Outcomes of mental health care for children and adolescents .2. Literature review and application of a comprehensive model

Objective: Using a comprehensive model of outcomes, the authors reviews the scientific literature to determine the extent of knowledge concerning the outcomes of mental health care for children and adolescents. Method: Previous research is examined to determine the degree to which it addresses live salient outcome domains: symptoms/diagnoses, functioning, consumer perspectives, environments, and systems (the SFCES model). Results: Despite numerous studies, only 38 met minimal scientific criteria. They generally fall into two categories, according either to their focus on the efficacy of treatment(s) for specific disorders or the effectiveness of a particular service or service system. Only two studies include outcome assessments across all five domains. Conclusions: As health care practices shift, improvements in mental health care will require credible evidence detailing the impact of clinical treatments and services oa ail salient outcome domains. Embedding efficacious treatments into effective service programs will likely improve care, but treatments will require modification to make them flexible, inclusive, and appropriate to multicultural populations. Furthermore, service delivery systems must be modified to meet the specific clinical needs of children with mental disorders and to embrace new efficacious treatments as they become available.