Disparity of SED Recovery

Abstract

How do youth from various community groups designated as having a serious emotional disturbance (SED) recover over time? We conducted an evaluation of a Substance Abuse and Mental Health Services Administration System of Care grant initiative for Monroe County, New York, to answer this and other questions. We looked at outcome differences over time using the Behavioral and Emotional Ratings Scale’s (2nd ed.) overall strength scores among youth living in four geographical places at the start of services: high-income urban, low-income urban, suburban, and rural. Minorities (be they nonwhite or white) within each group, except suburban, had the higher probability of being designated as having SED. We found recovery disparities among white urban youth and their nonurban counterparts, and among nonwhite suburban and high-income urban youth and their low-income urban and rural counterparts. Applied implications include the following: (a) Continue the restructuring of mental health and juvenile justice agencies to become more culturally competent, (b) create a social marketing campaign to address the stigma surrounding mental illness, (c) build coalitions to publicize risk factors to mental health and their prevention, (d) restructure schools away from the prevailing eurocentric model of education, and (e) create a labor hour exchange for the repair and upgrade of housing and other infrastructure.

Empowerment Evaluation, Postprofessionalization, and Oligarchy

“…1 These challenges were common to all SOC sites and were broadly addressed at regional and national SOC meetings. Here is the essence of Monroe County’s SOC, previously reported (Grape et al 2014): The Monroe County SOC focused on older, cross-systems youth: Those 14 to 21 years of age having a designation of SED and involvement with probation and/or child welfare. Traditional case management was converted to a more holistic care coordination model using the child and family team process to determine strengths, needs, resources, and referrals.…”

“…I do so because I found the process of conducting an empowerment evaluation quite challenging during the first four years of a Substances and Mental Health Services Administration (SAMHSA) system-of-care (SOC) mental health services transformation for youth with serious emotional disturbance (SED). We reported the details of this evaluation previously (Grape, Meeker, and Fielding 2013; Grape, Plum, and Fielding 2013, 2014).…”