Annual Report to Congress on the Evaluation of the Comprehensive Community Mental Health Services Program for Children and Their Families

System-Level Assessment

A central question that this evaluation addresses is whether greater improvements in children’s behavior and functioning are associated with a system-of-care approach. The underlying assumption depicted in the system-of-care theory model (see Figure 2, chapter I) is that a fully implemented system of care will lead to more effective service delivery, improved clinical and functional outcomes, and greater satisfaction with services. To answer the question, it is critical to know the extent to which CMHS-funded sites have implemented true systems of care. The system-level assessment has been designed to ascertain the degree of system implementation and to document how systems of care develop over time.

This component of the evaluation makes a unique contribution to the knowledge base about children’s mental health service delivery systems. While there have been some attempts to understand and assess system development, their focus has been more narrowly on linkages among agencies within the system (Heflinger, 1996; Morrissey, 1992). This evaluation attempts to comprehensively identify and assess the numerous features that comprise a system of care to discern whether differences in child and family outcomes across systems can be associated with the degree of system-of-care implementation.

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