MENTAL HEALTH DIVISION CONSUMER SURVEY FY 2019 Evan Turner, B.S., - - PowerPoint PPT Presentation

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MENTAL HEALTH DIVISION CONSUMER SURVEY FY 2019 Evan Turner, B.S., - - PowerPoint PPT Presentation

Nov 22, 2022 337 likes •786 views

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

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CHILD & ADOLESCENT MENTAL HEALTH DIVISION CONSUMER SURVEY FY 2019

Evan Turner, B.S., Barbara Low, MBA., David Jackson, Ph.D., & Trina Orimoto, Ph.D.

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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

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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
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Method

Survey Topic Areas

YSS-F Domains Description Cultural Sensitivity Staff sensitive to cultural/ethnic background 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 Social Connectedness Caregiver has support at time of crisis Caregiver feels listened to and understood Overall Program Assessment Overall satisfaction with services to child Outcomes/Functioning Child gets along better with friends & family Child better at coping, handling daily life Child shows improvement in school and work

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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
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SLIDE 6

RESULTS

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SLIDE 7

Overall Response Rate

2018 2019 Estimated Surveys Distributed 506 674 Surveys Returned 157 221

What do we see? Response rate has increased slightly since last year.

31 33

2018 2019

Percent of Surveys Returned

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Distribution Rate

Note: East HI and West HI do not have separate information for 2018.

10 20 30 40 50 60 70 80 90 100

Central Leeward Honolulu Maui East HI West HI Kaua'i Percentage

Family Guidance Centers

2018 2019

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Response Rate

Note: East HI and West HI do not have separate information for 2018.

10 20 30 40 50 60 70 80 90 100

Central Leeward Honolulu Maui East HI West HI Kaua'i Percentage

Family Guidance Centers

2018 2019

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Sample Representativeness (n=218, N=955)

Diagnostic Category

What do we see? The survey sample roughly represents the overall CAMHD population.

0.0% 10.0% 20.0% 30.0%

N/A Substance-Related and Addictive Disorders Schizophrenia Spectrum and Other Psychotic Disorders Posttraumatic Stress Disorder Other Trauma- and Stressor-Related Disorders Other Neurodevelopmental Disorders Other Infrequent CAMHD Diagnoses Obsessive-Compulsive and Related Disorders Intellectual Disabilities General Medical Conditions or Codes No Longer Used Disruptive, Impulse-control, and Conduct Disorders Depressive Disorders Bipolar and Related Disorders Autism Spectrum Disorder Attention-Deficit/Hyperactivity Disorder Anxiety Disorders Adjustment Disorder

Primary Diagnosis

(Returned) Sample CAMHD Population

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Sample Representativeness (n=219, N=954)

What do we see? The survey sample roughly represents the overall CAMHD population by gender, but not by age.

57.5% 58.1% 41.1% 41.7% (Returned) Sample CAMHD Population

Percent of Youth

Gender

Male Female

32.6% 29.1% 35.5% 2.8% 2.8% 34.7% 50.9% 11.4%

10 20 30 40 50 60

16 or older Between 13 to 15 Between 6 to 12 5 or younger Percent of Youth

Age Group

Age

(Returned) Sample CAMHD Population

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Sample Representativeness by FGC

What do we see? The response rate by FGC differs slightly from the actual distribution of CAMHD clients by FGC.

28.3 15.5 11 8.2 3.2 24.2 8.2 18.9 15.2 10.5 11.4 11.2 24.6 8.2

5 10 15 20 25 30

Central Leeward Honolulu Maui Kaua'i East Hawai'i West Hawai'i Percent of Responses Family Guidance Center

Sample Representativeness by FGC

(Returned) Sample CAMHD Population

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Overall Satisfaction (n=216)

“Overall, I am satisfied with the services my child received.”

1.9% 3.2% 5.1% 40.3% 49.1%

10 20 30 40 50 60 70 80 90 100

Strongly Disagree Disagree Undecided Agree Strongly Agree Percent of Youth

Percent of Positive Responses (Agree or Strongly Agree) What do we see? 89% of respondents indicated that they were satisfied with CAMHD services.

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Overall Satisfaction

Percent of Positive Responses Since 2012

What do we see? The percent of positive responses on overall satisfaction was higher this year than in any of the past 7 years.

