45.3 The Utility of Child and Adolescent Mobile Psychiatric Services (CAMPS) for Youth

Abstract

The incidence rates of mental illness in youth are increasing in the United States; however, structural and cost barriers in accessing treatment result in low treatment rates and high dropout rates. Given the complex, interconnected risk factors affecting youths’ functioning, home-based mental health services can be utilized to address some barriers. In 2019, the Child and Adolescent Mobile Psychiatric Services (CAMPS) team was piloted, comprising a case manager, social worker, and child and adolescent psychiatrist. Referrals included high-risk clinic patients. Frequency of visits and timing of discharge was explored during a weekly collaborative conference. Measures were administered at the start and completion of the program, including parental distress, impairment, barriers to treatment, use of services to date, and an exit survey. All procedures were approved by the University at Buffalo IRB. In the first 15 months, 28 families provided some data and 11 provided complete data. Of the 28, 12 identified as African American, 11 White, 3 Hispanic, and 2 Multiracial. The patients’ age range was 5 to 18 years (mean = 12). Twenty-six families had government-subsidized health insurance. Referrals were for functional impairment (74%), severe mood dysregulation (19%), or posthospital discharge (7%). Since enrollment in CAMPS, families’ overall attendance rate increased from 66% to 84%. A paired t test comparing each family’s pre- to postattendance rate showed significant improvement (t = 4.04; p < 0.001). A paired t test of parent-rated youth impairment (n = 11) suggested marginal reduction (t = 1.96; p = 0.08). Parental stress (pre = 41.1, post = 38.6) and barriers to treatment (mean number of barriers: pre = 1.92, post = 1.77) did not significantly differ. In the presurvey (n = 25), 7 families reported a history of hospitalization, 7 made a prior crisis call, and 15 reported difficulty with attending school. In posttreatment surveys (n = 11), no child was hospitalized, 2 families made a crisis call, and only 1 reported school attendance issues. Ten families found the program helpful, and 100% felt more informed about their child’s mental health needs. While our small sample size is a limitation, data indicate improvements in treatment engagement, school attendance, and decreased hospitalization rates.