The central goal of this study is to determine whether an intensive family- and home-based treatment (i.e., Crisis Family Preservation) is a more effective and less costly strategy than psychiatric hospitalization for addressing the mental health emergencies of adolescents with SED. Thus, this study directly addresses the widely held concern that children's mental health services have overrelied on expensive and restrictive inpatient treatments. Furthermore, the proposed study builds directly on the accomplishments of CASSP supported research and the Public-Academic Liaison initiative on formulating mental health policy and services in the state of South Carolina. Specifically, this study includes a 2 (treatment condition; Crisis Family Preservation vs. hospitalization for crisis stabilization) x 5 (time of assessment: within 24 hours of referral, post hospitalization, post family preservation, and 6- and 12-month follow-ups) design, with random assignment of yoked subjects to treatment conditions. Participants will include 252 12- to 17-year-old adolescents with SED referred to the project by the Crisis Stabilization program of the Charleston-Dorchester Community Mental Health Center. Youths will be presenting severe mental health problems such as homicidal intent, suicidal intent, serious affective disorder, or psychosis. A comprehensive multimethod, multisource evaluation will address the following questions: 1. """"""""To what extent does Crisis Family Preservation services prevent hospitalization and reduce the symptoms precipitating the crisis?"""""""" 2. """"""""Over the long-term (i.e., 12 months), to what extent does Crisis Family Preservation maintain reductions in identified symptoms; ameliorate the family, peer, and community problems associated with such symptoms; and prevent subsequent institutional placement?"""""""" 3. """"""""What factors moderate or mediate therapeutic outcome?"""""""" 4. """"""""What are the comparative financial costs of the treatment conditions?""""""""

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
1R01MH051852-01A1
Application #
2251305
Study Section
Special Emphasis Panel (SRCM (01))
Project Start
1994-08-01
Project End
1999-07-31
Budget Start
1994-08-01
Budget End
1995-07-31
Support Year
1
Fiscal Year
1994
Total Cost
Indirect Cost
Name
Medical University of South Carolina
Department
Psychiatry
Type
Schools of Medicine
DUNS #
183710748
City
Charleston
State
SC
Country
United States
Zip Code
29425
Huey Jr, Stanley J; Henggeler, Scott W; Rowland, Melisa D et al. (2005) Predictors of treatment response for suicidal youth referred for emergency psychiatric hospitalization. J Clin Child Adolesc Psychol 34:582-9
Huey Jr, Stanley J; Henggeler, Scott W; Rowland, Melisa D et al. (2004) Multisystemic therapy effects on attempted suicide by youths presenting psychiatric emergencies. J Am Acad Child Adolesc Psychiatry 43:183-90
Sheidow, Ashli J; Bradford, W David; Henggeler, Scott W et al. (2004) Treatment costs for youths receiving multisystemic therapy or hospitalization after a psychiatric crisis. Psychiatr Serv 55:548-54
Halliday-Boykins, Colleen A; Henggeler, Scott W; Rowland, Melisa D et al. (2004) Heterogeneity in youth symptom trajectories following psychiatric crisis: predictors and placement outcome. J Consult Clin Psychol 72:993-1003
Henggeler, Scott W; Rowland, Melisa D; Halliday-Boykins, Colleen et al. (2003) One-year follow-up of multisystemic therapy as an alternative to the hospitalization of youths in psychiatric crisis. J Am Acad Child Adolesc Psychiatry 42:543-51
Clingempeel, W Glenn; Henggeler, Scott W (2002) Randomized clinical trials, developmental theory, and antisocial youth: guidelines for research. Dev Psychopathol 14:695-711
Schoenwald, S K; Ward, D M; Henggeler, S W et al. (2000) Multisystemic therapy versus hospitalization for crisis stabilization of youth: placement outcomes 4 months postreferral. Ment Health Serv Res 2:12-Mar
Henggeler, S W; Rowland, M D; Randall, J et al. (1999) Home-based multisystemic therapy as an alternative to the hospitalization of youths in psychiatric crisis: clinical outcomes. J Am Acad Child Adolesc Psychiatry 38:1331-9
Cunningham, P B; Henggeler, S W (1999) Engaging multiproblem families in treatment: lessons learned throughout the development of multisystemic therapy. Fam Process 38:265-81
Henggeler, S W; Rowland, M D; Pickrel, S G et al. (1997) Investigating family-based alternatives to institution-based mental health services for youth: lessons learned from the pilot study of a randomized field trial. J Clin Child Psychol 26:226-33

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