CHILD & ADOLESCENT MENTAL HEALTH DIVISION CONSUMER SURVEY FY 2019 Evan Turner, B.S., Barbara Low, MBA., David Jackson, Ph.D., & Trina Orimoto, Ph.D.
Background • Part of federal requirement of Center for Behavioral Health Statistics & Quality (CBHSQ) contract • Conduct and report on Youth Services Survey for Families (YSS-F) • CAMHD’s only system -wide, standardized method of obtaining feedback from families
Method • Sampling • Clients registered on a particular day in May 2019 • Distribution period from June to September 2019 • Care Coordinators distributed to all potential respondents and helped explain purpose of survey (i.e., added a “personal touch”) • Data Collected • 2 pages (38 items) • Incentive • $5 gift card
Method Survey Topic Areas YSS-F Domains Description Staff sensitive to cultural/ethnic background Cultural Sensitivity Staff respected caregiver/family’s beliefs Treatment Participation Caregiver helped to choose services and goals, and participated in treatment Access Location and time of services Caregiver has support at time of crisis Social Connectedness Caregiver feels listened to and understood Overall Program Assessment Overall satisfaction with services to child Child gets along better with friends & family Outcomes/Functioning Child better at coping, handling daily life Child shows improvement in school and work
Method Additional Survey Topic Areas • Communication with Care Coordinator • Frequency of contact • Keeping family informed and obtaining feedback • Timeliness • Number of days before therapy services provided • Parent Partners • Offered Parent Partner services • Help Your Keiki Website • Access to website • Information Access
RESULTS
Overall Response Rate What do we see? Response rate has increased slightly since last year. Percent of Surveys 33 Returned 31 2018 2019 2018 2019 Estimated Surveys Distributed 506 674 Surveys Returned 157 221
Distribution Rate 100 90 80 70 Percentage 60 50 40 30 20 10 0 Central Leeward Honolulu Maui East HI West HI Kaua'i Family Guidance Centers 2018 2019 Note: East HI and West HI do not have separate information for 2018.
Response Rate 100 90 80 70 Percentage 60 50 40 30 20 10 0 Central Leeward Honolulu Maui East HI West HI Kaua'i Family Guidance Centers 2018 2019 Note: East HI and West HI do not have separate information for 2018.
Sample Representativeness (n=218, N=955) Diagnostic Category What do we see? The survey sample roughly Adjustment Disorder Anxiety Disorders represents the overall Attention-Deficit/Hyperactivity Disorder Autism Spectrum Disorder CAMHD population. Bipolar and Related Disorders Primary Diagnosis Depressive Disorders Disruptive, Impulse-control, and Conduct Disorders General Medical Conditions or Codes No Longer Used Intellectual Disabilities Obsessive-Compulsive and Related Disorders Other Infrequent CAMHD Diagnoses Other Neurodevelopmental Disorders Other Trauma- and Stressor-Related Disorders Posttraumatic Stress Disorder Schizophrenia Spectrum and Other Psychotic Disorders Substance-Related and Addictive Disorders N/A 0.0% 10.0% 20.0% 30.0% (Returned) Sample CAMHD Population
Sample Representativeness (n=219, N=954) Gender Age 11.4% 5 or younger 2.8% 41.1% 41.7% Percent of Youth 50.9% Age Group Between 6 to 12 35.5% 34.7% Between 13 to 15 29.1% 57.5% 58.1% 2.8% 16 or older 32.6% 0 10 20 30 40 50 60 Percent of Youth (Returned) Sample CAMHD Population (Returned) Sample CAMHD Population Male Female What do we see? The survey sample roughly represents the overall CAMHD population by gender, but not by age.
What do we see? The response rate by FGC differs slightly from the actual distribution of CAMHD clients by FGC. Sample Representativeness by FGC Sample Representativeness by FGC 28.3 30 24.6 24.2 25 Percent of Responses 18.9 20 15.5 15.2 15 11.4 11.2 11 10.5 8.2 8.2 8.2 10 3.2 5 0 Central Leeward Honolulu Maui Kaua'i East Hawai'i West Hawai'i Family Guidance Center (Returned) Sample CAMHD Population
Overall Satisfaction (n=216) “Overall, I am satisfied with the services my child received.” Percent of Positive Responses Strongly Agree 49.1% (Agree or Strongly Agree) Agree 40.3% Undecided 5.1% Disagree 3.2% What do we see? 89% of respondents indicated that they were satisfied with CAMHD services. Strongly Disagree 1.9% 0 10 20 30 40 50 60 70 80 90 100 Percent of Youth
Overall Satisfaction What do we see? The percent of positive responses on overall satisfaction was higher Percent of Positive Responses Since 2012 this year than in any of the past 7 years. 100 89.4 88.5 87.2 87 83.2 82.9 Percent of Positive Responses 80.2 80 (Agree or Strongly Agree) 75 50 25 0 2012 2013 2014 2015 2016 2017 2018 2019
Domain Ratings (n=218) Percent of Positive Responses by Survey Domain 93.1% Cultural Sensitivity 90.8% Treatment Participation 86.8% Access Domains 84.8% Social Connectedness 80.6% Overall Program Assessment 65.1% Functioning 62.8% Outcomes 0 25 50 75 100 Percent of Positive Responses* *Positive responses determined by a mean score of 3.5 or higher for all items within each domain. A five-point Likert-type scale was used for each item [i.e., ‘Strongly Agree ‘ (5), ‘Agree’ (4), ‘Undecided’ (3), ‘Disagree’ (2), or ‘Strongly Disagree’ (1)].
