E v o l v i n g T o w a r d s M a t u r i t y. Preliminary Results

Transcription

1 Project Ho omohala E v o l v i n g T o w a r d s M a t u r i t y Preliminary Results Ranilo Laygo, Lead Evaluator Carol Matsuoka, Project Director Stephanie Manley, Evaluation Team Member Tina Tauasosi, Evaluation Team Member Susannah Wesley Community Center WAI AKA, Inc. HAWAII FAMILIES AS ALLIES

2 Project Goals and Objectives Implement the Transition to Independence Process in the Kalihi-Palama Community Provide high quality transitional support services to youth and young adults with emotional or behavioral challenges in the Kalihi-Palama Community Integrate a comprehensive array of age appropriate services and supports, peer mentoring, and targeted policy and system activities Utilize a comprehensive life skills program

3 Goals and Objectives Cont d Develop a comprehensive Young Adult Support Organization for the Kalihi-Palama Community Develop a Youth Community Center within the Kalihi-Palama Community Assure that the infrastructure enhancement achieved by the project are comprehensive, effective and sustainable and can be replicated in other parts of the state

4 Target Population Youth and young adults with serious emotional or behavioral challenges, ages 15-21, living in the Kalihi-Palama community Youth ages will be given priority and followed until their 21 st birthday.

5 Criteria for Enrollment A DSM-IV diagnosis or symptoms characteristic of such a diagnosis for at least 12 months, OR on the basis of diagnosis, severity, or multi-agency intervention is expected to last more than one year Receiving services from two or more community service agencies in the areas mental health, education, child welfare, juvenile justice, substance abuse, and primary healthcare For youth 18-21, community service agencies include adult mental health, social services, vocational counseling, higher education, criminal justice, housing, and primary healthcare

6 Section I: Youth and Family Status at Intake The purpose of this section is to provide a detailed description of the youth and families being served by Project Ho omohala. Information in this section was gathered at intake using the following instruments: Enrollment and Demographic Information Form (EDIF): The EDIF gathers demographic, diagnostic, and system-of-care enrollment information on all youth receiving services. Information for the EDIF is gathered from record review and caregiver report. Caregiver Information Questionnaire Intake (CIQ I): The CIQ I is administered to caregivers and gathers additional demographic information, as well as information on risk factors, family composition, custody status, service use history, and presenting problem(s) for youth enrolled in the longitudinal outcome study.

7 Demographic Characteristics of Youth Served Demographics Project Ho omohala Communities** Communities** Gender (n = 25) (n = 11,758) (n = 6,085) Male 48.0% 66.0% 66.8% Female 52.0% 34.0% 33.2% Average Age (n = 24) (n = 11,673) (n = 6,079) 16.0 years 11.0 years 12.2 years Race and Ethnicity* (n = 25) (n = 10,701) (n = 5,952) American Indian or Alaska Native 4.0% 8.6% 10.6% Asian 68.0% 0.8% 0.8% Black or African-American 21.7% 31.5% Native Hawaiian or Other Pacific Islander 52.0% 0.5% 0.5% White 32.0% 61.9% 52.1% Of Hispanic Origin 12.0% 10.4% 10.2% Multi-racial 48.0% 5.7% 7.6% Other 1.7% 1.5% * Because individuals may claim more than one racial background, percentages for race may sum to more than 10. ** Center for Mental Health Services. (2004). Annual Report to Congress on the Evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program, Atlanta GA: ORC Macro.

8 Intake Referral Information and Agency Involvement Referral Agency Agency Involvement* Corrections Juvenile Court Probation School 8.0% 16.0% Corrections Juvenile Court Probation 4.0% 4 Mental Health** 44.0% School 76.0% Physical Health** Mental Health** 52.0% Child Welfare** Substance Abuse Clinic Family Court Caregiver 8.0% Physical Health** Child Welfare** Substance Abuse Clinic 4.0% Self 4.0% Family Court 12.0% Other 2 Other 24.0% 0% 20% 40% 60% 80% 100% Percent n = 25. n = 25. 0% 20% 40% 60% 80% 100% Percent *Because individuals may claim involvement in more than one agency, percentages for agency may sum to more than 10. **Mental health = Mental health agency, clinic or provider; Physical health = Physical health care agency, clinic, *or provider; Child welfare = Child welfare agency or child protective services.

