In-Home Services Programs Information from October 1994 through September 2010
Youth Villages provides In-Home Services in nine states and the District of Columbia through two programs - Multisystemic Therapy (in North Carolina, Washington, DC, Dallas, TX and Dothan, AL) and Intercept (in TN, MS, AL, FL, GA, MA and NH).
www.youthvillages.org
Youth and Family Characteristics
• Demographics – Over 60% male – More than 70% of youth are 12 to 18 years old
• Clinical Factors – Over 80% have multiple presenting issues – Nearly half of the families have a history of multiple difficulties – More than 75% of parents report at least one high-risk parenting characteristic – Approximately 18% of youth perceive severe parental rejection; only 7 to 10% of youth in the general population perceive this level of parental rejection.
www.youthvillages.org
In-Home Services Programs Demographics Youth served October 1994 through September 2010 N = 20,473
100%
80% 63% 57% 60% 37%
40%
36%
20% 3%
4%
0% Male
Female
Gender
African American
Caucasian
Hispanic
Race/Ethnicity
Other
In-Home Services Programs Age Group Youth served October 1994 through September 2010 N = 20,473
100%
80%
60% 42% 32%
40%
20%
13%
13%
0% 8 Years Old and Younger
9 to 11 Years Old
12 to 14 Years Old
15 to 18 Years Old
In-Home Services Programs Presenting Issues Youth served July 2000 through September 2010 N = 20,473
100%
90%
80%
70% 57%
60%
36%
33%
40%
37%
20%
0% Behavioral Disorders
Over 80% of youth have multiple presenting issues.
Substance Abuse
Emotional Disorders
Victim of Abuse and/or Neglect
Suicidal Ideations or Gestures
Legal Issues
In-Home Services Programs History of Family Difficulties Youth served July 2000 through September 2010 N = 20,473
100%
80%
60%
49% 35%
39%
40%
33%
30%
20%
0% Mental Illness
Nearly half of families have multiple difficulties.
Domestic Violence Substance Abuse
Legal Trouble
Parent Experienced Abuse as a Child
In-Home Services Programs Adult and Adolescent Parenting Inventory Assessments completed July 2007 through September 2010 N = 3,968 High Risk Parenting Characteristics • Expectations – Caregiver holds inappropriate expectations of a
100%
child’s abilities and behaviors • Empathy – Caregiver has a low level of empathy • Discipline – Caregiver has a strong belief in the value of corporal punishment • Family Roles – Caregiver reverses family roles • Power – Caregiver restricts the child’s power/independence
80%
Almost 80% of parents reported at least one high risk parenting characteristic*.
60%
40%
47% 40%
37%
33% 27%
20%
0% Expectations
Empathy
The AAPI is administered at admission to caregivers provide information to clinicians regarding their values beliefs regarding parenting.
Discipline
Family Roles
Power
*Approximately 16% of parents in the general population report at least one high risk parenting characteristic.
In-Home Services Programs Parental Acceptance and Rejection Questionnaire Assessments completed July 2007 through September 2010 N = 3,395 Warmth/Affection – Perception that the caregiver does not provide love or affection without qualification
100%
80%
Hostility/Aggression – Perception that the caregiver is angry, bitter, resentful, or intends to verbally or physically harm the client Indifference/Neglect – Perception that the caregiver is unconcerned or uninterested in the client
20%
Undifferentiated Rejection - Perception of a general overall rejection of the client by the caregiver Total Score – Composite score of all domains listed above except Control
36%
60%
40% 22%
21%
25% 18%
18%
41%
}
20%
For the Control domain, scores that fall into either Moderate or Firm Control indicate the youth’s perception of the caregiver’s control is an area of strength.
3% 0% Warmth
Hostility
Indifference
Undifferentiated Rejection
Total Score*
Control Strict/Restrictive Firm Moderate Low/Lax
The PARQ is administered at admission to all youth over 11 years old to provide information to clinicians regarding youth’s perception of their caregivers.
*7 – 10% of youth in the general population perceive severe rejection by their caregivers.
Program Characteristics
• Growth – Fairly steady growth in program admissions since 2001 – Admissions more than doubled between 2007 and 2010
– More than 4,000 admissions in 2010
• Geographic Distribution – Middle Tennessee serves the largest number of youth, followed by West Tennessee – North Carolina serves the largest number of youth outside of Tennessee – Mississippi and Alabama have each served more than 1,000 youth in In-Home Services
www.youthvillages.org
In-Home Services Programs Admissions by Fiscal Year October 1994 through September 2010 N = 23,077
4500
4,109 3,712
4000 3500
2,704
3000 2500
2,003 2000
1,822 1,567
1500
1,225
1,382
858
1000
679
500
16
144
292
377
295 410
992
490
0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011*
Youth may have multiple admissions to the program.
Fiscal Year – July 1 to June 30
* Represents the first quarter of the fiscal year.
In-Home Services Programs Admissions by Region October 1994 through September 2010 N = 23,077 7000
6,142 6000
5,106 5000
4,264 4000
3000
2,132 1,709 2000
1,377 868 1000
549
338
263
258
45
26
0 West TN Middle TN East TN
Youth may have multiple admissions to the program.
AL
MS
TX
Washington DC
NC
MA
FL
GA
VA*
NH
*Youth Villages no longer provides services to youth in Virginia.
In-Home Services Programs Current Census by Program Census on September 30, 2010 N = 1,473
MST, 20.4%
Intercept, 79.6%
MST Programs are currently located in North Carolina, Dallas, Washington, DC, and Dothan, AL; Intercept Programs operate in all other Youth Villages locations.
