EVALUATING PERFORMANCE AND CHANGE IN MENTAL-HEALTH SYSTEMS SERVING CHILDREN AND YOUTH - AN INTERORGANIZATIONAL NETWORK APPROACH

Planning for the delivery of community mental health services has evol ved from models of services within individual agencies to community-wi de systems of care, but development of methodologies for assessing sys tem performance has lagged behind. This article presents one approach to system-level assessment by viewing children's mental health systems as an interorganizational network. Data are presented on two county-b ased child mental health systems in North Carolina that participated i n the Robert Wood Johnson Foundation Mental Health Services Program fo r Youth. Site-specific data on client referrals, fund exchanges, and i nformation flows were collected at two rime points (1991 and 1993) to measure the cohesiveness and concentration of the service system using networkk-core analyses. In addition, stakeholder ratings of service a dequacy, quality, availability, coordination, and overall demonstratio n project goal attainment were obtained at both time periods. Findings indicate that the rural system was outperforming the urban system at the time of the first survey but the urban system caught rep over the study interval. There was high agreement between the network and stake holder ratings of system performance at both time periods. The method of data collection and analysis used in this study provides tools that can be used in a variety of settings to assess service system growth and development.