Wraparound care coordination associated with many positive outcomes
amongst youth with serious and complex behavioral health needs

Date:
December 3, 2021
Source:
Elsevier
Summary:
A study finds that Wraparound Care Coordination (Wraparound),
which has been adopted in states and jurisdictions across the
country to help meet the needs of children and adolescents with
serious emotional and behavioral disorders, produces more positive
outcomes for youth when compared to more common service approaches.



FULL STORY ==========================================================================
A study in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), published by Elsevier, finds that Wraparound
Care Coordination (Wraparound), which has been adopted in states and jurisdictions across the country to help meet the needs of children and adolescents with serious emotional and behavioral disorders, produces
more positive outcomes for youth when compared to more common service approaches.


========================================================================== Moreover, Wraparound may hold the potential for reducing disparities
in outcomes for youth of color, which has long been found in mental
health services.

A team of researchers, led by Jonathan Olson, PhD, at the University of Washington Department of Psychiatry and Behavioral Sciences, Seattle,
WA, USA, conducted a meta-analysis of 17 controlled studies, and their
results, published between 1996 and 2019 in order to compare the effects
of Wraparound to regular services in youth with SED (serious emotional disorders).

"For many years, public systems have used Wraparound because it makes
sense and provides families with the kind of compassionate approach,
something that all families say they want and need," said Dr. Eric Bruns, Professor of Psychiatry and senior author on the research team. "Now we
have clear results that support what many have seen in their own local
systems of care: that Wraparound is more effective and cost-effective
than traditional services." Significant effects in favor of Wraparound
across a range of important youth outcomes were found -- including
reduced out-of-home placements and improved mental health functioning
and school outcomes. The study also found significantly lower overall
care costs for youth in Wraparound care, due to less spending on costly out-of-home placements. Across the 17 studies, Wraparound effects were
more positive for samples with higher proportions of youth of color.

"Wraparound lives up to principles we want to uphold -- for example,
being youth- and family-driven, strengths-based and using a team
of people with a blank checkbook to 'do whatever it takes' to meet
the needs of the youth and family," added Dr. Bruns. "While many
states have taken Wraparound to scale, others have been more hesitant,
saying it wasn't 'evidence-based.' This study should help address those concerns." Wraparound was established in the 1980s as an alternative
to service delivery strategies that kept youth and family services
in fragmented siloes, driven by professionals and often relying on
costly institution-based care rather than investing in community
supports. Instead, Wraparound invests in a care coordinator with a
low caseload who convenes a team that includes the family, friends and
members of the wider community, as well as service and support providers.

Dr. Olson also points out, however, that the study additionally reinforced
how important it is to implement high-quality Wraparound services that
are true to the model: "Unfortunately, many studies were conducted before
there were measures of fidelity, or measures of 'doing Wraparound right,'"
he said.

"However, for studies that did measure fidelity, we saw more positive
outcomes for youth and families who received care that was of high-quality
and closely adhered to Wraparound principles." The potential for
Wraparound to better meet the needs of youth of color was an unexpected finding, concluded Dr. Bruns, but perhaps not surprising: "We need to
remember that in all these studies, Wraparound was compared to more
traditional services delivered in mental health, child welfare and
juvenile justice.

"There is a long history of research showing disparities in access
and outcomes for youth of color and their families. It may be that
by allowing for more youth and family voice and choice, and teams
that include family, friends, and community members, Wraparound
helps reduce those disparities. However, such questions were
not the explicit focus of these studies. We need to investigate
the issue of what may address disparities with greater rigor." ========================================================================== Story Source: Materials provided by Elsevier. Note: Content may be edited
for style and length.


========================================================================== Journal Reference:
1. Jonathan R. Olson, Philip H. Benjamin, Alya A. Azman, Marianne A.

Kellogg, Michael D. Pullmann, Jesse C. Suter, Eric
J. Bruns. Systematic Review and Meta-analysis: Effectiveness of
Wraparound Care Coordination for Children and Adolescents. Journal
of the American Academy of Child & Adolescent Psychiatry, 2021;
60 (11): 1353 DOI: 10.1016/ j.jaac.2021.02.022 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2021/12/211203095807.htm

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