MHSPY: a children's health initiative for maintaining at-risk youth in the community.

The Massachusetts Mental Health Services Program for Youth (MHSPY) is a home-based clinical intervention that seeks to maintain youth with severe functional impairment in the community via delivery of integrated primary care, mental health, substance abuse, and social services. Using blended public agency funding, traditional and nontraditional services are provided within a private, not-for-profit, managed care organization. Individualized, comprehensive care plans are developed by an MHSPY care manager, who works intensively with the family and the Care Planning Team to identify needs and resources. Data on clinical functioning are collected at baseline and every six months during the program. Service utilization and cost are measured on a quarterly basis. Family, youth, and agency satisfaction ratings are collected at disenrollment. Aggregate analyses based on four years of data show that MHSPY participants have improved clinical functioning, including significant reduction in risk to self and others. They also experience reduced service utilization and cost and high rates of family satisfaction.