9 DSM Axis I and Axis II Diagnoses Diagnosis* (n = 24) Mood Disorders 58.3% Attention-Deficit/Hyperactivity Disorders 12.5% Oppositional Defiant Disorder 12.5% Substance Use Disorders ** 12.5% Adjustment Disorders 4.2% PTSD and Acute Stress Disorder 20.8% Disruptive Behavior Disorder 12.5% Anxiety Disorders Pervasive Developmental Disorders V Code *** 4.2% Conduct Disorders 29.2% Schizophrenia and Other Psychotic Disorders Learning, Motor Skills, and Communication Disorders 4.2% Impulse Control Disorders 4.2% Mental Retardation Personality Disorders Substance Induced Disorders 4.2% Other * Because youth may have more than one diagnosis, percentages for diagnoses may sum to more than 10. ** Substance Use Disorders include caffeine intoxication. *** V Code refers to Relational Problems, Problems Related to Abuse or Neglect, and additional conditions. Percentage excludes V71.09 (No Axis I or II diagnosis).

10 Presenting Problems Reported Suicidal Ideation/Self-Injury 16.0% Depression 44.0% Anxiety 12.0% Presenting Problems* Hyperactivity and Attention Conduct/Delinquency Substance Use Adjustment Psychotic Behaviors Pervasive Developmental Disability Specific Developmental Disability 8.0% 8.0% 4.0% 24.0% 32.0% 72.0% Learning Disability 4.0% School Performance 2 Eating Disorder Other 4.0% n (records reviewed) = 25. 0% 20% 40% 60% 80% 100% Percent * Because youth may present with more than one problem, percentages for presenting problems may sum to more than 10.

11 Youth and Family History 4 of caregivers reported a family history of depression (n = 10) 3 reported a family history of mental illness (n = 10) 8 reported a family history of substance abuse (n = 10) Has the youth ever...? Witnessed domestic violence? (n = 10) 7 Lived with someone who was depressed? (n = 10) 8 Lived with someone who had a mental illness? (n = 10) 2 Lived with someone who was convicted of a crime? (n = 10) Lived with someone who had a substance abuse problem? (n = 10) 2 6 Been physically abused? (n = 11) 45.5% Been sexually abused? (n = 11) 18.2% Run away? (n = 11) 54.5% Had substance abuse problems? (n = 11) 63.6% Attempted suicide? (n = 11) 18.2%

12 Custody Status* Two Parents** 27.3% Biological Mother Only 54.5% Biological Father Only Adoptive Parent(s) Sibling(s) Aunt and/or Uncle Grandparent(s) Adult Friend Ward of the State Other 18.2% 0% 20% 40% 60% 80% 100% n = 11. Percent * Custody Status refers to legal custody, which may not reflect living arrangement. ** Includes two biological parents, or one biological parent and a step or adoptive parent.

13 Family Income Household Income (n = 11) Less Than $5, % $5,000 $9,999 $10,000 $14, % $15,000 $19, % $20,000 $24, % $25,000 $34,999 $35,000 $49, % $50,000 $74, % $75,000 $99,999 $100,000 and over 2007 Department of Health and Human Services Poverty Guidelines* Persons in Family or Household Hawaii 1 $11,750 2 $15,750 3 $19,750 4 $23,750 5 $27,750 6 $31,750 7 $35,750 8 $39,750 For each additional person, add $4,000 Unknown 9.1% * Federal Register, Vol. 72, No. 15, January 24, 2007, pp

14 Section II: Juvenile Justice Involvement The purpose of this section is to provide information on youth s contact with the criminal justice system. Information in this section was taken from the Delinquency Survey Revised (DS R). The DS R gathers information on the types of illegal, violent, or delinquent activities youth have engaged in, along with the frequency of these acts. It also gathers information on law enforcement contacts and the results of those contacts. The DS- R is administered to youth enrolled in the longitudinal outcome study.

