Client Outcomes II: Longitudinal Client Data from the Colorado Treatment Outcome Study

New York State Office of Mental Health, Albany.
Milbank Quarterly (Impact Factor: 3.38). 02/1994; 72(1):123-48. DOI: 10.2307/3350341
Source: PubMed


The outcomes of a reform of the Denver mental health system, cosponsored by the state and the RWJF, are contrasted with changes in a comparison area of the state. The study examines the structural characteristics of the mental health system, staff attitudes and satisfaction, and client-reported services and outcome. Results indicate that, in Denver, structural changes, the introduction of new services, and an intervening financial crisis increased worker dissatisfaction. Client reports documented parallel changes in the following variables: continuity of care, unmet need for case management services, frequency of symptoms, and satisfaction with services. The reform had no impact, however, on most quality-of-life indicators. The possibly adverse consequences of centralizing the system and the indirect influences of system integration on quality of life are discussed.

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    • "Regardless of the future refinement of the measurement, the constructed CQ presented an excellent preliminary reliability level ( .98) in terms of overall internal consistency. For the purposes of discriminant validity analysis, the Colorado Symptom Index (CSI) was used, which is also a self-reported measure of psychiatric symptoms frequency within a temporal frame (Shern et al., 1994). We used the briefer 14-item version, in which participants rate the frequency of symptoms experienced in the past month according to a 5-point Likert scale (1 not at all, 5 at least every day). "
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    ABSTRACT: The aim of the present study was to develop the Portuguese version of the Recovery Assessment Scale (RAS-P), and to assess the validity of the findings using the revised test, with 213 users from 5 nonprofit community-based mental health organizations. Participants in the assessment completed a self-reported survey investigating their sense of personal recovery, personal empowerment, capabilities achievement, psychiatric symptoms' frequency, and demographic data. Evidence from exploratory and confirmatory factor analyses using the 24-item version of the test, validated a 4-factor structure for the RAS-P model based on the dimensions of Personal Goals and Hope, Managing Help Needs, Supportive Interpersonal Relationships, and Life Beyond Symptoms, consistent with components of the recovery process. Convergent and discriminant validity was also achieved using bivariate correlation coefficients among the 4 subscales' scores, between the overall scale and the subscales, and in relation to external variables. Findings allowed for the interpretation that the RAS-P is measuring a particular psychological construct, which is different from symptoms of the mental illness. A hypothesized significant association with personal empowerment and with capabilities achievement was demonstrated. Positive association was also found between participants' use of recovery-oriented services such as independent housing or supported employment programs. The RAS-P scores also revealed excellent internal consistency for the overall scale (α = .90), and good consistency for the subscales (>.75), which attest to its precision in measurement. In conclusion, the study proved the RAS-P a reliable and useful tool in the context of the community mental health practice. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
    Psychological Assessment 06/2015; DOI:10.1037/pas0000176 · 2.99 Impact Factor
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    • "Index (CSI). The CSI (Shern et al., 1994) was used to measure psychiatric symptoms and is consistent with the National Institute of Mental Health task force criteria for outcome measures (Ciarlo, Edwards, Kiresuk, et al., 1981). Although two versions of the CSI exist, the version reported on in this article is the 14-item version. "
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    ABSTRACT: The purpose of this study was to examine the prevalence of self-perceived oral health needs among Medicaid-enrolled adults with and without mental health problems and to identify factors predictive of enrollees' perceived oral health needs. The study involved a secondary analysis of 1,721 respondents to the Florida Health Services Survey. Contrary to the previous research, the findings from this study indicated that respondents with mental health problems (52.9%) did not differ significantly in their dental needs compared to those who did not have mental health problems (49.3%). The results from a logistic regression suggested that after controlling for demographic characteristics, substance abuse problems and functional needs increased the likelihood of self-reported oral health needs, whereas the receipt of Supplemental Security Income (SSI) was associated with decreased dental needs. The prevalence of unmet dental needs among these respondents (i.e., 23%) supported the conclusion that a significant gap exists in the accessibility of oral health services among this population.
    Evaluation &amp the Health Professions 06/2014; 38(1). DOI:10.1177/0163278714537271 · 1.91 Impact Factor
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    • "Current psychiatric symptomatology was assessed using the Colorado Symptom Index (CSI; Shern et al., 1994). This widely used self-report measure assesses the frequency of psychiatric symptoms in the past month. "
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    ABSTRACT: The purpose of this study was to extend the investigation of criminal thinking of persons with mental illness beyond prison and community settings to a jail setting. Participants consisted of 122 individuals incarcerated in a county jail who were diagnosed with a severe mental illness, including schizophrenia spectrum and major mood disorders. Results indicated that people with mental illness in this sample of jail inmates presented with thinking styles that support a criminal lifestyle, and have criminal thinking styles that follow a pattern that is very similar to a sample of prison inmates with serious mental illness. These findings support the need for therapeutic programs for justice-involved persons with serious mental illness to develop a multipronged treatment approach that integrates interventions for individuals' criminal thinking and antisocial attitudes with treatment for their mental illness and substance abuse issues. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Law and Human Behavior 04/2014; 38(6). DOI:10.1037/lhb0000084 · 2.16 Impact Factor
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