Use of the CAFAS to Evaluate Outcome for Youths with Severe Emotional Disturbance Served by Public Mental Health

Abstract

Outcomes are reported for youths with serious emotional disturbance receiving customary services from community mental health service providers who receive state mental health funds. Various outcome indicators for the Child and Adolescent Functional Assessment Scale (CAFAS) are described, as well as a procedure for categorizing youths into client types based on the CAFAS subscale scores. The youth's intake assessment was compared to the last CAFAS evaluation that the youth received. A statistically significant reduction in mean CAFAS total score was observed for the entire sample and for each client type. In addition, the mean number of subscales on which the youth was rated as severely impaired significantly decreased for the total sample and for each client type. The proportion of youths who experienced a clinically meaningful improvement in functioning was 58.6%. For the subset of youths who were rated as severely impaired on one or more subscales at intake, 53.1% left services without any severe impairments. The pattern of outcome results differed for subgroups based on type and extent of impairment. Implications of these findings and suggestions for using outcome monitoring to improve services in the public mental health sector are discussed.