolescent Needs Strengths (CANS) assessment, Adult Assessment (ANSA), Family Advocacy Support Tool (FAST), amongst others (https://praedfoundation.org/). These are used throughout US serving adult mental system not only assure standardized process, but also provide real-time Decision (DS) assessors about client treatment planning disposition. We propose novel method for developing CMX DS utilizing linear optimization (commonly known programming (LP) or (mixed) integer (ILP MILP)). Using administrative data from Pennsylvania’s Medicaid Behavioral Health system, MILP model developed differentiate profiles that benefit one two programs in Pennsylvania care. The picked both children at risk out home placement, their clinical models different. There often debate which program most appropriate given family, thus help facilitate this decision making. health, well testing validating model. then identifying impact on care utilization could have facilitating improved matching system. close with discussion how information be planning, development issues.

Language: Английский

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Identifying core measures to be used in mental health research with care experienced young people: A Delphi study

Children and Youth Services Review, Journal Year: 2023, Volume and Issue: 157, P. 107380 - 107380

Published: Dec. 6, 2023

Care experienced young people, including those who are neurodivergent, experience worse mental health outcomes than their non-care counterparts. Understanding the of this population, how it changes over time, is critically important to development more effective, supportive services. However, one challenges lack consensus around a set suitable measures that can be used with care neurodivergent. The primary aim study was develop core by researchers when investigating Additional research questions included: (1) what strengths and limitations these measures?; (2) value drawbacks attempting (3) do people think about measures? This mixed methods approach. method classical Delphi design where from panel experts (n=18) sought in relation recommendation 7 measures. These covered 4 domains: general health, quality life/related life, anxiety depression, suicide self-harm. Alongside Delphi, an advisory group (n=6) asked examine suitability/ appropriateness collection Findings- There were number highlighted experts. Given these, only SDQ RCADS-25 recommended for routine use people. Moreover, In addition, suggested there would need significant wording content all improve suitability. Lastly, tension exists relating utility recommending potential restrictions may impose.

Language: Английский

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