Evaluation of an Intensive Case Management Program for Transition Age Youth and Its Transition to Assertive Community Treatment

摘要

This study reports on an evaluation of Our Town, an innovative case management program based on the Village Integrated Service Agency (ISA) program of Long Beach, Calif., and focusing on providing early, intensive psychiatric and psychosocial intervention for transition-age youth aged 18-25 with serious mental illness. A longitudinal, 2-year pre-post design was used. Two sets of data were collected. The interview data compared participants' progress during the first year of treatment with their functioning during the year prior using in-depth, face-to-face interviews (n = 39 individuals at program entry; n = 22 at 12 months). The tracking data consisted of monthly progress reports from program staff on a reduced set of measures for 18 months. Compared with the year prior to admission, there were no significant changes in quality of life and on most ratings of clinical functioning. However, clients showed improved adult daily living skills; they were more likely to be working (60.8% vs. 21.7%) and less likely to be convicted of a misdemeanor (2.1% vs. 16.0%) or to be homeless (8.7% vs. 30.4%); and they showed a trend to be less likely to be in prison (8.7% vs. 34.8%). During the course of the intervention, members showed progressive improvement in global assessment of functioning (GAF) and ratings of overall progress. In addition, members were less likely to be hospitalized by the end of treatment (0%) compared with the first 6 months of treatment (15.4%), and during the first year of treatment (12.5%), compared with the year prior to treatment (33.3%). The demonstration pilot provided initial support for the effectiveness of an intensive case management model serving a subgroup of transition age youth with very serious mental health problems.