Residential treatment centers and other organized mental health care for children and youth: United States, 1988.
Residential treatment centers (RTCs) for emotionally disturbed children are an important component of the mental health services delivery system in the United States. The 440 RTCs operating in 1988 represented 9 percent of all mental health organizations in the U.S. in that year. They served approximately 10 percent of the patients who received inpatient and residential treatment care and approximately 2 percent of outpatient psychiatric visits in organized settings. Their 39,000 full-time equivalent (FTE) staff and $1.3 billion expenditures were, respectively, 7 percent and 6 percent of the total for all mental health organizations. Between 1986 and 1988, the number of RTCs increased slightly, while the volume of residential treatment care changed little. However, partial care and outpatient care expanded in RTCs, with the number of visits in these categories increasing by 75 percent and 42 percent, respectively. FTE staff grew by 13 percent, and expenditures increased by 33 percent between 1986 and 1988. In 1988, RTCs were located in all States except North Dakota. The largest number were found in California (48), Massachusetts (38), and New York (28). By definition, all RTCs provided residential treatment care. About one-third of them also provided partial care and one-third provided outpatient care. The highest rates of additions to residential treatment care in RTCs per 100,000 civilian population were found in Minnesota and Colorado. Reflecting the role of RTCs as providers of care to children and youth, 94 percent of residential treatment patients in RTCs were under age 18. Seventy percent of residential treatment patients were male; 28 percent, black; and 10 percent, Hispanic. Approximately 94 percent had mental illness as their principal disability. In December 1988, 43,000 staff worked in RTCs; 14 percent were employed part-time, and 3 percent were trainees. Among others, the staff included approximately 900 psychiatrists, 300 other physicians, 1,700 psychologists, 4,800 social workers, and 1,000 nurses. Nationally, expenditures by RTCs averaged $5 per capita, but the highest per capita spending was $20 in Massachusetts and $14 in Arizona. The principal sources of funds for RTCs were local governments (the source of 33 percent of total funds available to RTCs), State mental health agencies (15 percent of funds), and other State government sources (21 percent of funds). RTCs focus their care on children and youth more than do any other type of mental health organization. At year-end in 1988, 64 percent of all the patients on the rolls of all types of programs in RTCs were under age 18.(ABSTRACT TRUNCATED AT 400 WORDS)
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Sunshine
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Witkin
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Atay
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Manderscheid
D000293:Adolescent; D000342:Affective Symptoms / Q000453:epidemiology* / Q000523:psychology / Q000534:rehabilitation*; D002648:Child; D003156:Community Mental Health Services / Q000191:economics / Q000706:statistics & numerical data / Q000639:trends*; D003430:Cross-Sectional Studies; D006301:Health Services Needs and Demand / Q000639:trends; D006801:Humans; D015994:Incidence; D007604:Juvenile Delinquency / Q000523:psychology / Q000534:rehabilitation* / Q000706:statistics & numerical data*; D010348:Patient Care Team / Q000639:trends; D012114:Residential Treatment / Q000191:economics / Q000639:trends*; D014481:United States / Q000453:epidemiology