Abstract
This study was designed to investigate typical patterns of mental health service utilization among children and adolescents, and to explore whether there is a correlation between the level of recommended care as determined by a standardized assessment tool (CALOCUS) and the type and intensity of treatment services provided within a rural system of care. The study is based on secondary assessment and treatment data that was originally collected between July 2010 and December 2011 and is maintained in County clinical and billing records. The study population consists of 65 mental health clients aged 18 and under who received treatment services between July 1 and September 30, 2010 and had an available CALOCUS assessment dated during or after July 2010. Service utilization was measured by compiling the number of minutes of mental health services received during the six months following the month of CALOCUS assessment. Within study population, individual treatment accounted for nearly half (48.8%) of all mental health services provided; other modalities each accounted for less than 15% of the total treatment units. Children in the study received a wide range (0 – 11,219) of total treatment minutes, with an average of 1,755 minutes of treatment received during the six months following CALOCUS assessment. The median number of treatment minutes was 983, indicating that the mean was positively skewed by individual cases of high utilization. The corresponding cost for all mental health services received by participants in the study ranged from $0 to $40,077, with a mean cost for each individual of $5,345 and a standard deviation of $7,837. Further analysis of the data indicates that the CALOCUS assessment score is correlated to total minutes of treatment (r=.30) and therefore the cost of service (r=.34). The resulting coefficient of determination (R2) for total minutes of treatment (R2=0.09) indicates that 9% of variance in the utilization of treatment services within the study group coincides with differences in assessed acuity as determined by the CALOCUS Level of Care score. Similarly, the coefficient of determination (R2) for total cost of treatment (R2=0.11) means that 11% of variance in the cost of treatment within the study group coincides with differences in acuity as assessed by the CALOCUS measure. While the correlation coefficients calculated in this study are typically understood to represent a “moderate” magnitude of association, ANOVA analysis demonstrates that the apparent correlation between CALOCUS Level of Care and treatment intensity is not statistically significant.