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Cited by 117Psychiatric care and mental health servicesChild and Adolescent Psychosocial and Emotional DevelopmentMental Health Treatment and Access

Quality of Publicly-Funded Outpatient Specialty Mental Health Care for Common Childhood Psychiatric Disorders in California

Zima, Bonnie T., Hurlburt, Michael S., Knapp, Penny, Ladd, Heather, Tang, Lingqi, Duan, Naihua, Wallace, Peggy, Rosenblatt, Abram +2 more·2005·Journal of the American Academy of Child & Adolescent Psychiatry
DOI 10.1097/00004583-200502000-00005
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Abstract

Objective To describe the documented adherence to quality indicators for the outpatient care of attention-deficit/hyperactivity disorder, conduct disorder, and major depression for children in public mental health clinics and to explore how adherence varies by child and clinic characteristics. Method A statewide, longitudinal cohort study of 813 children ages 6.0-16.9 years with at least 3 months of outpatient care, drawn from 4,958 patients in 62 mental health clinics in California from August 1, 1998, through May 31, 1999. The main outcome was documented adherence to quality indicators based on scientific evidence and clinical judgment, assessed by explicit medical record review. Results Relatively high adherence was recorded for clinical assessment (78%-95%), but documented adherence to quality indicators related to service linkage, parental involvement, use of evidence-based psychosocial treatment, and patient protection were moderate to poor (74.1%-8.0%). For children prescribed psychotropic medication, 28.3% of the records documented monitoring of at least one clinically indicated vital sign or laboratory study. Documented adherence to quality indicators varied little by child demographics or clinic factors. Conclusion Efforts to improve care should be directed broadly across clinics, with documentation of safe practices, particularly for children prescribed psychotropic medication, being of highest priority.

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  • There is wide variation in the use of evidence-based treatments in usual care.

    “An implementation research grant should cite service system research that demonstrates unmet need [15], the wide variation in the use of evidence-based treatments in usual care [16-19], or the association between the burden of disease and variations in the use of guidelines [20].”

    From Writing implementation research grant proposals: ten key ingredients (2012) · cites this paper as [19]

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Authors
Zima, B. T., Hurlburt, M. S., Knapp, P., Ladd, H., Tang, L., Duan, N., Wallace, P., Rosenblatt, A., Landsverk, J., & Wells, K. B.
Affiliations
RAND Corporation (US)
Corresponding author
Zima, Bonnie T.
ORCID
Venue
Journal of the American Academy of Child & Adolescent Psychiatry
Publisher
Elsevier BV
Published
2005-02
Volume
44
Issue
2
Pages
130-144
ISSN
0890-8567 (ISSN-L)
DOI
10.1097/00004583-200502000-00005
OpenAlex
W2079878051
Cited by
117
References
124
Citations by year
2026: 1 · 2025: 1 · 2023: 5 · 2022: 4 · 2020: 5 · 2019: 10 · 2018: 5 · 2017: 3 · 2016: 7 · 2015: 5 · 2014: 9 · 2013: 8 · 2012: 10
FWCI
8.47
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute of Mental Health (P30 MH50313)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
Keywords
quality indicators, attention deficit hyperactivity disorder, conduct disorder, major depressive disorder, children, service linkage, parental involvement, patient safety, California
MeSH terms
Adolescent, Adolescent Psychiatry, Mental Disorders, California, Child, Child Psychiatry, Feasibility Studies, Female, Follow-Up Studies, Humans, Male, Mental Health Services, Public Health Administration, Cohort Studies, Quality Indicators, Health Care

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