Gateways and Pathways Project (GAPP) Principal Investigator: Arlene Stiffman, PhD
Funder: National Institute of Mental Health (5 R24 MH 56425)
Timeframe: Funded 4/97-3/00
Affiliation: Center for Mental Health Services Research (CMHSR)Project Staff: Ed Spitznagel, PhD, Statistician
Project Contact: Arlene Stiffman, PhD, (314) 935-6685
E-mail: arstiff@wustl.edu
Project Update as of 12/17/2007
Stage: Project completed
Key Findings:
Developed instruments to assess providers’ egocentric perspectives on organization centrality, density, etc.
Youths perceived receipt of service in interactions that are casual to providers
Description:
Previous research shows that a majority of adolescents with mental health problems fail to receive mental health services, even when adults recognize they have a problem and could provide a gateway to care. Examining the pathways and obstacles to mental health services, this study built upon the previous YSP project. Questionnaires received from 228 service providers and 111 organizational leaders detailed providers’ perspectives in specialty and nonspecialty sectors, showing how youth access mental health care. Paired provider and recipient reports allowed the comparison of subjective and objective indicators of need for mental health care and pathways to care. This study explored a model of mental health service use that includes the moderating effect of gateway providers’ perceptions and structural/organizational factors on the relationship between adolescents’ use of mental health services and need, predisposing characteristics, and enabling characteristics including availability, accessibility, acceptability, and affordability.
Conference Presentations:2002 Treatment Participation: Dilemmas and Current Research: A Workshop. Stiffman, A.R., Brown, E., Striley, C., Limb, G., Nelson, J., & Pescarino, R.A. The Role of Gateway Providers in youth's treatment access: Contrasts in African American and American Indian experiences. SSWR, San Diego, January.
2001 Striley, C.W., Stiffman, A.R., & Pescarino, R. The importance of functioning to improve access to substance and mental health care in teens. SSWR, Atlanta, January.
2001 Stiffman, A.R., Pescarino, R., Striley, C.W., & Hadley-Ives, E. Potentially modifiacle predictors of providers' accurate assessment of youths' problems. SSWR, Atlanta, January.
2000 Stiffman, A.R., Striley, C.W., Horvath, V., Hadley-Ives, E., Elze, D., Johnson, S., & Doré, P. Organizational context, service system integration, and provider perceptions as determinants of access to mental health services. Association for Health Services Research, Los Angeles., June.
2000 Hadley-Ives, E., Stiffman, A.R., Elze, D., Johnson, S., & Dore, P. Factors associated with increasing provider understanding of youth and their problems. Society for Social Work and Research, Charleston, S.C.
1999 Stiffman, A.R., Hadley-Ives, E., Elze, D., Johnson, S., & Doré, P. A model of service use that includes the person in environment perspective and and role of gateway professionals: A social work revision of the Andersen and Pescosolido models. Society for Social Work and Research, Auston, TX, January.
Forthcoming, In Press, or Published Papers:
Elze, D., Stiffman, A.R. & Dore', P. (1999). The association between types of violence exposure and youths' mental health problems. International Journal of Adolecent Medicine and Health, 11, 221-255.
Johnson, S.D., Stiffman, A.R., Hadley-Ives, E. & Elze, D. (2001). An analysis of stressors and comorbid mental health problems that contribute to youth's paths to substance-specific services. The Journal of Behavioral Health Services and Research, 28, 412-426.
Hadley-Ives, E., Stiffman, A.R. & Dore', P. (2000). Measuring neighborhood and school environments: Perceptual and aggregate approaches. Journal of Human Behavior in the Social Environment, 3(1), 1-38.
Hoagwood, K., Horwitz, S.M., Stiffman, A.R., Weisz, J., Bean, D., Rae, D., Compton, W., Cottler, L., Bickman, L. & Leaf, P. (2000). Concordance between parents reports of children's mental health services and service records: The Services Assessment for Children and Adolescents (SACA). Journal of Child and Family Studies, 9, 315-331.
Stiffman, A.R., Abeloff, J., Kaggwa, E., Meissner, D., Regier, M., & Winn, C. (In Press) Violent Adolescents: Implications for intervention. In Rosner, R. (Ed.), Textbook of Adolescent Psychiatry, Washington, D.C.: American Psychiatric Press.
Stiffman, A.R., Abeloff, J., Kaggwa, E., Meissner, D., Regier, M. & Winn, C. (2003). Violent adolescents: Implications for intervention. In R. Rosner (Ed.), Textbook of adolescent psychiatry, (pp. 112-124). London, England: Arnold Publishers.
Striley, C.W. & Stiffman, A.R. (2003). Youth functioning in school, home, community helps determine access to needed services. In C.J. Liberton, K. Kutash, & R.M. Friedman (Eds.), Conference proceedings: A system of care for children's mental health, expanding the research base. Tampa, FL.: Research and Training Center for Children's Mental Health.
Stiffman, A.R. (2001) Services for Adolescents. In Lerner, JV & Lerner RM. (Eds.), Adoescence in America: An Encyclopedia (pp. 640-649). Santa Barbara, CA: ABC-CLIO.
Stiffman, A.R., Hadley-Ives, E., Dore, P., Polgar, M., Horvath, V.E., Striley, C. , Elze, D. (2000) Youths’ access to mental health services: The role of providers’ training, resource connectivity, and assessment of need. Mental Health Services Research, 2, 141-154.
Stiffman, A.R., Horwitz, S.M., Hoagwood, K., Compton, W., Cottler, L., Narrow, W. & Weisz, J. (2000). Adult and child reports of mental health services in the Service Assessment for Children and Adolescents (SACA). Journal of the American Academyt of Child and Adolescent Psychiatry, 39(8), 10032-39.
Stiffman, A.R., Elze, D., Hadley-Ives, E., Johnson, S. (1999) Youth and provider perspectives on social workers’ roles in mental health services. Journal of Social Service Research, 25 (3), 83-97.
Stiffman, A.R., Hadley,-Ives, E., Elze, D., Johnson, S. & Dore', P. (1999). Impact of environment on adolescents' mental health and behavior: Structual equation modeling. American Journal of Orthopsychiatry, 69(1), 73-86.