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Full-Text Articles in Medical Specialties

Privatized Medicaid Managed Care In Massachusetts: Disposition In Child And Adolescent Mental Health Emergencies, Joanne Nicholson, Stephen Young, Lorna Simon, William Fisher, Anne Bateman Mar 2012

Privatized Medicaid Managed Care In Massachusetts: Disposition In Child And Adolescent Mental Health Emergencies, Joanne Nicholson, Stephen Young, Lorna Simon, William Fisher, Anne Bateman

Joanne Nicholson

Data from child and adolescent emergency mental health screening episodes prior and subsequent to privatized Medicaid managed care in Massachusetts are used to investigate the relationship between payer source and disposition and to compare the match between clinical need and disposition level of care. Having Medicaid as the payer in the post-Medicaid managed care period decreased the odds of hospitalization by nearly 60%. None of the clinical need variables that contributed to hospitalization for Medicaid episodes in the pre-Medicaid managed care period were significant in the post-Medicaid managed care period. Multiple forces shaping professional standards, decision making, and quality of …


A Qualitative Study Of Programs For Parents With Serious Mental Illness And Their Children: Building Practice-Based Evidence, Joanne Nicholson, Beth Hinden, Kathleen Biebel, Alexis Henry, Judith Katz-Leavy Mar 2012

A Qualitative Study Of Programs For Parents With Serious Mental Illness And Their Children: Building Practice-Based Evidence, Joanne Nicholson, Beth Hinden, Kathleen Biebel, Alexis Henry, Judith Katz-Leavy

Joanne Nicholson

The rationale for the development of effective programs for parents with serious mental illness and their children is compelling. Using qualitative methods and a grounded theory approach with data obtained in site visits, seven existing programs for parents with mental illness and their children in the United States are described and compared across core components: target population, theory and assumptions, funding, community and agency contexts, essential services and intervention strategies, moderators, and outcomes. The diversity across programs is strongly complemented by shared characteristics, the identification of which provides the foundation for future testing and the development of an evidence base. …


A Comparison Of Mothers With Co-Occurring Disorders And Histories Of Violence Living With Or Separated From Minor Children, Joanne Nicholson, Norma Finkelstein, Valerie Williams, Jennifer Thom, Chanson Noether, Megan Devilbiss Mar 2012

A Comparison Of Mothers With Co-Occurring Disorders And Histories Of Violence Living With Or Separated From Minor Children, Joanne Nicholson, Norma Finkelstein, Valerie Williams, Jennifer Thom, Chanson Noether, Megan Devilbiss

Joanne Nicholson

Data from the Women with Co-occurring Disorders and Histories of Violence Study are used to examine characteristics distinguishing mothers currently providing care for all their minor children (n = 558) from mothers separated from one or more minor children (n = 1396). Mothers are described and compared on background characteristics and experiences, well-being and current functioning, situational context, and services used. Analyses control for number of children, race, and years of education. Mothers separated from children have more children, less education, have more often been homeless, in juvenile detention or jail, and have lower incomes than mothers living with all …


An Overview Of Issues In Research On Consumer Satisfaction With Child And Adolescent Mental Health Services, Stephen Young, Joanne Nicholson, Maryann Davis Mar 2012

An Overview Of Issues In Research On Consumer Satisfaction With Child And Adolescent Mental Health Services, Stephen Young, Joanne Nicholson, Maryann Davis

Joanne Nicholson

Research that focusses on consumer satisfaction with child and adolescent mental health services is reviewed. Satisfaction is broadly conceived to include any study where the perspectives of children, adolescents or their parents about mental health services were gathered and presented. Important conceptual issues in research on consumer satisfaction with children's mental health services are discussed. Some of the general methodological issues that have faced satisfaction researchers are also considered. The wide range of methodological variations that have been used to investigate this topic area are outlined. The most significant findings of previous research are presented and critiqued. In conclusion, suggestions …


Family Options For Parents With Mental Illnesses: A Developmental, Mixed Methods Pilot Study, Joanne Nicholson, Karen Albert, Bernice Gershenson, Valerie Williams, Kathleen Biebel Mar 2012

Family Options For Parents With Mental Illnesses: A Developmental, Mixed Methods Pilot Study, Joanne Nicholson, Karen Albert, Bernice Gershenson, Valerie Williams, Kathleen Biebel

Joanne Nicholson

OBJECTIVE: The objective of this paper is to provide a description of Family Options, a rehabilitation intervention for parents with serious mental illnesses and their children focusing on recovery and resilience, and to report the findings from a pilot study at 6-months post-enrollment for participating mothers. METHODS: A developmental design, and mixed quantitative and qualitative methods facilitate an in-depth understanding of Family Options and its impact on parents early in the implementation process. RESULTS: Participating families faced significant challenges, including long-term mental health conditions in adults, and emotional and behavioral difficulties in children. Data from mothers (n = 22) demonstrate …


The Invisible Children's Project: Key Ingredients Of An Intervention For Parents With Mental Illness, Beth Hinden, Kathleen Biebel, Joanne Nicholson, Liz Mehnert Mar 2012

The Invisible Children's Project: Key Ingredients Of An Intervention For Parents With Mental Illness, Beth Hinden, Kathleen Biebel, Joanne Nicholson, Liz Mehnert

Joanne Nicholson

This study used a collective case study design to identify key ingredients of the Invisible Children's Project, an intervention program for families in which a parent has a mental illness. Data were obtained from interviews with parents and service providers, and from family file records. Qualitative analyses were used to generate hypotheses regarding key ingredients and targeted outcomes, and to develop a testable intervention model. Key ingredients were defined as core processes, essential services, and mediators. Strong convergence across parents and providers suggested core processes defined by family-centered, strengths-based, emotionally supportive, and comprehensive approaches; essential services including family case management, …


Impact Of Medicaid Managed Care On Child And Adolescent Emergency Mental Health Screening In Massachusetts, Joanne Nicholson, Stephen Young, Lorna Simon, Anne Bateman, William Fisher Mar 2012

Impact Of Medicaid Managed Care On Child And Adolescent Emergency Mental Health Screening In Massachusetts, Joanne Nicholson, Stephen Young, Lorna Simon, Anne Bateman, William Fisher

Joanne Nicholson

OBJECTIVE: The study evaluated the impact of Medicaid managed care on decision making during emergency mental health screening and the outcomes of such screening for children and adolescents. METHODS: Data on client attributes and on system characteristics (payer, referral source, and disposition) were available for 297 Medicaid and non-Medicaid episodes of emergency mental health screening that occurred one year before the implementation of a statewide managed Medicaid program in Massachusetts and 393 episodes that occurred one year after implementation. Outcomes included changes in the volume of service provided and in the pattern of dispositions, particularly inpatient admissions. RESULTS: Although the …