Collaborative community-based mental health services improve youth outcomes and physicians and school personnel should strive to be part of these teams. Further research is needed to more closely examine the challenges of helping youth to meet the goals associated with their wraparound services. Relatively higher service attrition rates in low-income African American youth warrants further investigation. (PsycINFO Database Record

Research has documented positive outcomes for youth who receive wraparound services; however, the specific mechanism for change has not yet been clarified. Data were collected from a sample of 253 youth with Serious Emotional Disturbance (SED) who completed wraparound services as a part of publically-funded community-based mental health services (58% male; 49% Caucasian; mean age 12.25 years). Results indicated that both environmental and individual protective factors increased significantly and risky behaviors, including self-harm and aggressive behaviors, decreased significantly throughout youths' time in wraparound services. Improvements in protective factors and decreases in risk factors were significant predictors of clinically significant mental health improvement at exit from community-based wraparound services. Study findings highlight the utility and importance of a dual-factor approach to mental health assessment when implementing and evaluating wraparound services.

Society for Social Medicine pattern of the disease in Southampton, which shows a peak of frequency in September-October, does not correspond with the pattern of isolation of haemolytic streptococci from throat swabs. These findings suggest that streptococcal infection is not a factor in the aetiology of most cases of the disease. Data from four other areas of Britain show a varying seasonal pattern, but a trough in frequency in July-August is a constant finding. It has been suggested that the disease may result from hypersensitivity to organisms other than haemolytic streptococci which cause upper respiratory tract infection. Of the Southampton patients 63 % gave a history of upper respiratory infection in the month preceding admission compared with 50% of a control group. The geographical distribution of the disease within the city showed only a slight correlation between incidence and overcrowding. This finding does not support the hypothesis that a contagious disorder such as respiratory infection is important in the aetiology of the disease.

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