Bickman L, Noser K, Summerfelt W T
Center for Mental Health Policy, Vanderbilt Institute of Public Policy Studies, Vanderbilt University, Nashville, TN 37212, USA.
J Behav Health Serv Res. 1999 May;26(2):185-202. doi: 10.1007/BF02287490.
This study evaluates an exemplary system of care designed to provide comprehensive mental health services to children and adolescents. It was believed that the system would lead to more improvement in the functioning and symptoms of clients compared to those receiving care as usual. The project employed a randomized experimental five-wave longitudinal design with 350 families. While access to care, type of care, and the amount of care were better in the system of care, there were no differences in clinical outcomes compared to care received outside the system. In addition, children who did not receive any services, regardless of experimental condition, improved at the same rate as treated children. Similar to the Fort Bragg results, the effects of systems of care are primarily limited to system-level outcomes but do not appear to affect individual outcomes such as functioning and symptomatology.
本研究评估了一个旨在为儿童和青少年提供全面心理健康服务的示范性护理系统。人们认为，与接受常规护理的人相比，该系统将使服务对象的功能和症状得到更大改善。该项目采用了随机实验五波纵向设计，涉及350个家庭。虽然在护理系统中，获得护理的机会、护理类型和护理量都更好，但与系统外接受的护理相比，临床结果没有差异。此外，无论实验条件如何，未接受任何服务的儿童与接受治疗的儿童改善速度相同。与布拉格堡的结果类似，护理系统的效果主要限于系统层面的结果，似乎并未影响诸如功能和症状等个体结果。
