Children and Youths Need Assessment
To assess the mental health and substance abuse treatment of children and youth in Alaska, the Department of Health and Social Services (DHSS) contracted with the Alaska Comprehensive and Specialized Evaluation Services (ACSES) to conduct a needs assessment about the service needs of Alaska children and youth. This needs assessment was to collect comprehensive data about all aspects of care delivery to help the Alaska DHSS and its relevant Divisions refine and expand existing services to care more optimally for children and youth in need of mental health or substance abuse treatment. The Children and Youth Needs Assessment (CAYNA) became a comprehensive and far-reaching effort assessing perceived, normative, expressed, and relative needs for children and youth services statewide to deliver the following information:
Descriptions of the current statewide system of care, including:
- assessment of in-state system utilization and ability to meet current needs;
- analysis of the services currently utilized out of state;
- analysis of impediments and barriers; and
- assessment of gaps in types and capacity.
Descriptions of the children and youth in need of services, including:
- clinical and demographic characteristics of the youth as a whole;
- differences between youth served in and out of state;
- differences between youth in state custody versus youth not in state custody; and
- differences based on the interaction between custody status and service location.
Recommendation about the principles that should guide a comprehensive and seamless system of care for children and youths, including:
- priorities for service reconfigurations, expansions, and enhancements; and
- priorities for new service developments.
Although the primary impetus for CAYNA was to bring home youth currently served out of state, the overall purpose of the needs assessment was to obtain information that would assist DHSS in developing a plan for creating a complete array of integrated services to meet the needs of Alaska's children and youth who experience severe mental, emotional, and behavioral disorders. Information obtained through the needs assessment was to be used to guide future decision-making regarding the reconfiguration or restructuring of existing resources and systems of care. It was to be used to assist with defining additional resource needs, establishing priorities for increasing capacity of existing service types, and developing new services for children and youth in Alaska. It was envisioned that the needs assessment would provide the basis for developing a comprehensive, long-range plan to better meet the mental health needs of children and youth with severe mental, emotional and behavioral disorders through a complete continuum of care in Alaska, integrated across service systems.
The needs assessment drew on several data collection strategies, including quantitative (factual) and qualitative (opinion) data collection protocols. These efforts were as follows:
- 350 charts were reviewed for children and youth who had received residential and substance abuse treatment services during FY 02 at in-state or out-of-state agencies. The Child and Adolescent Needs & Strength (CANS) and a specially developed supplementary demographic and clinical protocol were used by specially trained raters to ensure uniformity in the review process.
- A review took place of existing data and information sources statewide and within individual agencies and divisions to the extent that they were available and usable. A similar review took place for out-of-state services used by Alaska children and youth in FY 02.
- Statistical analyses were conducted of data from relevant information management systems available within DHSS, such as DMA MMIS, ADA MIS, ARORA, DFYS attendance utilization, DFYS Psychiatric Nurse files, and First Health databases, as they were available and usable.
- To inquire about program services availability, capacity, gaps, and impediments, 81 provider interviews were conducted, using a uniform list of questions and standardized procedures. Respondents were relevant program directors as identified in collaboration with DHSS staff.
- To inquire about optimal and current service systems, 24 key informant interviews were conducted, using a uniform list of questions and standardized procedures, with relevant stakeholders as defined by DHSS staff.
- Across Anchorage and Juneau, four focus groups were conducted, using a uniform list of questions and standardized procedures, to solicit input from relevant stakeholders about relevant purposes as defined by DHSS staff.
- To gather additional input from parents and advocates, a public meeting was held in Anchorage at which these important stakeholders were given opportunity to voice their concerns and preferences about mental health services for children and youth.
Four reports were prepared by ACSES about these needs assessment efforts. Three outline detailed findings about service availability in and out-of-state, characteristics of the children served, and information about stakeholder perceptions of children's needs in the state of Alaska. These three data reports are currently posted on the website for the State of Alaska Department of Health and Social Services website. A link to the DHSS website can be found below and in the Technical Reports area of this website. A fourth report was prepared and submitted with specific recommendations based on the findings for additions to, enhancements of, and changes in the current system of care for children and youth in Alaska. This fourth report was released under the name of the DHSS Commissioner.