87 80 83.2 80.2 87.2 82.9 88.5 89.4 25 50 75 100 2012 2013 2014 2015 2016 2017 2018 2019

Percent of Positive Responses (Agree or Strongly Agree)

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Domain Ratings (n=218)

Percent of Positive Responses by Survey Domain

*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)]. 62.8% 65.1% 80.6% 84.8% 86.8% 90.8% 93.1%

25 50 75 100 Outcomes Functioning Overall Program Assessment Social Connectedness Access Treatment Participation Cultural Sensitivity

Percent of Positive Responses*

Domains

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Domain Ratings

Percent of Positive Responses Since 2011

10 20 30 40 50 60 70 80 90 100 2011 2012 2013 2014 2015 2016 2017 2018 2019 Social Connectedness Cultural Sensitivity Functioning Treatment Participation Outcomes Access Overall Program Assessment

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Domain Ratings

Positive Responses on Cultural Sensitivity Since 2011

88 92

88

96.1 94.9 94.7 91.8 96.2 93.1

10 20 30 40 50 60 70 80 90 100 2011 2012 2013 2014 2015 2016 2017 2018 2019 Cultural Sensitivity

e.g., “Staff were sensitive to my cultural/ethnic background.”

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Domain Ratings

Positive Responses on Treatment Participation Since 2011

82 88 81 92.7 89.4 87.2 90.2 89.2 90.8

10 20 30 40 50 60 70 80 90 100 2011 2012 2013 2014 2015 2016 2017 2018 2019 Treatment Participation

e.g., “I helped to choose my child’s treatment goals.”

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Domain Ratings

Positive Responses on Access Since 2011

77 89 81 90.5 91.9 84.3 86.8 87.7 86.8

10 20 30 40 50 60 70 80 90 100 2011 2012 2013 2014 2015 2016 2017 2018 2019 Access

e.g., “Services were available at times that were convenient for us.”

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Domain Ratings

Positive Responses on Social Connectedness Since 2011

77 81 81 87.2 89 90.5 88.6 87.8 84.8

10 20 30 40 50 60 70 80 90 100 2011 2012 2013 2014 2015 2016 2017 2018 2019 Social Connectedness

e.g., “In a crisis, I would have the support I need from family or friends.”

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Domain Ratings

Percent of Positive Responses on ‘Overall Program Assessment’ Since 2011

73 87 81 89.3 89.4 82.9 85.9 82.2 80.6

10 20 30 40 50 60 70 80 90 100 2011 2012 2013 2014 2015 2016 2017 2018 2019 Overall Program Assessment

e.g., “My family got as much help as we needed for my child.”

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Domain Ratings

Positive Responses on Child Functioning Since 2011

56 60 51 63.2 68.6 56.4 60.9 57.6 65.1

10 20 30 40 50 60 70 80 90 100 2011 2012 2013 2014 2015 2016 2017 2018 2019 Functioning

e.g., “My child is better able to do things he or she wants to do.”

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Domain Ratings

Positive Responses on Child Outcomes Since 2011

56 58 48 63.1 69.5 56.4 60.7 57.3 62.8

10 20 30 40 50 60 70 80 90 100 2011 2012 2013 2014 2015 2016 2017 2018 2019 Outcomes

e.g., “I am satisfied with

  • ur family life right now.”
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Items with the HIGHEST and LOWEST Scores

  • f Agreement on the YSS-F (1=Strongly Disagree;

5=Strongly Agree)

HIGHEST Scores of Agreement

1.

Staff treated me with respect (M=4.59)

2.

Staff spoke with me in a way that I understood (M=4.58).

3.

Staff were sensitive to my family’s religious/spiritual beliefs (M=4.49). LOWEST Scores of Agreement

1.

My child is better able to do things he or she wants to do (M=3.69).

2.

I am satisfied with our family life right now (M=3.66).

3.

My child is better able to cope when things go wrong (M=3.64).

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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)

  • “The services equipped me with the tools & skills that have greatly impacted
  • ur lives.”

Therapy General

(n=41, 20%)

  • “In home services - my child feels more comfortable in his own

environment.”

General Home Therapy

(n=38, 19%)

  • “_____ connected well with _____ and was able to address & identify his

concerns/needs”

Specific Therapist

(n=21, 10%)

  • “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.”

Specific Service or Therapy

(n=20, 10%)

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Qualitative Responses

“What would improve the services offered through Hawaii’s Child and Adolescent Mental Health Division?” (n=160; NOTE: 46% percent of responses were positive/neutral)

  • “More residential treatment options for youth with severe

emotional/behavioral issues”

Increase Service Array

(n=20, 13%)

  • “Match up client with appropriate therapist sooner - not just any
  • therapist. Initially our son was in such a bad way that we had to

send him to the mainland as it took too long for DOH services”

Timeliness

(n=12, 8%)

  • “Having a therapist for all the minor children in home.”

More Available Therapy

(n=8, 5%)

  • “If all services were in sync with each other.”