Domain Ratings Percent of Positive Responses Since 2011 100 90 80 70 60 50 40 30 20 10 0 2011 2012 2013 2014 2015 2016 2017 2018 2019 Social Connectedness Cultural Sensitivity Functioning Treatment Participation Outcomes Access Overall Program Assessment
e.g., “Staff were sensitive to my Domain Ratings cultural/ethnic background.” Positive Responses on Cultural Sensitivity Since 2011 96.1 94.9 96.2 94.7 100 93.1 92 91.8 88 88 90 80 70 60 50 40 30 20 10 0 2011 2012 2013 2014 2015 2016 2017 2018 2019 Cultural Sensitivity
e.g., “I helped to choose my Domain Ratings child’s treatment goals.” Positive Responses on Treatment Participation Since 2011 100 92.7 90.8 90.2 89.4 89.2 88 87.2 90 82 81 80 70 60 50 40 30 20 10 0 2011 2012 2013 2014 2015 2016 2017 2018 2019 Treatment Participation
Domain Ratings e.g., “Services were available Positive Responses on Access Since 2011 at times that were convenient for us.” 100 91.9 90.5 89 87.7 86.8 86.8 84.3 90 81 77 80 70 60 50 40 30 20 10 0 2011 2012 2013 2014 2015 2016 2017 2018 2019 Access
e.g., “In a crisis, I would Domain Ratings have the support I need from family or friends.” Positive Responses on Social Connectedness Since 2011 100 90.5 89 88.6 87.8 87.2 84.8 90 81 81 77 80 70 60 50 40 30 20 10 0 2011 2012 2013 2014 2015 2016 2017 2018 2019 Social Connectedness
Domain Ratings e.g., “My family got as much help as we needed for my Percent of Positive Responses on ‘Overall Program Assessment’ Since 2011 child.” 100 89.3 89.4 87 85.9 90 82.9 82.2 81 80.6 80 73 70 60 50 40 30 20 10 0 2011 2012 2013 2014 2015 2016 2017 2018 2019 Overall Program Assessment
Domain Ratings e.g., “My child is better able to do things he or she wants Positive Responses on Child Functioning Since 2011 to do.” 100 90 80 68.6 65.1 70 63.2 60.9 60 57.6 56.4 56 60 51 50 40 30 20 10 0 2011 2012 2013 2014 2015 2016 2017 2018 2019 Functioning
Domain Ratings e.g., “I am satisfied with Positive Responses on Child Outcomes Since 2011 our family life right now.” 100 90 80 69.5 70 63.1 62.8 60.7 58 57.3 56.4 56 60 48 50 40 30 20 10 0 2011 2012 2013 2014 2015 2016 2017 2018 2019 Outcomes
Items with the HIGHEST and LOWEST Scores of Agreement on the YSS-F (1=Strongly Disagree; 5=Strongly Agree) HIGHEST Scores of Agreement Staff treated me with respect (M=4.59) 1. Staff spoke with me in a way that I understood (M=4.58). 2. Staff were sensitive to my family’s religious/spiritual beliefs (M=4.49). 3. LOWEST Scores of Agreement My child is better able to do things he or she wants to do (M=3.69). 1. I am satisfied with our family life right now (M=3.66). 2. My child is better able to cope when things go wrong (M=3.64). 3.
Qualitative Responses “What service has been the most helpful to you and your child and what is it about that service that has been so helpful?” (n=202) Therapy General • “The services equipped me with the tools & skills that have greatly impacted our lives.” (n=41, 20%) General Home Therapy • “In home services - my child feels more comfortable in his own environment.” (n=38, 19%) Specific Therapist • “_____ connected well with _____ and was able to address & identify his concerns/needs” (n=21, 10%) Specific Service or Therapy • “ TFH; the timely manner in which it was identified. The care coordinator was able to find a family home in which the child was most comfortable.” (n=20, 10%)
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