Outcomes • At Discharge – 86% of youth are discharged to home with family – More than 90% of parents report satisfaction with Youth Villages’ services
• At One Year Post-Discharge – 83% of youth remain at home with family – Gains made during treatment are sustained (as measured by the SDQ) – 82% of youth report no trouble with the law – 90% of youth are in school, have graduated from high school, or are in GED classes – Few youth have experienced an out-of home placement; 7% have been in residential treatment, 2% in a psychiatric hospital, and 5% in a detention or correctional facility – 15% of youth under 18 at the time of follow-up are in state custody; all youth who participate in In Home Services are at high risk of placement into state custody at the time of admission
www.youthvillages.org
In-Home Services Programs Discharge Location Youth discharged July 2000 through September 2010 N = 17,046 100% 86% 80%
60%
40%
20% 2%
1%
3%
8%
0% Home
Residential Treatment Center
Note: Only includes youth who received at least 60 days of service; 13.0% (2,550 out of 19,596) of admissions ended prior to 60 days
Psychiatric Hospital
Detention/ Corrections
Other*
*includes placements such as group homes, runaway, foster care and rehab centers
In-Home Services Programs Parent Satisfaction at Discharge Parents surveyed July 2000 through September 2010
100%
94%
96%
93%
93%
93%
80%
60%
40%
20%
0% Fam ily Therapy you received
Note: Figures include only youth who received at least 60 days of service.
Counselor's Know ledge and Professionalism
Links to Com m unity Services
Overall Satisfaction
Would Recom m end YV to a Friend
In-Home Services Programs Success at Follow-up Follow-ups conducted July 2000 through September 2010
100% 81%
83%
83%
80%
60%
40%
20%
0% Six Months
Note: Figures include only youth who received at least 60 days of service.
Twelve Months
Twenty-four Months
Success is defined as living at home with family.
In-Home Services Programs Strengths and Difficulties Questionnaire Assessments conducted July 2007 through September 2010 N = 11,080 79%
Conduct Difficulties
68% 57% 52%
Emotional Difficulties
The SDQ is administered at admission, discharge, and twelve months post-discharge to all caregivers as well as youth over 10 years old. It provides information to clinicians regarding areas of difficulty for a child and family.
42% 42% 56%
Hyperactivity
45% 50% 57% 54%
Peer Problems 50%
72%
Impact of Difficulties
59% 44% 62% 60%
Prosocial Behavior 40%
70%
Total Score
58% 56%
0%
20%
40%
Twelve Months Post-Discharge
Note: Figures include only youth who received at least 60 days of service.
60%
Discharges from Youth Villages
Cases by Type Admission to Youth Villages: Discharge from Youth Villages: 12-Month Post Discharge:
N 5,800 4,579 701
80%
100%
Admissions to Youth Villages
Bars represent percent of youth in the clinical range (includes Borderline, High, and Very High for all domains except Prosocial Behavior; Borderline, Low, and Very Low are included in the bar for Prosocial Behavior).
In-Home Services Programs Youth reporting NO Trouble with the Law Follow-ups conducted July 200 through September 2010
100% 82%
82%
82%
80%
60%
40%
20%
0% Six Months
Note: Figures include only youth who received at least 60 days of service.
Twelve Months
Twenty-four Months
In-Home Services Programs School Status Follow-ups conducted July 2000 through September 2010
100%
92%
90% 85%
80%
60%
40%
20%
0% Six Months
Note: Figures include only youth who received at least 60 days of service.
Twelve Months
Twenty-four Months Indicates the number in school, graduated from high school, or in GED classes at the time of follow-up.
In-Home Services Programs Out of Home Placements Follow-ups conducted July 2000 through September 2010
100%
80%
60%
40%
20% 6%
2%
5%
7%
2%
5%
5%
1%
5%
0% Six Months Residential Treatment Center
Note: Figures include only youth who received at least 60 days of service.
Twelve Months Psychiatric Hospital
Twenty-four Months Detention/Corrections
In-Home Services Programs Youth under 18 in State Custody at Follow-up Follow-ups conducted July 2000 through September 2010
100%
80%
60%
40% 15%
15%
16%
20%
0% Six Months
Note: Figures include only youth who received at least 60 days of service.
Twelve Months
Twenty-four Months
Youth who participate in the In-Home Services program are at significantly increased risk of placement into state custody either due to abuse/neglect or delinquency issues.
About our Response Rates Surveys through 09/10 Discharge Surveys
64.2% (10,080 out of 15,708)
6-Month Follow-up
64.2% (9,183 out of 14,298)
12-Month Follow-up
57.1% (7,007 out of 12,276)
24-Month Follow-up
47.9% (4,338 out of 9,059)
•
Surveys are conducted by research staff via phone with letter surveys to non-respondents
•
•
Please note: Surveys are completed with youth/families who have discharged from YV services altogether. If a youth re-enters YV services, the survey cycle is reset and begins again at their discharge.
Internet search of public records (Lexis-Nexis) is completed to locate accurate contact information
•
While no consensus exists regarding adequate response rates, 40% - 60% has been identified as appropriate for surveys of this type and size1.
•
Rate of re-entry into YV services: 6-Month Follow-up – 5.0% (751 out of 15,049) 12-Month Follow-up – 8.3% (1,114 of 13,390) 24-Month Follow-up – 12.9% (1,342 out of 10,401)
1PWGSC
(Public Works and Government Services Canada). (2008). Advisory Panel on Telephone Public Opinion Survey Quality: Standards and Guidelines for Response Rate.