15 Criminal Justice History at Intake 81.8% of youth reported some type of criminal justice contact prior to intake (n = 11). Have you ever been... Questioned by the Police* (n = 11) 45.5% Arrested (n = 11) 81.8% Told to Appear in Court* (n = 11) 45.5% Convicted of a Crime (n = 11) 27.3% On Probation (n = 11) 45.5% Sentenced to a Secure Facility (n = 11) 18.2% * Because you were suspected of committing a crime. 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Percent

16 Section III: Substance Use The purpose of this section is to provide information on the types of substances used by youth and the frequency with which these substances are used. Information in this section was taken from the instrument listed below, which are administered to youth enrolled in the longitudinal outcome study. Substance Use Survey Revised (SUS R): The SUS R gathers information on youth s use of alcohol, tobacco, and other drugs (illegal, prescription, and over-the-counter). In addition to the types of substances used, information such as age of first use and frequency of use over the past 30 days is captured.

17 Substance Use at Intake 100% of youth reported using at least one substance prior to intake (n = 11). Substance* Ever Used Alcohol 81.8% (n = 11) Cigarettes 90.9% (n = 11) Chewing Tobacco/Snuff 27.3% (n = 11) Marijuana/Hashish 81.8% (n = 11) Cocaine (all forms) 36.4% (n = 11) Hallucinogenics (e.g., LSD, shrooms) (n = 11) PCP (n = 11) Ketamine (Special K) (n = 11) MDMA (Ecstasy, X) 18.2% (n = 11) GHB (n = 11) Inhalants (n = 11) Heroin 9.1% (n = 11) Amphetamines/Stimulants (n = 11) Pain Killers (e.g., Darvocet, Vicodin) 27.3% (n = 11) Ritalin, Adderall, Desoxyn (n = 11) Tranquilizers (e.g., Valium, Xanax) (n = 11) Barbiturates/Sedatives (e.g., Seonol, Nembutal) (n = 11) Non-Prescription/OTC (e.g., diet pills, No-Doz) 18.2% (n = 11)

18 Section IV: Caregiver and Family Measures The purpose of this section is to provide information on caregivers perceptions of family functioning and the strain associated with caring for a child with behavioral and emotional problems. Information in this section was taken from the following instruments, which are administered to caregivers: Caregiver Strain Questionnaire (CGSQ): The CGSQ assesses the extent to which caregivers are affected by the special demands associated with caring for a child with emotional and behavioral problems. The CGSQ is comprised of three subscales which range in severity from 0 to 5. Objective Strain refers to observable disruptions in family and community life (e.g., interruption of personal time, lost work time, financial strain). Subjective Externalized Strain relates to negative feelings about the child such as anger, resentment, or embarrassment. Subjective Internalized Strain refers to the negative feelings that the caregiver experiences such as worry, guilt, and fatigue. Higher scores on each of these scales indicate greater strain. A Global Strain score is calculated by summing the three subscales (i.e., Objective Strain, Subjective Externalized Strain, and Subjective Internalized Strain) to provide an indication of the total impact of the special demands on the family. Global Strain scores range from 0 to 15. As with the individual subscales, higher scores indicate greater strain. Family Life Questionnaire (FLQ): The FLQ assesses family communication, decision-making, and support and bonding. The FLQ consists of 10 statements describing positive family interactions. Using a 5-point scale, caregivers are asked to rate how often each interaction occurs in their family. Responses range from never (1) to always (5).

19 Caregiver Strain at Intake Caregiver Strain Questionnaire Subscales* Mean Score Objective Strain (n = 10) 2.6 Subjective Externalized Strain (n = 10) 2.7 Subjective Internalized Strain (n = 10) 4.1 Global Strain (n = 10) 9.4 * The three CGSQ subscales range in severity from 0 to 5. Global Strain scores range from 0 to 15. On all scales, higher scores indicate greater strain.

20 Caregiver Assessment of Family Life at Intake* Our family. Talks about fun things and things that make us laugh (n = 10) 3 Agrees about things like what to watch on TV or what to eat for dinner (n = 10) 5 Spends time together as a family (n = 10) Talks about our problems and troubles (n = 10) Relies on each other when problems arise (n = 10) Does things together outside of our home (n = 10) Talks about things that make us angry without fighting (n = 10) 2 2 Can solve problems our child has when they happen (n = 10) 1 Deals with crises or major problems without fighting (n = 10) Our child talks with members of our family about things that make him/her happy, sad, or upset (n = 10) 1 2 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Percent** * As indicated by the items comprising the FLQ. ** Percentages reported combine the responses Most of the time and Always.