A UCLA-led study of children’s patient records at California’s public mental health clinics identifies strengths and gaps in quality of care.
Published in the February edition of the Journal of the American Academy of Child and Adolescent Psychiatry, the study examines safety and appropriateness of care for attention deficit hyperactivity disorder (ADHD), conduct disorder and major depression in the public clinics. It is the first statewide study on quality of care for children.
The study gives high marks to the comprehensiveness of mental health evaluations, but finds moderate to poor documentation of medical monitoring psychoactive medications, child abuse screening and reporting, parent consent for medication treatment, and recommended contact with schools and other health-care providers. For example, nearly three-quarters of patient records of children receiving psychoactive medication did not document adequate safety monitoring through vital signs or laboratory studies.
In addition to Zima and Wells, the research team included Heather Ladd, Lingqi Tang, and Naihua Duan of the UCLA Neuropsychiatric Institute; Michael S. Hurlburt and John Landsverk of Children’s Hospital in San Diego; Penny Knapp of the California Department of Mental Health and the University of California at Davis, Peggy Wallace of Santa Monica, Calif.-based RAND Corp.; and Abram Rosenblatt of the University of California at San Francisco.
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