Better Communication

(n=8, 5%)

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Communication with Care Coordinator (Percent of Positive Responses Since 2014)

82.4 82.9 83.9

25 50 75 100

2014 2015 2016 2017 2018 2019

Percent of Positive Responses (Agree and Strongly Agree)

My Care Coordinator contacted me (in person or by phone) at least one time every month my child was receiving services (n=217) During the time my child received services from CAMHD, I was kept informed about the exact services my child was receiving (n=217) During meeting(s) with my child's Care Coordinator, I was asked for my feedback about my child's treatment plan (n=217)

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“My Care Coordinator contacted me (in person or by phone) at least one time every month my child was receiving services.” (n=217)

82.4

25 50 75 100

2014 2015 2016 2017 2018 2019

Percent of Positive Responses (Agree and Strongly Agree)

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“During meeting(s) with my child’s Care Coordinator, I was asked for my feedback about my child’s treatment plan.” (n=217)

83.9

25 50 75 100

2014 2015 2016 2017 2018 2019

Percent of Positive Responses (Agree and Strongly Agree)

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“During the time my child received services from CAMHD, I was kept informed about the exact services my child was receiving.” (n=217)

82.9

25 50 75 100

2014 2015 2016 2017 2018 2019

Percent of Positive Responses (Agree and Strongly Agree)

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Communication with Care Coordinator

4.2 4.2 2.3 6 26.9 56.5

25 50 75

N/A Strongly Disagree Disagree Undecided Agree Strongly Agree Percent of Youth

During the time my child received services from CAMHD, I felt supported by my Care Coordinator (n=217)

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Timeliness

“Timely access to services is important to CAMHD. When you first began services with the CAMHD, about how many days did it take to start therapy sessions (use your best guess)?” (n=138)

Mean: 30.77 Median: 14 Range: 1-720

Less than 16 days 16-30 days 31-45 days 46-61 days 62-76 days 77-90 days > 90 days

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Looking back to the start of treatment, what additional supports could have been helpful for you while you waited for therapy services to start? (n=178)

19.7% 41.6% 34.3% 24.7%

Other Parent support group Respite care Access to a website about how to help your child

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During the last year, were you offered Parent Partner services? (n=188)

47.3% 52.7% Yes No

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During the last year, did you access the Help Your Keiki website

(http://helpyourkeiki.com/) for information about services for your child?

(n = 199)

14.1% 85.9% Yes No

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SLIDE 36

436 230 82

100 200 300 400 500 600 700 800 900

Visits Per Month

Global US Hawaii

Help Your Keiki Website Visitors Flow (http://helpyourkeiki.com/)

(April 2012 - December 2020)

FY 2019

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421 496 89.5

100 200 300 400 500 600 700 800 900

Visits Per Month New Visitor Sessions Total Sessions Percentage New Visitor

FY 2019

Help Your Keiki Website New Visitors Flow (http://helpyourkeiki.com/)

(April 2012 - December 2020)

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Where do you PRIMARILY go for information

  • n children's mental health? (n=206)

22.4% 4.9% 62.6% 18% 17% 31.6%

Other Check social media (facebook, Instagram, etc.) Talk to a medical professional Talk to a school staff member Ask a family member or friend Search the internet

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Caveats

  • Consumers were rating CAMHD services overall (which includes the services of contracted

providers).

  • Peak-End rule
  • Yelp phenomenon
  • Consumers might have been completing the survey during treatment services.
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Summary

  • Overall, consumers are satisfied with services (89%) and there has been an increasing trend
  • f satisfaction in the last 7 years.
  • Areas of strength
  • Higher distribution and response rates, relative to last year
  • Relatively high and stable scores (across time) on treatment participation and cultural sensitivity
  • Relatively high and stable scores (across time) on care coordinator communication (84% of

respondents reported feeling supported by care coordinators)

  • Increasing scores on perceptions of functioning and outcomes
  • Lots of praise for therapy in general, the in-home nature of services, and specific services,

therapists, and care coordinators

  • At least 50% of consumers reported that therapy sessions began in 14 days or less
  • Relative to last year, access of the Help Your Keiki website increased
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Summary

  • Opportunities for improvement
  • Perceptions of functioning and outcomes are relatively lower than other domains on the YSS-F
  • Compared to last year, there were relative decreases in satisfaction with access, social

connectedness, and overall program assessment on the YSS-F

  • Consumers suggested that CAMHD services could be improved by: more available services,

increased timeliness, increased intensity/availability of services, and improved communication between team members

  • Continually low rates of awareness of the Help Your Keiki website, despite the fact that ~30% of

caregivers indicate that they search the internet for information on childrens’ mental health and 25%

  • f respondents reported that a website would be a helpful resource while they waited for therapy

services to start.

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Three Things to Work On

  • Continue to improve timeliness and assess for areas of potential improvement within the

workflow

  • Continue to improve youth and family outcomes and functioning
  • Increase awareness of the Help Your Keiki website and other resources (e.g., parent support)

that might serve as a support while families wait for therapy services to start

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MAHALO! QUESTIONS?

David.Jackson@doh.hawaii.gov Trina.Orimoto@doh.hawaii.gov Research, Evaluation & Training Program Improvement & Communications Office